Mirin to Resign as Medical Director At End of Year

APA Medical Director Steven Mirin, M.D., announced last month that he will bring his tenure in that job to a close on December 31.

Mirin’s surprising announcement came just a few months after the Board of Trustees agreed to offer him a contract for an additional three years as medical director. His original five-year contract runs out at the end of June. Mirin had not signed the new contract at the time he announced his departure but said he wanted to provide the APA Board with adequate time in which to select and hire a successor.

Mirin explained that a major factor leading to his decision to leave the position was the burden on his family of “the enormous amount of time and energy the job requires,” including extensive travel and a steady diet of night and weekend meetings. He noted that he wants to spend more time with his two youngest sons, ages 9 and 14.

APA President Richard Harding, M.D., commented that Mirin “has made remarkable contributions to APA during a period of significant change for psychiatry and the greater world of medicine and health care. He has been a powerful advocate and spokesperson for our patients and our profession, and a very capable leader of our Association.”

Immediately after Mirin announced his decision, Harding and APA President-elect Paul Appelbaum, M.D., began considering appointments to the search committee that will recommend medical director candidates to the Board of Trustees. Harding said that he hopes the Board will make its selection by September, which will allow time for the current and incoming medical director to work together and achieve a seamless transition by the beginning of 2003.

Harding cited a number of accomplishments of Mirin’s tenure as medical director that he said have made APA a stronger organization than when he arrived in 1997. Among these are his leadership of staff participation in the development of the strategic goals and priorities that now define and guide APA’s decisions about which initiatives and programs to pursue. He also initiated and shepherded the corporate reorganization of APA and its subsidiaries, which was completed in January 2001. As a result, APA is now a 501(c)6 organization, removing constraints on the Association’s ability to support advocacy financially at the state and federal levels on issues like parity, patients’ rights, medical-record privacy, and scope of practice.

The corporate reorganization allowed APA to begin a revenue-sharing arrangement with its district branches and state societies. The corporate integration of APA’s publishing activities with those of the American Psychiatric Press Inc. (APPI) was also part of the reorganization.

Mirin said he was particularly pleased about his role in establishing the American Psychiatric Institute for Research and Education (APIRE), whose board of directors he chaired from its founding in 1998 until last year, when Herbert Pardes, M.D., was named president of the APIRE board. APIRE, a tax-exempt 501(c)3 organization, has competed successfully for NIH, foundation, and industry support for health services research, fellowships, and training grants. As a result, Mirin said, over the past five years external funding for APIRE activities has grown to $4.5 million a year, and the number of APA-sponsored fellowships has grown from 80 to 130.

Mirin also played a key role in initiating the development process for DSM-V as part of a collaborative effort with the leadership of NIMH, NIDA, NIAAA, and several international organizations, including the WPA and WHO.

Mirin also presided over the dramatic growth of the American Psychiatric Foundation (APF), working with the APF Board and hiring a new executive director. In 2001 the foundation received contributions of over $4.2 million, which it will use to support research, public education, and other projects.

Asked what he found most gratifying during his tenure as medical director, Mirin cited some of the working relationships he developed with APA members and staff. In particular, he praised the APA staff as “dedicated, talented, and totally committed to the Association’s mission.”

Mirin identified several challenges with which his successor will have to grapple. Among these are redefining APA’s mission and goals and working with the APA leadership to provide members with the tools they need to care for patients and overcome the constraints imposed by managed care. The new medical director also needs to ensure that APA continues to play a key role in shaping the nation’s mental health care delivery system to make it more responsive to “the needs of our patients and those who care for them,” Mirin said.

Another challenge for the next medical director is to ensure that APA pays adequate attention to the concerns of its multiple constituencies, including researchers, educators, and clinicians working in the public sector, as well as those in private practice.

“Our strength is in being the only organization that represents the full breadth of our field,” he said.

Asked to cite disappointments in his tenure at APA’s helm, Mirin responded that “improvements in our information systems are still a work in progress.” He noted that his successor will have to oversee the implementation of a new information management system that will allow better coordination with district branch offices, so that “APA, its district branches, and its members are on the same screen.”

Mirin also said that he, like many APA leaders, is concerned about the gradual decline in APA membership. “We need to do a better job of communicating what members get for their dues dollars” and reshape the Association to better meet the needs of residents, early career psychiatrists, women, and those who belong to underrepresented groups.

Mirin concluded by saying that he appreciated the opportunity “to work with a lot of terrific people” during his tenure and to be in a position where what he did could “make a difference” for patients and for the field, but he noted it is “time for someone else to pick up the challenge.”

As for future career plans, Mirin said that he is interested in working on health policy issues, particularly those that affect the delivery of patient care, interspersed with family trips to exotic fly-fishing destinations. ▪