APA Assembly Reflects Needs, Concerns of Clinicians in the Field
Abstract
The outgoing speaker says APA’s Assembly is vital to the functioning and vitality of the association as first and foremost a member organization.
“The APA Assembly is the voice of the individual general member, the body within the APA governance structure where individual members make their opinions heard,” said outgoing APA Assembly Speaker Jenny Boyer, M.D., J.D., Ph.D.
Jenny Boyer, M.D., has been especially passionate in advocating for member concerns about what she calls burdensome and clinically irrelevant Maintenance of Certification requirements.
In an interview with Psychiatric News, Boyer—whose term as speaker ends this month—explained why the Assembly is vital to the health and well-being of the organization and an indispensable component of its policymaking process. She noted that Assembly membership includes not only elected representatives and deputy representatives of the 74 district branches/state associations, but also members representing resident-fellow members, early career psychiatrists, allied organizations, and minority and underrepresented group caucuses. As such, it expresses the diversity of the APA membership.
Boyer also pointed to a variety of issues on which the Assembly’s voice and role in APA policymaking has been crucial, including development and implementation of APA’s five-year strategic plan, advocacy to convey widespread physician dissatisfaction with Maintenance of Certification requirements, refinement and approval of APA practice guidelines, promotion of policy to improve access to psychiatric care for veterans, and participation in the development of DSM-5 to ensure that the manual would be clinically relevant.
Historically, Boyer said it was the diversity of the APA Assembly that helped bring attention to an issue that would eventually come to national prominence—the potential involvement of psychiatrists in interrogations of prisoners in the war on terror. She noted that it was Assembly representatives from the uniformed services district branch who were among those who brought to light the fact that psychiatrists would be ethically compromised if they participated in such interrogations; in time, policy was developed with the input of APA’s entire governance structure and a number of councils and committees asserting that involvement in interrogations was incompatible with psychiatrists’ ethical obligations.
Boyer, who is deputy chief of behavioral medicine at Jack C. Montgomery VA Hospital in Muskogee, Okla., has been especially passionate as Assembly speaker about the issue of Maintenance of Certification (MOC).
She said it was in the Assembly that concerns about MOC requirements began to be heard about a process that Boyer called “burdensome, time-consuming, and not clinically relevant.” At its March meeting this year, the Board of Trustees approved a letter—on the basis of recommendations of the Assembly Executive Committee (AEC)—to Larry Faulkner, M.D., president of the American Board of Psychiatry and Neurology (ABPN), urging ABPN to advocate with the American Board of Medical Specialties for the elimination of Part 4 of the MOC (See “From the Speaker” in the May 1 Psychiatric News).
Boyer told Psychiatric News that the Assembly is naturally the component of APA governance where issues like MOC come to light. “It’s our members in the field who have to take the test and fulfill the requirements, and they know what is relevant to serving their patients,” she said. “It’s our members in the field who experience the issues that affect them as clinicians first, and it’s the Assembly where members can make those issues known to the leadership.”
Created by an amendment to the APA bylaws in 1952, the Assembly is composed of its officers (which include the speaker, speaker-elect, recorder, and parliamentarian), a representative and deputy representative from each of APA’s seven geographical Areas, a representative and deputy representative from each of the 74 district branches and state associations; a representative and deputy representative from each of the seven minority/underrepresented groups; a resident-fellow member representative and deputy representative from each Area; an Early Career Psychiatrist representative and deputy representative from each Area; and representatives from 18 Allied Organizations.
The Assembly customarily meets twice a year (during the APA annual meeting in May and near APA headquarters in November). The AEC meets in conjunction with the two meetings of the Assembly each year, as well as at two other times.
What Are the AEC and JRC?
The Assembly Executive Committee (AEC) is a 25-member group composed of the speaker of the Assembly, the speaker-elect of the Assembly, recorder of the Assembly, the two immediate past speakers, 14 Area representatives and deputies, the chairs of the Committee on Minority and Underrepresented Groups, the Committee of Area Resident-Fellow Member representatives, the Committee of Area Early Career Psychiatrist representatives, the Committee of Allied Organization Liaisons, the Parliamentarian, and the CEO and medical director.
The voting members of the Joint Reference Committee (JRC) are the president-elect, who serves as the chair; the speaker-elect, who serves as vice chair; two members of the Board of Trustees (one of whom is the immediate past president); two members of the Assembly (traditionally the recorder and the immediate past speaker); and the CEO and medical director. The chairs of the councils serve on the JRC as ex-officio nonvoting members.
The Assembly debates action papers, which can be brought by any individual APA member, through the district branch that represents the member. When an action paper is received by the Assembly, it is reviewed and debated by “reference committees”—small groups of Assembly members—before being forwarded to the entire Assembly for discussion and a vote.
Action papers that are approved by the Assembly are sent to the Joint Reference Committee (JRC), which acts as a kind of clearinghouse, referring them for review by relevant councils or other components and the APA administration; they may be revised or recommended for rejection. After review, the JRC may approve sending the action paper to the Board of Trustees for consideration and possible action.
(For the composition of the Assembly Executive Committee and the Joint Reference Committee, see box at left).
Boyer said Assembly members are APA’s “foot soldiers,” noting that some of those who are on special Assembly work groups may spend as much as 10 hours a month on organizational business, in addition to regular Assembly meetings—all this on top of busy professional lives.
Boyer said she hopes that the APA members who cannot participate directly in the Assembly—through running for election or submitting action papers for consideration—will recognize the important role the Assembly plays in shaping policy that may affect their professional lives.
“The discussions and debates that take place in the Assembly over time,” Boyer said, “distill a viewpoint from the grassroots that is lasting and reflects psychiatry’s values and helps to shape APA’s mission and long-term goals.” ■
