APA President Nada Stotland, M.D., set the tone for the Board of Trustees'
meeting last month in Arlington, Va., by emphasizing that the Trustees would
have to make tough and unpleasant decisions on behalf of APA at that meeting
and in the near future because the financial prospects facing the Association
are bleak.
Driving the decline in revenues available to APA are a steep drop in
pharmaceutical advertising in APA publications, an expected decline in other
types of revenue from the pharmaceutical industry as APA decreases its
involvement with that industry on several fronts, declining annual meeting
revenues, and member dues that have not risen in 13 years despite the steady
march of inflation.
The 2009 operating budget is approximately $55 million. Since the Board had
decided not to use money from APA's reserves to fund its operations, the
Trustees agreed to cut nearly $1 million out of the 2009 budget for APA
governance. Governance includes the Board of Trustees, Assembly, Joint
Reference Committee, and all of the committees, councils, and work
groups.
Staff reductions will also help APA balance its 2009 budget. APA Medical
Director James H. Scully Jr., M.D., told the Board that 23 staff positions are
being eliminated, of which 10 are currently filled. Three of those 10 staffers
are being offered other jobs at APA. Many other staff positions are remaining
vacant and subject to a hiring freeze. The travel budget has also been
slashed.
On an upbeat note, Eve Herold, director of APA's Office of Communications
and Public Affairs, reported results of a national, APA-sponsored survey of
the American public that found that perceptions of psychiatrists have become
more positive over the last three years and that attacks on psychiatry by
groups such as the Church of Scientology are having little impact on people's
view of psychiatrists and the treatments they provide. Nearly half of
respondents (48 percent) have a positive view of psychiatrists and
psychologists (49 percent, see chart at right), both up about 15 percent in just
the last three years.
The survey also found that 92 percent of respondents now believe that"
people with mental illness can lead very successful lives" and
that 77 percent consider seeing a psychiatrist "a sign of
strength."
In contrast, 73 percent of respondents said that "psychiatrists are
too quick to medicate children," and 65 percent believe that"
psychiatrists' integrity is compromised by financial and professional
links with pharmaceutical companies."
A finding that points to an area in which APA has to do more public
education is that most respondents can still not indicate the differences
between psychiatrists and psychologists.
To gather the data, Opinion Research Corporation conducted telephone
interviews with a representative sample of 1,003 American adults aged 18 and
older from October 29, 2008, through November 2, 2008.
Among the actions taken by the Board at last month's meeting was to allow
corresponding members of APA councils and committees to have a vote on those
components.
The Trustees also voted to defer until their March meeting an action from
the Assembly urging APA to raise member dues for 2010.
In addition, Stotland created two Board work groups, one of which will deal
with scope-of-practice issues, particularly how psychologist-prescribing laws
are affecting psychiatrists in the two states that have enacted them—New
Mexico and Louisiana. The other work group is tasked with developing a plan on
how APA can best use its resources in dealing with the increasingly crucial
area of mental illness
prevention.
The Board heard from the president of the Maryland Psychiatric Society,
Scott Hagaman, M.D., who stressed that money is at the heart of the most
pressing concerns members of his district branch are confronting.
"Physicians practices have to be viable businesses" but that
viability is under attack on multiple fronts, including from the tort system
and the managed care industry. Many practices in his state are closing, he
said, and the ever-shrinking lack of options for receiving psychiatric care is
extremely troubling. Thousands of patients had been receiving care in the
now-closed practices, he noted. "The membership wants APA to do more to
solve the health care financing problem" in this country, Hagaman
said.
A summary of actions taken by the Board at its December 2008 meeting
will be posted in the Members Corner section of APA's Web site at<www.psych.org>.▪