In early September, we held our components and Board of Trustees meetings
in Washington, D.C. As we have explained in previous columns, we are now
functioning under a new component structure resulting from the reorganization
efforts begun by Dr. Nada Stotland when she was
The new structure is certainly leaner and expected to be more efficient,
although obviously only time will tell. As we have reported, we now have nine
councils (reduced from 14) and some 14 committees (reduced from some 73).
Holding the Board meeting at the same time as the council meetings allowed
Board members and council chairs to interact around key topics. In the last
issue, I reported on the utility of this in discussing how we have dealt with
health reform and policy decisions.
While the reorganization was instituted for efficiency reasons, the
component meetings had about 220 attendees in contrast to previous years'
attendance of about 500 to 600. This has resulted in a major savings for APA
and allowed us to have the component meetings within the markedly reduced
budget that the Board had approved.
Dr. Carol Bernstein, our president-elect; Dr. Jay Scully, our medical
director; staff Margaret Dewar; and I were able to have a breakfast meeting
with the council chairs to review how the council meetings were going,
coordinate efforts between councils, and discuss reviewing the new structure
for possible modification. Dr. Bernstein is heading a new task force that will
continue to work on governance issues, and that group will promulgate the
mechanisms for considering possible revisions, including reinstating some
The Board of Trustees meeting focused on several key issues. As previously
reported to you, health care reform was a major topic, and we formally voted
on supporting HR 3200, including a public option as long as physicians can opt
out of participating (see APA Board Takes Stance on Health Reform Proposals).
The bill certainly has pluses and minuses, but its positions on mental health
are favorable to psychiatry and our patients, and it was the opinion of the
Council on Advocacy and Government Relations and the Board that we support it.
As you all know, the issues are still in debate, and our position allows us to
be a participant in the discussions.
A second major topic was how to deal with the pharmaceutical industry. To
aid in the discussion, we heard a panel that included Dr. Tom Stossel, a
renowned cancer researcher at Harvard and an advocate for working with
industry; Dr. John Hayes, a vice president of Eli Lilly and Co. and a member
of the board of our American Psychiatric Foundation; and Dr. Sid Weissman, who
is going to head a Board task force on the issue. The session covered a great
deal of ground and highlighted many benefits of working with industry that we
need to be mindful of, particularly the dissemination of information regarding
new or about-to-be released products that could be innovative and have a
tremendous impact on patients' lives. We look forward to hearing from Sid's
task force over the next months.
A third key issue had to do with further reorganizing APA's overall
structure. As you may know, APA consists of four not-for-profit entities. They
include APA itself—which is a so-called 501(c)(6) corporation that does
the day-to-day business of the membership—and three 501 (c)(3)
organizations that are in essence foundations that perform certain tasks;
these include American Psychiatric Publishing Inc., the American Psychiatric
Institute for Research and Education, and the American Psychiatric
Each of these entities has its own governance structure with separate
boards that meet several times of year. The (c)(6) APA Board appoints the
members of the affiliate boards. Because some of APA's officers serve on these
affiliate boards, some of us have as many as 12 board meetings a year.
Another aspect of the arrangement that has caused some problems has to do
with transfer of funds for programs. The (c)(6) can provide funds to the
(c)(3) organizations and does so, but the reverse is significantly restricted
under federal law. Many medical organizations have a (c)(3) and (c)(6)
arrangement to their structure, but we are unusual in having three (c)(3)
organizations. The cost of maintaining this complicated structure is high and
inefficient, the transfer of funds is cumbersome, and the structure no longer
serves APA or its members. Thus, the Board of Trustees decided to begin
consolidating these organizations and to look at switching some functions
between them and the (c)(6). This will allow for greater flexibility, lower
cost, and greater efficiency. The decision to consolidate was reached at the
September Board meeting, but the Executive Committee had discussed it for over
a year, working with consultants and legal counsel. We believe this new
overall structure will better serve all of you. We will be reporting to you
details and progress as the process moves along. ▪