It’s time for the annual meeting once again, and this is my last column for Psychiatric News. Rather than bore everyone with a list of APA’s accomplishments over the two years that I’ve sat on the Board, I’ve decided to put this column to a better use.

This year members voted in such low numbers that we almost didn’t pass the corporate reorganization proposal, and we are still seeing a decline in the number of dues-paying members. I think APA’s mission needs to undergo a radical change if APA is going to continue to be a leader in the mental health field, and what follows are some thoughts on why that is.

APA is psychiatrist oriented, but not member oriented. What do I mean? I would argue that we are primarily an advocacy group for psychiatrists. Despite the things we do to educate patients and the public directly, many of us would agree that much, if not most, of what APA does is help patients indirectly by increasing access to psychiatrists and improving psychiatrists’ knowledge of psychiatry and happiness with the field.

That means that any potential member basically looks at our goals—what APA is doing from year to year—to decide whether she or he should join. The problem is that APA’s specific goals change every year along with our elected officials, and as they say, you can’t please all of the people all of the time, no matter how many strategic initiatives you agree on.

Despite this, APA’s business model used to work just fine. It and other professional organizations gained members because they fostered a sense of community in a world where just having membership in an organization was enough to accomplish that. APA was the leading source of information about things that affected psychiatrists, and it was a matter of professional pride to become an APA member. This kind of member loyalty is what provided the dues to support APA’s advocacy efforts. My second point, then, is this: APA can no longer rely on professional 1oyalty to keep existing members or gain new members.

The reason is simple. As communication has improved via new technologies such as the Internet, there are now dozens of sources for psychiatric knowledge and ways maintain contact with other psychiatrists. You don’t need to be an APA member to keep up with the latest research findings, get treatment guidelines, or find a psychiatrist for a consultation.

In fact, APA is not doing a very good job of providing those services. So each time a member who needs a service is frustrated by APA’s system and gets the information faster somewhere else, she or he thinks, "What am I paying $1,000 a year for?"

Just as many large companies are losing customers and revenues to smaller but more technologically advanced companies, APA is starting to do the same. That leads to the third point: Our biggest source of value as an organization is the information that our members have. Each is an expert in something, from the youngest medical student to the most experienced life fellow, and our collective knowledge is something that no other mental health organization can match. However, this collective knowledge is barely accessible because of poor communication both within the organization and among its membership.

The mission of APA, while it has undoubtedly been appropriate for the last century, needs to change to move us into the next century. If APA doesn’t change in a very fundamental way, it will become extinct. Here is what it needs to do to continue to exist:

• Scrap the current computer system. Over the years APA has spent a lot of money to create a technological infrastructure that does not work as planned. It’s time for APA to either invest in a better system or outsource this to a company that specializes in information technology.

• Make APA member focused. "Surface cures" won’t work. For example, if you’ve been to the APA Web site, you know how difficult it is to use. Why? Because it’s organized according to APA’s governance structure rather than by type of information a user might be seeking.

• Create a membership network. APA needs to make it easier for members from all over the world to communicate with each other and work together on projects such as our treatment guidelines. List serves are simply not adequate, and our system of creating councils and committees that meet at certain times of the year is outdated in a world where people can gather in a virtual setting—on the phone or on the Internet.

If APA does not become a leader in using technology, it will find that more technologically friendly health care organizations will soon be using the brightest psychiatric minds to create material and guidelines for them instead of for us.

I hope that this column stirs some thoughts and that people will let me know what they think. I can be reached at jksmd@ earthlink.net or just find me at the annual meeting, where I’ll be networking the old-fashioned way: in person.

Also, this is my last column as APA’s member-in-training trustee. My successor is Sandra de Jong, M.D., who takes office at the end of APA’s 2000 annual meeting. You will be in excellent hands. I know Sandra looks forward to, as I did, hearing from you about any APA or psychiatric issue that concerns you.