May 7, 1999

BY NORMAN A. CLEMENS, M.D.

This is a special time in APA's history. The confluence of many forces is leading to widespread rethinking of its structure and function. Externally, the profession must deal with managed care; the business assault on professional identity, ethics, and sense of individual responsibility; workforce reduction; financial distress for our members; pressure on early career psychiatrists; and the power of the pharmaceutical industry-at the same time as scientific breakthroughs are leading to more effective treatment and greater public understanding of mental illness. Relations between APA, its district branches, and the members are under strain. Within APA, the work of the Task Force on Strategic Planning, organizational analysis by the new medical director, a special report on internal organization, various presidential initiatives by Drs. England, Eist, Sacks, Muņoz, and Tasman, and the follow through on all of this by the Assembly and the Board of Trustees have led to myriad changes already accomplished or in the works. Though incremental in nature, they add up to a thorough revamping of APA that will make the organization more relevant to our members. These changes can be summarized as follows:

• The development of a statement of mission, values, strategic goals, and priorities for the Association.



• Outreach to members through the special insert of APA's annual report in the March American Journal of Psychiatry; a toll-free telephone number that APA members can use when calling APA, the Answer Center, list serves for all APA members (Member-2-Member), early career psychiatrists, members-in-training, and other groups within APA; and the creation of the Division of Membership, Marketing, and Communication and the Office of District Branches and State Societies



• The attendance of district branch presidents-elect at Board meetings, and Area Trustee and officer visits to district branches.



• Beefed up government relations section on state legislation, with priorities on psychologist prescribing, parity, managed care regulation, privacy, and grants to district branches under duress with dangerous legislation.



• Reorganization of staff offices: Medical Education and Career Development now encompasses the annual meeting and Institute for Psychiatric Services; the functions of the former Office of Economic Affairs have been moved to the Office of Healthcare Systems and Financing and the Office of Quality Improvement.



• Separation of legislative and advocacy functions from educational and scientific functions and strengthening of both through the American Psychiatric Institute on Research and Education to concentrate activities and allow focused funding



• Intensive study of components to cut complexity, redundancy, excessive tenure, and lack of specific tasks and responsibilities and to seek greater involvement of allied organizations.



• The study and revitalization of publishing activities, with greater integration of APA and APPI operations, improved visual presentation of journals and Psychiatric News, and electronic publishing.



• Fiscal responsibility: sale of land under the 1400 K Street headquarters building in Washington, D.C., reexamination of asset management, ongoing assessment of present and future revenue sources (especially from pharmaceutical companies), and costs.



• Extensive revision of information systems and electronic communications, Y2K preparation, and enhanced use of list serves, e-mail, and conference calls to improve efficiency and cut costs.



• The creation of the Commission on Psychotherapy by Psychiatrists to restore and revitalize the role of psychotherapy in psychiatry.



• The development of quality indicators to assess delivery systems and an outpatient treatment report form to facilitate uniformity in reporting procedures for managed care systems.



• The continued support of practice guidelines, DSM-IV-R, peer-reviewed journals, the Practice Research Network, and other scientific activities that enhance APA's stature, credibility, and influence as the world's premiere organization in the field of mental illness.

Dr. Clemens is APA's Area 4 trustee and chair of the APA Commission on Psychotherapy by Psychiatrists.