August 6, 1999

This has been a busy summer for the APA Board of Trustees.

The annual Board retreat, held in June, focused on the theme "Leading Through Change." At the retreat, the Board reaffirmed its commitment to aggressive advocacy for our colleagues and patients and to the continued transformation of APA into an activist, proactive organization.

At the Board's meeting last month in Washington, D.C., several actions were supported that are of great importance to our members. The most important action was to provide APA support for the class-action antitrust lawsuit, Russell Holstein, Ph.D., et al. v. Green Spring Health Services, et al. This suit, originally filed in May 1998, involves nine large managed care organizations and is currently pending in federal court. The class of plaintiffs includes all psychiatrists, psychologists, and social workers who provide mental health care for patients covered by one of these companies.

As you can imagine, the managed care companies are vigorously defending the lawsuit. Recently, the attorney who filed the suit was successful in defending against a motion filed by the companies to dismiss the suit prior to discovery. The discovery process will now proceed, and it is anticipated that if there is a trial, it will begin in late 2000 or early 2001.

The Board of Trustees voted with unanimity and enthusiasm to provide APA support for this suit. We authorized the immediate release of $10,000 to the attorney who is prosecuting the suit, and we will also begin to take these steps:

• Develop guidelines by which the Board of Trustees will consider additional financial support of the lawsuit.


• Assist in identifying and approaching psychiatrists best suited to serve as experts regarding the clinical matters at issue in the lawsuit, for example, the efficacy and cost-effectiveness of psychotherapy treatments.


• Identify individuals with specific clinical, economic, and statistical expertise to serve as expert witnesses for the plaintiffs.


• Publicize the lawsuit and APA's support through stories in Psychiatric News, APA's Web site, district branch newsletters, and other media outlets.


• Discuss the lawsuit with other professional associations whose members are included in the plaintiff class and educate them about the suit.

The Board of Trustees will further review this issue at its September meeting and discuss possible other ways of supporting the lawsuit.

There were other significant decisions made at the July Board meeting. Of major importance to our members, we had an extensive discussion of our budget process and the goal of providing more support for member priorities. We agreed to direct the Budget Committee to present options to the Board at its October meeting, when much discussion of next year's budget will take place, on ways to direct significantly more resources to programs in three areas: (1) advocacy in the public policy arena, including government relations, public affairs, and initiatives to business and industry, with particular emphasis on support of activities at the state and local levels; (2) improving our communications infrastructure, especially electronic communications; and (3), most important, redirecting resources to further support district branch initiatives and programs that will provide more value for the dues each member pays.

I expect that, based on the Board's direction to the Budget Committee and on the September report of our ad hoc work group to study dues, the Board's October decisions regarding APA's 2000 budget will be marked by enthusiastic and unified support for major reallocations of funds and new support for programs in the areas I have just described.

Another significant action from the July Board meeting was agreement to support a major move by APA to enter the rapidly expanding Internet-based patient information business. APA, the AMA, and several other medical specialty societies are moving rapidly to establish, in collaboration with Healtheon, a major Internet medical information provider, a society-owned Web site. We have reliable survey data indicating that of the tens of millions of Web searches conducted each month for health-related data, more than half seek information on mental health problems.

The opportunity to become one of the founding owners of a multispecialty Web site offers the ability to ensure that we can control the quality and content of information the public receives. Further, because the site will be cosponsored by other medical societies, it will likely be viewed as the authoritative source for health information. Also, the collaboration with medical colleagues will allow for better integration of mental health and general health information in a way that has never before been possible.

I will keep you updated on how our Web and other electronic communication initiatives are progressing as further developments occur. There will also be number of major discussions and actions by the Board of Trustees over the next six months. We will be discussing a new series of initiatives to educate and collaborate with the business community regarding parity coverage for all psychiatric illnesses, including alcoholism and substance abuse; further consolidation of our publishing enterprises; significant reorganization and expansion of our public policy and advocacy initiatives; resource reallocation; and new strategies and programs to further support members at the local level. The Board of Trustees is often criticized for inaction on issues of major importance to our member colleagues. This year, we are united in our resolve to reverse that perception.