May 7, 1999
APA's Assembly Has Helped Make Major Gains for Members, Patients
BY DONNA M. NORRIS, M.D.
Ending discriminatory health insurance coverage, guaranteeing privacy and confidentiality for computerized medical records, establishing a commission to promote psychotherapy by psychiatrists, and increasing opportunities for residents and early career psychiatrists to become actively involved in making APA policy are just a sample of the many areas in which the Assembly has led the way to making a difference for our patients and our psychiatrist colleagues.
In talking with APA members throughout the U.S. and Canada, however, I have learned that many have little knowledge about the work we do. I hope this column will shed light on the important work the Assembly has done-and will continue to do-on behalf of psychiatry and people with mental illnesses.
What is the Assembly?
- APA members elected by their district branches and by caucuses of minority and underrepresented groups to represent and act for individual members.
- A forum for members to deliberate and formulate policy on mental health issues that impact patients, psychiatrists, and the profession. These issues come to the Assembly from the district branches, Board of Trustees, or APA task forces, committees, and councils.
What has the Assembly accomplished?
The list below is a brief description of the range of issues that have been discussed and voted upon in the Assembly. While the topics are grouped under three headings (patients, psychiatric practitioners, and the psychiatric profession), many of them have an impact that crosses these arbitrary categories.
For Patients
- Nondiscriminatory access to health care parity
- Opposition to managed care gag clauses
- Protection of confidentiality of medical information
- Increased privacy guarantees for computer records
- Fair access to health care for uninsured persons
- Better access to clozapine, in which we pursued a strategy to reduce the costs and to remove impediments to the physicians' ability to manage and evaluate their patients for this medication
- Welfare reform, where monitoring by Assembly members led to a call for a study of the mental health effects of this reform on the lives of women, children, and families
- Medicaid reform, where we joined with the Board of Trustees in a task force to assist the states in better utilizing block grants for children's mental health
- Initiative to study the healing aspects of the physician-patient relationship
- Policy statement on the cessation of nuclear testing and the abolition of nuclear weapons
- Support for President Clinton's call to expand Medicare and endorsement of the removal of Medicare's discriminatory procedures and policies.
For Psychiatric Practitioners
- Endorsement of the establishment of APA's toll-free managed care help line
- Backing the establishment of the APA Committee on Managed Care
- Support for creation of a million-dollar APA litigation fund and plan for strategic action
- Establishment of the Commission on Psychotherapy by Psychiatrists
- Support for a moratorium on dues increases
- Reenergizing development of a strategic plan and priority setting for APA
- Enhancement of computer capacity to foster communication between the APA national office and district branches
- Expansion of codes that led to improved Medicare reimbursement
- Opposition to legislation to grant prescribing privileges to nonphysicians
- Ensuring nondiscriminatory treatment of international medical graduates.
For the Profession
- Reaffirmation of the ethical tenets governing the relationship between patient and doctor
- Improvement of recruitment and mentoring of members-in-training and recent graduates (early career psychiatrists) to help them become more involved in the profession and APA decision making
- Development of practice guidelines
- Development of the APA Practice Research Network
- Endorsement of a pilot project to build alliances with other specialties in psychiatry and with allied organizations as well as with other medical organizations
- Support for the development of certifications with special qualifications in geriatric, forensic, and addiction psychiatry
- Call for guidelines describing ethical practices in organized care systems
- Contributing to projects to develop quality and outcome measures
- Support for ERISA reform that would allow states to establish accountability and liability standards for medical care for its citizens and end the managed care industry's exemption from liability lawsuits.
As you can see, your Assembly is hard at work on issues that directly impact psychiatric practice and service delivery to patients. In addition, the Assembly has in the last year been actively involved in APA's strategic planning effort that focuses on improving our responsiveness to the district branches and enhancing fiscal accountability. We invite you to come and experience the Assembly in action during our meeting May 14 to 16. This meeting will be held in conjunction with APA's 1999 annual meeting in Washington, D.C. Take this opportunity to observe your representatives working on the issues that matter to you and your patients.
I think that you will agree that your Assembly continues to make a difference for our patients, for our members, and for the psychiatric profession.
Organizations with Assembly Liaisons
American Academy of Child and Adolescent Psychiatry
American Psychoanalytic Association
American Association for Social Psychiatry
Caucus of Family /Systems Psychiatry
American Academy of Psychiatry and the Law
Academy of Psychosomatic Medicine
American Association of Community Psychiatrists
American Association for Geriatric Psychiatry
American Academy of Clinical Psychiatrists
American Academy of Psychiatrists in Alcoholism/Addictions
American Association of Psychiatric Administrators
American Academy of Psychoanalysis
Psychiatry Special Interest Section of the American Group Psychotherapy Association.