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April 2, 1999
BIOGRAPHICAL STATEMENT: I am a private-practicing Baltimore psychiatrist with broad and unique leadership experience.
Majoring in philosophy at Princeton, I am also an alumnus of Columbia University's College of Physicians and Surgeons. After an internship at San Francisco General Hospital, I trained in general and child psychiatry at Columbia, and completed psychoanalytic training in Baltimore. I am ABPN certified in general and child psychiatry and an APA fellow.
My background includes
Concerned about patients and families as well as doctors, I am a longtime member of both Maryland AMI and the Mental Health Association.
What is not revealed above is that I have served during times of crisis and change. I was president of my county medical society during the successful struggle for "tort reform." As president of the MPS during utilization review (UR) battles, I helped shape model legislation in Maryland. As a psychiatrist member of the Board of the Maryland State Medical Society, I provided strategic leverage in the battle for mental health parity. During my terms as trustee and president we accomplished a major internal restructuring while also externally pursuing a vigorous legislative agenda, enacting a(n)
I have fought successfully for significant changes in the Assembly.
My wife, Carol, and I have been married 35 years. We have three daughters and two grandchildren.
CANDIDACY STATEMENT: For elections to have meaning, they should offer voters a choice between different ideas and visions of the future. Here are mine.
APA is now engaged in a great struggle over change. How did we get here? During the 1980s, APA grew at levels not sustainable. Partly this was due to more liberal third party payment to psychiatrists, partly to improved treatment drawing young physicians into the field, partly to APA's offering highly desired benefits to its members, partly to APA's having a lock on less expensive and better liability insurance. These advantages were lost unexpectedly in the early 90s, leaving APA with a static or declining dues-paying membership unable or unwilling to continue funding ever-larger budgets with yearly dues increases. That led the Association to freeze dues, constrain its budget, and initiate a strategic planning process.
Two Task Forces on Strategic Planning have been appointed and made reports, yet little has changed. Why? Some will say that vested interests were not willing to give up their prerogatives. But I believe the strategic planning has not addressed a crucial problem, the lack of an integrated, focused governance. The Assembly, the Board, and the components function largely independently of each other for historical reasons. All authority is vested in the Board, which is overwhelmed and does not have the diversity needed to engage the many complex issues it faces. This ultimately weakens the organization, despite exemplary leadership.
What can be done about it? Administrative oversight and fiscal responsibility should remain with the Board, but most governing structures place policymaking decisions in the largest elected body. Thus, Congress decides war and peace and domestic policy. The AMA gives its House of Delegates policymaking authority. They do this so the greatest diversity of voices may be heard during policy construction. APA could achieve this by constitutional amendment. But the value of it can be tested by having the Assembly modify its procedural code so voting members of the Board could be seated in the Assembly, assuring that they could participate in the debate before making major policy decisions. This would not alter the voting strength of the district branches, as a Maryland action paper noted two years ago.
What about DB representation in the Assembly? If the Board and Assembly agree to downsize, then the formula offered by Areas 2 and 6 seems sound. Savings could come also from eliminating the Joint Reference Committee, an anachronism, since council and commission chairs now attend Assembly reference committees.
Where could further savings come from? To "right size," APA needs to see itself in context. It must sort out what only it can do and in what areas it can share the effort. The AMA and psychiatric subspecialty societies are eager to join hands with us. So are many academic and research institutions. Actively engaging with its constituencies can help APA identify less costly ways of carrying out its laudable goals. A "base closing" strategy is a means of last resort.
Finally, APA must give more than lip service to the importance of DBs. They are not like franchisees of McDonalds. They are like quasi-sovereign states. They do not need APA drafting their constitutions, etc. They need latitude to innovate in tough times.
Members' ideas deserve to be processed in a timely way through the governance to achieve a debated, just, proactive APA agenda.