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"Strategic planning, and especially commitment to new ways of achieving objectives, takes courage and determination," noted R. Dale Walker, M.D., as he presented the Board of Trustees with the report of the Task Force on Strategic Planning last month.
The task force, which Walker chairs and APA Vice President Richard Harding, M.D., cochairs, was established in March 1997 to identify what APA's priorities should be for the next three to five years; develop statements of mission, goals, and objectives; and devise a budget framework to ensure that money is spent to promote these priorities and reduced for programs whose priority is lower on the list (Psychiatric News, January 2, March 20).
One critical issue the task force tackled was how to attract new members and retain psychiatrists who have already joined APA. "Our members are adrift, and members adrift don't ordinarily choose to stay," said Walker, describing the urgency of the situation. The task force recommended that APA undertake a four-part membership strategy consisting of the following initiatives:
The Board endorsed several recommendations designed to put momentum behind these initiatives. It authorized the Task Force on Strategic Planning to work with existing components and one or two district branch executive directors to study the relationship between district branches and the national APA and suggest ways to improve it to the benefit of both. The Trustees asked that a report with recommendations be presented at their December meeting.
The Board also adopted a "forceful goal" of reducing combined national and district branch dues over the next five years. This is to be accompanied by a search for new income sources and a decrease in the Association's operating costs.
The Trustees then endorsed a continuation of APA's existing membership recruitment and retention efforts with a budget adequate to achieve successful results.
In addition, they authorized development of a new marketing campaign aimed at APA members "that compels member recognition of the Association's efforts to serve their needs." This effort will describe APA's accomplishments in service of the five goals-advocating for patients; advocating for the profession; supporting education, training, and career development; defining and supporting professional values; and enhancing the scientific basis of psychiatric care.
Asecond area the task force undertook was the development of "strategic goals and priorities." After endorsing the five goals-and deciding the patient advocacy should be first on the list-the Board voted to adopt priority activities under each goal and instructed the medical director and Budget Committee chair to develop timetables and cost estimates for conducting each activity. The task force, Walker noted, was aware that "to successfully achieve any set of strategic priorities, other APA activities will have to be reduced or eliminated."
Under the goal of advocating for patients, for example, strategic priorities include advocating for nondiscriminatory public policies that affect financing and delivery of mental illness care, disseminating information that could reduce stigmatization of mental illnesses, "taking the lead in defining" standards of care for psychiatric patients, developing and researching clinical outcome measures, and advocating for treatments designed to respond to the needs of "diverse populations."
The goal of advocating for the profession describes such strategic priorities as defining the role of nonphysicians in mental health care, advocating for "appropriate reimbursement" for psychiatrists under all payment systems, working to protect the doctor-patient relationship from interference and forces trying to weaken it, and developing "reliable and appropriate estimates" of the number of psychiatrists the country will need in the future.
Goal three, which is supporting education, training, and career development, instructs APA to increase collaboration with district branches and state societies to "develop and provide high-quality educational services and resources to members and other health care professionals," to attract "a diverse group of high-quality trainees" to the field, and to reshape residency curricula to provide younger psychiatrists with the tools needed to succeed in a reshaped health care world.
Under the goal of defining and supporting professional values are two priorities-to adapt ethics codes to reflect a changing health care system and to increase involvement in developing and maintaining protection standards for human psychiatric research subjects.
The final APA goal, enhancing the scientific basis of psychiatric care, subsumes such strategic priorities as advocating for public and private support for health services research and encouraging "talented young people" to make psychiatric research a major focus of their careers.
Aconsiderable portion of the strategic planning report is devoted to restructuring APA governance. Key elements of the plan the Board adopted call on APA to reduce the size of both the Assembly and the Board of Trustees "while retaining full representation of APA's diverse membership." The Board did not adopt a specific roadmap for reducing the size of its membership, but charged the strategic planning task force with presenting several options for accomplishing this goal. The Assembly will be responsible for exploring options for downsizing its current membership of 254. That figure includes both voting and nonvoting representatives.
Acknowledging that as psychiatric practice and the health care delivery system change, the Association's strategic plan will also have to be modified, the Board voted to form a permanent Strategic Planning Committee that will "facilitate and monitor implementation of APA's planning process each year."
After endorsing the recommendations from the strategic planning task force, the Trustees went on to enact several changes to APA's Operations Manual as part of its mission of reforming, streamlining, and reducing the cost of the Association's governance structure.
The Trustees agreed, for example, to change the manual's section on councils and other components so that the president-elect would only appoint consultants to these committees and councils "in special circumstances and only to provide a special expertise." This was an effort to rein in the number of nonvoting consultants, which has grown considerably in recent years, and improve the efficiency with which components move toward their goals. The Board also charged the Council on Internal Organization with reviewing the size of each component to see if the number of committee members was appropriate to carry out the component's tasks.
Also to be scrutinized is the "need, role, and functions" of the liaisons the Board and Assembly appoint to link the two governing bodies with APA's councils, commissions, and committees. The liaisons attend component meetings and report back on deliberations and actions.
APA President Rodrigo Muņoz, M.D., characterized as historic the changes and strategic goals the Board adopted at its two-day meeting. "These policies will revolutionize APA," he emphasized, "and better prepare us to fight for psychiatrists and patients."