January 15, 1999

APA's Board of Trustees devoted a significant amount of time at its December meeting in Denver to various proposals for reorganization of itself and the Association. The extraordinary effort, spanning now several years, has the ultimate goal of trimming APA's governance so that it will be more quickly and efficiently responsive to the needs of the membership. But the path to the goal is long and uphill.

Chief among the proposals considered last month was one to reduce the size of the Board by combining the representative functions of several elected members and limiting or removing from the Board certain ex officio members, including past presidents. The specific actions were recommended by a Board task force, headed by Jeremy Lazarus, M.D., in response to the report of the Task Force on Strategic Planning, chaired by R. Dale Walker, M.D.

The Board voted to convert one of the three trustee-at-large positions to a seat for early career psychiatrists and to ask for additional input from minority groups about whether to convert another trustee-at-large position to a minority seat.

A proposal to designate former presidents as voting members of the Board for three years after they leave office and nonvoting members for an additional seven years was initially supported, but later tabled until the Board's March meeting. Currently past presidents serve as voting members for three years after their presidency and then as nonvoting members for the rest of their lives.

The Board defeated a measure that would have added the speaker-elect of the Assembly as a voting member of the Board.

In an effort to strengthen its outreach to district branches, the Board agreed to develop job descriptions for APA's two vice presidents, which will include the responsibility for district branch liaison as a duty of the senior vice president. (Some of the Board's actions will require changes in the Association's bylaws.)

Additionally, the Board approved dozens of actions reshaping APA's committees and components as recommended by the Council on Internal Organization. Aimed at increasing the speed by which APA members' ideas flow into action and eliminating redundancy, the actions begin a process of streamlining APA's "incredibly complex and bureaucratic" structure, according to council chair Fred Gottlieb, M.D.

At the staff level, change is also taking place. APA Medical Director Steven Mirin, M.D., announced that his consolidation of the business functions of APA and the American Psychiatric Press was progressing well. He also advised the Board of another reorganization of staff: the creation of the Division of Membership, Marketing, and Communication, under which he will merge present membership activities, communication functions including Psychiatric News and Public Affairs, a new marketing department, and information services, such as the Library, APA Answer Center, and the Web site. The focus of the new division will be significantly improved outreach to members and the public in vigorously promoting APA's and psychiatry's goals.

A new mission statement for APA's continuing medical education programs was approved following presentations by Deputy Medical Director James Thompson, M.D., and Council on Medical Education and Career Development Chair James Scully, M.D. (Details will appear in the next issue of Psychiatric News.) The Board also voted to require that all model criteria developed by APA components be referred to the Council on Medical Education and Career Development before they can be submitted to the Board.

In other actions, the Board

• Approved the Association's budget for 1999 and directed that various components and staff produce a semiannual report of the budget for the APA membership, to be published in Psychiatric News and/or other suitable publications.



• Voted to continue to work within the AMA's American Medical Accreditation Program in suggesting improvements for the program standards and activities that are important for psychiatrists and to ask for clarification of a number of issues.



• Received the report of its Task Force on Quality Indicators (John Oldham, M.D., chair) and referred it to the Commission on Psychotherapy for review prior to consideration by the Board in March.



• Voted to approve a change in Section 1, Annotation 1, of the Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry, to read: "A psychiatrist shall not gratify his/her own needs by exploiting the patient."



• Reaffirmed its commitment to the "letter and spirit" of the ACCME Essentials and Standards for Continuing Medical Education and to the "rigorous enforcement" of the standards.



• Ratified an executive action of the president, speaker, and medical director granting authority for the Task Force on Local Arrangements for APA's 1999 annual meeting to develop a broad coalition event (a march or similar activity) to promote parity for mental illness to be held in Washington, D.C., during the annual meeting.



• Welcomed APA's new chief financial officer, Kathleen Dempsey, to the staff.



• Approved the continuation of the current process for reviewing proposed practice guidelines with the addition of a member of the Commission on Psychotherapy.



• Established a contingency fund so that APA can support member activities in dealing with mental health issues in disaster situations (airline crashes and natural disasters, for example).



• Approved the Manual of Nursing Home Care for the Psychiatrist.



• Supported the activities of the Consortium for Health and Human Rights relative to the 50th anniversary of the U.N. Declaration of Human Rights.