We need APA to help us simplify documentation of treatment plans, charting, and insurance claims. We need to stop calling the work we do with patients "med visits." I have found it exceedingly hard to treat any seriously psychiatrically ill patient pharmacologically, regardless of the presence of other therapists, by just "doing med backup." We need to trim the organization, including the multiple accretions gathered over the years. Of course, this would not have guaranteed success in individual issues such as the appalling psychologist prescribing debacle in New Mexico, but it could have helped to retain members and to focus on the major issues.