APA Assembly members, at their meeting last month in San Diego, elected
Ronald Burd, M.D., of Fargo, N.D. (right), for speaker-elect and Gary
Weinstein, M.D., of Louisville, Ky., for recorder. Burd, who just completed a
term as the Assembly's recorder, defeated Herbert Peyser, M.D., a
representative of the New York County District Branch. Weinstein, who was Area
5 representative, outpolled Joanne Ritvo, M.D., of Denver. Ritvo is a
representative from the Colorado Psychiatric Society.
Access-to-care issues were prominent on the agenda of the APA Assembly
during its three-day meeting last month in San Diego, with the representatives
passing several action papers related to ensuring that patients can receive
the psychiatric care they need and advocating for patients on several
This focus meshed well with a presentation by Rep. Susan Davis (D), who
represents San Diego in Congress (and is married to a psychiatrist). "We
need to build a health care system that maximizes patient access to the latest
and best evidence-based care," she emphasized. "Mental health is
just as vital as physical health for one's well-being.... When people have
access to care, recovery is possible."
The Assembly discussed federal parity legislation that has the potential to
override state parity laws. The group voted that APA should support
legislation that best preserves state laws that provide greater coverage to
patients than is included in some federal proposals. The action paper urged"
full and informed" communication between APA and its district
branches and state associations (DBs/SAs) and stated that any decision to
endorse federal parity legislation "must be based on an assessment of
the overall benefits to patients."
The goal of another access-related paper was to expand the number of state
and federal facilities to which veterans can turn for assessment and treatment
of posttraumatic stress disorder (PTSD) and related neuropsychiatric
disorders. The authors maintained that the Department of Veterans Affairs
sometimes fails to recognize and treat these disorders and could benefit from
APA-generated PTSD-related training materials.
Stephen McLeod-Bryant, M.D., chair of the Assembly Committee of
Representatives of Minority/Underrepresented Groups, urges members to attend
the Institute on Psychiatric Services in New Orleans in October.
The Assembly also voted to have APA develop a policy statement saying that
children who have been victims of physical or sexual abuse should not be
forced to confront the alleged perpetrator during court proceedings, when such
confrontations could harm the child.
Assembly members also urged APA to advocate with federal officials to have
psychiatric medications included among medications in the Strategic National
Stockpile, which is a resource the government can tap after disasters or
Several proposals that the Assembly adopted were directed toward the goal
of advocating for the psychiatric profession. Among these were two calling for
psychiatry to be "carved in" by insurance companies and federally
qualified health centers.
AMA Board member William Hazel Jr., M.D., shows one of the advocacy
resources AMA has prepared to help physicians fight scope-of-practice
expansions by nonphysicians—this one addresses psychologist-prescribing
Credit: David Hathcox
Another paper sought to establish a work group to develop recommendations
on ways APA could provide support, though not legal advice, to members who are
sued for malpractice, and representatives also voted to have several APA
committees discuss the feasibility of a "peer-to-peer support
program" as a form of outreach to members in regions struck by natural
or manmade disasters.
The Assembly voted to have APA increase its involvement in the development
and implementation of health information technology to ensure that the needs
of psychiatrists and their patients are considered by policymakers and to
begin a pilot project in which members-in-training who are active in APA
activities would spread the word to other residents in their regions about the
value and benefits of APA membership. Programs in New York City will be the
first targets of the pilot project.
In addition, Assembly members endorsed the appointment of an Assembly
committee to address concerns that may be unique to Canadian APA members. The
committee is to consist of three Canadian and two U.S. representatives. With
the overwhelming focus of APA on political and health-system issues in the
United States, the Assembly agreed that more attention should be paid to
issues that impact Canadian psychiatrists. Representatives also asked APA's
medical director to include issues of concern to Canadian members in his
reports to the Assembly and to the membership in general.
Michael Kalm, M.D., David Duncan, M.D. , and Jason Hunziker,
M.D., of the Utah Psychiatric Association congratulate each other after
winning the Assembly's District Branch Best Practice Award for the DB's
Soundbyte program with the Utah legislature.
Credit: David Hathcox
Expressing its continuing concern about the power balance between it and
the Board of Trustees, the Assembly revisited a proposal that would give it,
in some circumstances not involving the Board's fiduciary responsibility to
APA, the ability to override the Board when action papers from the Assembly
are not approved by the Board. The Assembly endorsed a compromise that would
have the speaker work with the Board to appoint a joint task force that would
recommend a plan introducing additional checks and balances to increase the
A proposal to have APA issue a call for more private funding of research
and clinical trials that lead "to the commercial licensure of
prescription marijuana" generated considerable controversy and was
defeated by Assembly members. The proposal would have also urged APA to"
recommend that patients be protected when in possession and/or using
legal quantities of marijuana under physician supervision."
Carol Trippitelli, M.D., chair of the Assembly Committee of Early
Career Psychiatrists, presents its semiannual report.
In addition to Rep. Davis, the Assembly heard from several other invited
speakers. David Shern, M.D., president and CEO of Mental Health America talked
about the group's mission and decision to change its name from the National
Mental Health Association (Psychiatric News, April 6).
Colorado representative Joanne Ritvo, M.D., waits her turn to speak
during an Assembly debate.
Credit: David Hathcox
AMA Board member William Hazel Jr., M.D., an orthopedic surgeon, expressed
the AMA's solidarity with APA on scope-of-practice issues involving
psychologists and asked Assembly members to lend their support to other
medical specialists as they combat scope-of-practice expansions sought by
other nonphysicians. He also lamented the disappearance of psychiatrists from
the medical staffs of community hospitals and urged psychiatrists to be more
involved in those settings. "We miss the collegiality," he
Finally, Prof. Sheila Hollins, president of the United Kingdom's Royal
College of Psychiatrists, talked about the way England's National Health
System deals with patients who have or may have a mental illness and changes
that may soon reshape some facets of that system. ▪