Candidate for President-Elect
About the Candidate
Life Fellow, 1965
| •. | Full-Time Private Practice: Child, Adolescent, Adult, and Family Psychiatry, 1990- | ||||
| •. | APA Board of Trustees: Treasurer, 1994-98; Vice President, 1989-91; Area 6 Trustee, 1986-89 | ||||
| •. | APA Assembly: Speaker, 1984-85; Representative of CPA, 1980-82, and SCPS, 1976-80 | ||||
| •. | Clinical Professor: UCLA, 1985- ; USC, 1994- | ||||
| •. | AACAP: Member, 1971- ; Faculty, Board Review Courses, 1977, 1995, 1999; Member, Family Committee, 1998- | ||||
| •. | APA Council on Internal Organization, Chair, 1998-2001 | ||||
Candidate’s Views
The Hippocratic Oath guides physicians’ individual relationships with colleagues and embodies a social contract with patients and families. That model is relevant for APA too. We must consider our identity and societal role as healers, our relationship with other caretakers, our interactions with psychiatric subspecialty groups, and our values about how APA operates. A reinvigorated Board, vigilant Assembly, respected member-driven components, and a welcome new medical director will enable us to do more than just staunch recent years’ losses of money, members, and morale: We can create new hope and expanded opportunities for our field.
I. Our Identity: Psychiatry’s Role in Society
We try to care for the whole patient. When APA actively opposes the self-serving insurance and MCO industries and fights practice constraints imposed by disheartened public agencies, we psychiatrists can more fully implement our unique expert interventions. Along with augmented neuroscience, residents seek more training in psychoRx because they know it’s important for their future. As an integrated multisystemic medical specialty, we need to
Continue our political and media efforts for genuine parity. | |||||
Seek prompt health care legislation covering all children. | |||||
Pursue universal access to high-quality health care for all citizens, with Rx coverage and comprehensive formularies. | |||||
Address the health care disparities affecting minorities and others who are poor, malhoused, uninsured, or underinsured. | |||||
Enhance our professional focus on prevention and coping. | |||||
Collaborate better with many different community resources. | |||||
Expand APA’s initiatives with business, employers, and workers. | |||||
II. Our Interactions With Other Caretaking Professionals, e.g., psychologists and nonpsychiatrist M.D.s.
Of course I believe psychologists should not be prescribing meds. But we have been reactive rather than proactive, late rather than early, misperceived by legislators as protecting turf rather than patients.
One way to enhance patient access and safety is to work more with PCPs, who currently Rx 70 percent of all psychoactive meds and whose expertise can be enhanced. Similarly, patient care would benefit by teaching in other specialties’ residency programs and with medical students beyond psychiatry course confines. We must
Increase formal and informal consultation with other M.D.s at both urban and rural sites. Models for this already exist in Wisconsin, California, and elsewhere. | |||||
Augment C/L programs and perhaps enhance cross-contact by | |||||
Supporting ongoing dues reductions for dual APA-AMA members. | |||||
III. APA’S Relationship With Other Psychiatric Organizations
With widely decreasing organizational memberships, we must eliminate overlapping programs and combine resources. | |||||
Facilitate natural alliances, rather than competing for members. Many feel strained with multiple organization billings and nondiscounted dues. We should study, as AMA now is doing, the possible benefits of a confederation structure. | |||||
Consider also a single discounted dues payment, with dues allocated according to what subspecialty groups are selected. | |||||
IV. The Way APA Operates
I have exceptional knowledge about APA’s internal structure. In work on numerous components and throughout many elective offices in the Assembly and on the Board, I’ve consistently sought to increase access and representation for all psychiatrists. I have tried to improve openness within APA; supported transparency in income, budgeting, and other financial closets; and have urged that individual Board member votes be recorded. Because APA needs more membership participation rather than less, I’ve spoken out to protect member components, actually a quite tiny part of APA expense, from routinely “taking the first hit” whenever budgets are tight.
Despite improvements in many areas, there is still a long way to go. So I ask you to vote for me now to support additional constructive challenges and effective change.
Primary Loci of Work and Sources of Income
Work:
90%—Office-based solo practice of child, adolescent, adult, couple, and family psychiatry
10%—Teaching and supervision: UCLA medical students, USC fellows in child psychiatry, Veterans Administration residents in adult psychiatry
Income:
98%—Private practice of psychiatry
2%—Veterans Administration teaching honoraria
