I’ve had the opportunity to combine a career of active clinical practice, teaching, clinical research, and community involvement in establishing new institutions in our growing area. It was my privilege to train at the University of Pennsylvania with outstanding teachers/mentors (Stunkard, Beck, Luborsky, Minuchen), who guided my career toward ideals for our profession that emphasize knowledge, compassion, caring, and service.
I am a clinical professor and director of eating disorder research in the department of psychiatry at UC Irvine. I have recently served as president of the clinical faculty of the College of Medicine of UCI (1996-98). I am in full-time clinical private practice of adult and child psychiatry and psychoanalysis and actively teach and supervise residents in clinical and research activities.
I was a president and a founder of my district branch (OCPS, Area 6) and have served as the Assembly representative since 1985.
Past work in the Assembly has involved liaison to the Scientific Program Committee, Membership Committee, and Quality Assurance and Improvement Committee, as well as sponsorship of action papers that defended our practice and promoted regionalization of APA resources. As chair of the Ad Hoc Task Force on Managed Care, I and Area members brought pressing regional issues to discussion and notice by the Assembly. The reference committees advance our informed deliberations; I have been chair of reference committees devoted to membership issues, scientific advances, and advocating for the profession.
I was a member (1990-95) of the Steering Committee for Practice Guidelines at its critical launching and continue my support as a liaison to the Practice Research Network.
Currently I serve as a member of the Commission on Psychotherapy by Psychiatrists (1996-2003), which is dedicated to advancing psychotherapy teaching, supervision, and research and restoring psychotherapeutic understanding and competency to the center of psychiatric training and practice. Most recently I helped to form and will chair the APA Caucus of Psychiatrists Who Treat Eating Disorders.
My mission in the Assembly is straightforward.
REPRESENTATIVE: Strengthen links to affiliate organizations and their role in Assembly activities. Encourage ECP and MUR representatives to actively present issues and actions. Support APA caucus process by encouraging membership, activity, and initiatives to Assembly.
INFORMED: Continue to support and develop the reference committees process. Encourage timely dissemination of background information/reports related to action papers and Assembly deliberations. Consider list serves for work groups to formulate specialized actions/positions.
EFFECTIVE: Continue reporting and tracking of actions. Promote Assembly representation on all components of APA and vigorous representation on the Board of Trustees. Encourage regionalization of resources to encourage efforts by Areas to support their DBs in meeting legislative challenges.
The APA Assembly is a powerful representative body that has gradually come to reflect the diversity of APA membership. I am fully committed to expanding representation to affiliated subspecialties and strongly advocate strengthening of state and regional units to carry out responsive and meaningful legislative and managed care initiatives.
We must do all we can to reverse the decline/stagnation in APA membership. This must involve active, meaningful outreach and personal networking beyond touting our services and offering "amnesty." The ECPs are the lifeblood of our organization and profession. We must continue progress in mentoring, guiding, and advancing their clinical and academic careers.
All efforts need support to implement actual "equality" of psychiatric evaluation and treatment—availability, comprehensiveness, and implementation in state and national legislation. We must vigorously counter efforts by MCOs via carveouts and onerous restrictions to defeat the intentions and real benefits of parity to patients.
We must reverse the trend toward split (fragmented, bifurcated, pseudo-collaborative) treatment. The 1999 PRN survey of treatment provided by members (n = 300+ members and N = >1000 patients) revealed over two-thirds of patients we treat may be in "split" treatment. A finger in the dyke will no longer suffice; we must reroute the river. Psychologist prescribing must be vigorously opposed nationwide with both regional and APA full support.
We must restore the core competencies of developmental understanding, multidetermined case formulation, comprehensive treatment planning, and sound grasp of psychotherapeutic process and application of varied techniques. This can be done by supporting this emphasis in training programs and integrating it into DSM-V and all practice guidelines/quality indicators that come from APA.
We have to continue to examine the broad influence (compromise of integrity, grabbing for clinical trials rather than creative research) of the pharmaceutical industry on APA, our daily practice, and training programs. Only 10 percent to 15 percent of "new research" at annual meetings involves psychosocial or innovative treatment approaches.
APA must continually confront exploitative entrepreneurial and governmental interests that obstruct and distort our relationship with patients and hinder the provision of properly formulated diagnosis and treatment. Treatment restricted is treatment denied.
We should rapidly advance our work on practice guidelines, a system of rational quality assurance, and the ongoing practice research network. Depending on the community context, APA should encourage forms of psychiatric practitioner organizations that can contract for fee for service and performance of psychiatrically controlled peer review. The management of patient care must be returned to the physician with elimination of middlemen that interfere in the delivery of care.
Let’s gather strength from our diversity, expertise, and commitment to counter the stigma, ignorance, and discriminatory attitudes and restrictions applied to psychiatric illness and the efforts of psychiatric physicians to treat and care for patients.
I am honored to be nominated for recorder of the APA Assembly. My background of organizational activity, patient care, teaching, and research should provide the breadth and scope to serve you well.