Difficult Choices Ahead for APA

Many APA members work within large systems of care. The Veterans Administration, state departments of mental health, and university hospitals and clinics are good examples. Other members run their private offices as small, independent businesses. What we all have in common is the need to plan and live within changing budgets. As recent events have shown us, it is not always possible to predict what we will be facing in the near or long term; however, fiscal trends are watched and adjustments to revenue or expenses are made. The following are two of many APA fiscal trends.

Trend one: A slowing of revenue for the Association. There has been a slow but persistent erosion of our membership base since 1996. This is partly due to the graying of our membership and partly due to a perceived dissatisfaction among younger members regarding the perceived value they get from their annual dues. While this year’s dues are ahead of last year’s, we must still mind the trend. In addition, the financial markets have leveled off and even dropped in some areas of the economy. This has caused a decrease in the income from investments that we had made during years of revenue growth.

Trend two: Continued growth of expenses. APA and its Board and Assembly have made every effort to meet the demands of the membership in a multitude of areas. APA is a large tent with many “tribes” who all have legitimate, important professional issues and desire help from APA. We, of course, want to provide that help but have traditionally had difficulty deciding what the trade-off will be when another good cause is added to our plate. It is also expensive to be headquartered in Washington, D.C., but it is also a distinct advantage. We have benefited greatly from the wonderful employees who live in the area. In contrast, we have suffered from pay rates, rent, and other expenses that are higher than most of us are used to in our hometowns. We have also seen an increase in the number of staff positions as our areas of interest expand without, again, tradeoffs being offered to keep the financial and resource expenditures in balance.

You will be reading about the shortfall in revenue for 2001 and 2002 and the need for painful but necessary budget cuts (see Original article: page 4). Those of you working in systems of care know these cuts all too well.

While reality is tough to deal with, it also necessitates an opportunity to make changes within our Association that will lead to more efficiency and effectiveness. We will need to ask the tough questions: Are we spreading ourselves too thin? Should we concentrate on only a small number of priority items such as advocacy for the mentally ill, including substance use disorders, and our profession?

If we work more closely with subspecialty organizations on common agendas, would this decrease the influence of general psychiatrists in these fields?

These are tough questions that will affect our patients and members in the near future. They are questions that traditionally have been punted to the next generation of members and leaders of APA. The Board and staff of APA are working to use this budget “problem” and turn it into an opportunity for improved performance and direction. Work plans are being finalized and long-term planning continues in process. No excuses. We will meet the challenge. ▪