For me, APA has been a lifelong labor of love. I started working with APA
just after residency training in 1974 as a young psychiatrist interested in
the economics of practice. After a decade in the U.S. Public Health Service, I
found myself coming to work at APA headquarters for Dr. Mel Sabshin, our
esteemed former medical director. I spent nearly four years on the APA staff
as deputy medical director and learned so much from Mel and others.
Although I left a formal appointment with APA in 1986 to come to Sheppard
Pratt, I have never really left APA. I have worked on numerous committees,
councils, and task forces and held a number of elected positions, all
culminating in this year as your president.
Being president of our wonderful Association has been a most extraordinary
experience for me. Thanks to Tom Cruise and his antipsychiatry rant on the"
Today" show last June, I experienced my first 15 minutes of fame.
This event was a reminder that there remains misunderstanding about the
benefits of psychiatric treatment and that stigma is alive and well.
Hurricanes Katrina and Rita brought to the surface all of the social
inequities that pervade our society, that affect many of our patients.
Being invited and traveling to Guantanamo Bay, Cuba, and interacting
intensively with the U.S. military on the role of psychiatrists in the
interrogation of detainees challenged my personal sense of ethics and
reinforced my strong opinion that as physicians we should, above all,"
do no harm."
Then I experienced being in the eye of another hurricane with the
implementation and rollout of the Medicare Part D prescription drug program.
My second 15 minutes of fame came when I commented on the plight of our
patients who, in transitioning from Medicaid to Medicare, experienced severe
disruptions in their treatment. I was the "Quote of the Day" on
January 21 in the New York Times.
In this column, I have written about such topics as our profession's uneasy
relationship with the pharmaceutical industry, our need to be proactive with
patients who refuse to acknowledge their illness and require "caring
coercion," the importance of the biopsychosocial model and psychosocial
treatments in particular, the impact of the electronic health record on our
practice and the challenge to privacy, and the likely impact of psychologist
prescribing on the practice of psychiatry.
These and other issues will continue as central areas of attention for Dr.
Pedro Ruiz, my successor as president of APA. He assumes office later this
month at the conclusion of APA's 2006 annual meeting in Toronto.
In traveling countless miles and meeting with many psychiatrists at
district branch meetings, grand rounds, and other venues, I came away feeling
that our specialty is alive and prospering. And so is our Association. We are
doing well, very well. Membership is increasing, the budget is balanced, we
have superb leadership with Jay Scully as our medical director, and the APA
staff could not be composed of more dedicated, hardworking, and truly
The culmination of the presidential year is the annual meeting. This one in
Toronto promises to be extraordinary. Thank you to Dr. Mimi Butterfield and
the entire Scientific Program Committee. I will be saying thank you to many of
you as I wander the halls and attend symposia and workshops at our annual
meeting. Thank you for the opportunity to advocate for our profession and for
each of you individually. Thank you also for your help in supporting my
There is much that remains to be accomplished by APA. Psychiatry always
seems to be in the eye of a hurricane—inluding the public health crisis
of homeless and incarcerated mentally ill individuals, the struggle for parity
in public and private insurance, and the shortage of psychiatrists (especially
child psychiatrists) in the face of unmet mental health needs. Advocacy must
be part of our professional culture and identity. We must advocate for our
profession and our patients. As Rabbi Hillel said nearly 2,000 years ago,"
If I am not for myself, who will be for me? If I am for myself alone,
what am I? If not now, when?" ▪