Earlier this year, when I was president of the Colorado Psychiatric Society, an angry member wrote a letter of resignation to our Executive Council. The writer said, "I believe that the Colorado Psychiatric Society has failed to adequately advocate [in Colorado] for patients, psychiatry, and most psychiatrists."

As president of that district branch, I had to agree. I agree that we need to do more. This physician took the time to express his opinions. And that’s a start. But just writing a letter of complaint is not enough.

Our district branch, like all APA district branches and state societies, is a volunteer organization whose income from members’ dues is primarily used to support educational activities and legislative efforts. The active members who work on various committees have put in many hours—as volunteers—to advocate for our members’ and patients’ interests. No one is paid to work for this organization other than our support staff, our lobbyist, and our legal counsel.

Our active members are a diverse group of working psychiatrists—as diverse a group as our general members.

The Executive Council of our district branch is long on ideas but is chronically short on volunteers. While the district branch always works hard to make the most of the small group of active participants that we do have, we are limited in the scope of what we are able to accomplish. And while we think we are doing the best we can, it can only enhance our organization to have a fresh perspective on our purpose, committees, and budget.

Some members think that our state psychiatric society should focus only on advocating for our patients. Patient and family organizations like the National Alliance on Mental Illness and the Mental Health America can’t advocate alone, they maintain. We already lobby our state legislators for better treatment of persons with mental illnesses. We provide educational programs for the public. In Colorado, we have responded to events such as the shootings at Columbine High School. But we can, of course, do more.

Other members believe we should instead focus on advocating for our profession. They argue that we must advance the interests and needs of psychiatrists because no one else will. Most of us have been financially and emotionally hammered by the changes in the health care system in recent years. Increasingly, we are faced with taking care of more patients with fewer resources. The Executive Council of our district branch has had frequent discussions about these issues and what we should be doing to respond to them.

Some of our members may be unaware that antitrust laws make it illegal for district branches or APA to organize members to band together to reverse our decreasing reimbursement.

We can contribute to bettering the situation, however, by educating our members on the different ways that medical care has been organized and delivered in our state. While our legislative efforts have resulted in a limited parity law here in Colorado, we still are left with the reality of taking care of people with mental illnesses in a system that does not adequately cover their needs.

Unfortunately, there are no obvious answers and no easy solutions for how to best deal with the realities of managed care. Our district branch leaders are having discussions with several managed care organizations in this state. Specifically, we are talking about how to make it easier for their insured beneficiaries to access their psychiatric benefits and how to decrease the administrative burden on psychiatrists. But we can do more.

I suggest that psychiatrists need to do more than just complain or resign from their district branch. Those members dissatisfied with the state of psychiatry should join their colleagues at district branch meetings, share their ideas, and volunteer for projects that would actually help patients, psychiatry, and most psychiatrists.

If you are feeling unhappy with the current state of psychiatry, I urge you to do something constructive. Call your district branch office or one of your elected officials and volunteer your time and expertise. This isn’t the time to give up on your profession and resign from your psychiatric society.