APA Assembly: Your Voice Within APA

What is the APA Assembly? What can we do for each other?

APA’s governance has sometimes been perceived, by members and nonmembers alike, as not reaching out and helping our individual members. APA’s district branches and state associations (DBs/SAs) provide local leadership on local issues and representation on national issues. The DBs/SAs send elected representatives to serve on the APA Assembly, which meets twice a year—in November in Washington, D.C., and in May at the annual meeting. APA members may attend those meetings to observe and have their voices heard through their Assembly representatives regarding their interests and opinions.

The Assembly members develop, review, submit, and pass action papers advising the Assembly speaker, president, Board of Trustees, and chief executive officer and his support staff to address specific topics and speak for psychiatrists in the United States and Canada.

Position papers are developed on specific issues. For example, the issue of maintenance of certification (MOC) has been discussed within the APA Assembly since 2008. Many psychiatrists have felt a sense of loss with regard to MOC and maintenance of licensure (MOL) with the imposition of requirements that do not have clear validity, that is, that are not clearly evidence based. The American Board of Psychiatry and Neurology (ABPN), acting on behalf of the American Board of Medical Specialties (ABMS), has been responsible for the development and enactment of MOC criteria. For the past seven years, the Assembly and its members have struggled with MOC-related issues through multiple action papers and, more recently, more direct contact with the ABPN and ABMS. The Assembly and APA leadership represent the voice of APA members dissatisfied with MOC.

In February the speaker of the Assembly and other leaders of APA voiced members’ concerns to the ABPN regarding Part 4 of MOC, which is “Improvement in Medical Practice.” Part 4 includes the following:

• Engage in ongoing assessment and improvement activities to improve patient outcomes.

• Demonstrate use of evidence-based and best practices in comparison with peer performance and national benchmarks.

Immediately thereafter, the Assembly Executive Committee (AEC) overwhelmingly endorsed a motion to recommend the elimination of Part 4. I introduced this motion at the March meeting of the Board of Trustees, which unanimously approved it and also created a task force to study evidence-based alternatives to Part 4. The motion affirmed the need for continuing maintenance of certification (Psychiatric News, April 17).

In a letter to the ABPN signed by Chief Executive Officer and Medical Director Saul Levin, M.D., M.P.A., and APA President Paul Summergrad, M.D., APA urged the ABPN to advocate to the ABMS for the elimination of Part 4, a position that has also been promulgated by other specialty board members. With this action, the Board of Trustees acted in a strong and affirmative manner, representing the will of the Assembly and the APA membership. In addition, Assembly members have taken the initiative in their home states to ensure that MOL is not linked to MOC. At present, there is a dynamic discussion between the ABMS, ABPN, and APA with other medical specialty boards for changes in the MOC program.

Members may not realize their voices can be heard through their Assembly representatives, but using this avenue is vitally important to APA’s ability to live out its mission of ensuring that our patients have access to high-quality care and supporting members’ educational and professional needs.

The Assembly is your voice to the national APA. If you do not know your Assembly representatives, contact your local DB/SA and introduce yourself so that you may communicate your concerns to them and through them to the APA Assembly. APA will welcome your voice.

After APA’s 2015 annual meeting in Toronto, Assembly representatives will be requesting their DB/SA executive secretaries to contact their respective members to encourage them to voice their opinions about issues of concern. This is what we can do for each other, for our profession, and for our patients. ■