American Psychiatric Association 2014 Elections, Moving Further On


As many of you may know, the American Psychiatric Association (APA) elections began on the first of the month and the candidates asking for our votes are leaders moving further on in the process. However, the Academy of Psychosomatic Medicine (APM) typically asks for position statements on the important issues facing APA and APM President Linda Worley, MD, FAPM asks voters:

“As you may know, APA elections for President Elect open today (see for details). You may also recall that it is Academy practice to solicit and post comments from the candidates regarding key issues impacting our lives in psychosomatic medicine, to learn their views and their anticipated leadership plans.

I am writing to let you know that we expect to be able to share these responses with you early next week; you may wish to consider waiting to vote until after you have had an opportunity to read them. Please look for a further email from me next week when these comments are ready for your review on the Academy website.”

Rather than vote today, I urge my colleagues in Psychosomatic Medicine to wait for the position statements, as Dr. Worley suggests.

And today’s post is pertinent to the APA presidential election. It’s copied from my comments on LinkedIn:

“I want to thank two of the APA candidates for President-Elect, Dr. Renee Binder and Dr. Mark Rapaport, for their comments on my discussions regarding Maintenance of Certification (MOC). I would also like to say that if it had not been for the advice and encouragement of my local Iowa Psychiatric Society President, Dr. Daniel Gillette, I probably would not have renewed my APA membership this year.

That’s partly because of the price of the MOC Psychosomatic Medicine recertification examination application fee to the American Board of Psychiatry and Neurology (ABPN). It’s $1,500. I thought very long and hard how much membership would be worth to me, given the cost of annual membership in the American Medical Association (AMA), and the other costs of maintaining my place as a physician, including but not limited to renewal of my medical license and DEA license.

It’s also partly because of my impression that APA has been largely silent on the MOC issue. MOC is controversial at best, and it seems APA tacitly endorses this overly-complicated and expensive regulatory process which has no strong evidence base for effectiveness in changing patient outcomes.

My initial reluctance to renew my APA membership has several roots, not the least of which is my frustration about MOC. Let me hasten to point out that it’s not the only issue for APA membership—but it is jugular. I think MOC, in its current form, could be a disincentive to undergraduates to enter medical school, and Maintenance of Licensure (MOL, which would essentially couple your medical license to MOC) could be a disincentive to attracting psychiatrists to practice in shortage areas. I’m from Iowa and my state is one of the shortage areas. So this is not just about my personal gripe against MOC and MOL.

The candidates encourage us to vote and vote early. I have come to the realization, albeit and admittedly quite late in my career, of the importance of voting. Many in this discussion group probably recall the failed referendum on the Performance in Practice (PIP) module of the MOC in the 2011 APA elections. It was critical of the ABPN PIP requirements currently required. 80% of the voters supported the statement.

But because only 25% of the members voted rather than the 40% needed, the referendum failed to pass. The referendum garnered a higher percentage of votes than for any of the candidates running for office.

I remember that ruefully as I looked over the position statements of each of the three candidates for President-Elect. I’m encouraging everyone to look past the campaign rhetoric and examine the level of detail and specificity with which they describe their positions and goals on the jugular issues facing APA. They are all admirable candidates and I thank them for their proposals to lead APA.

Can we ask which ones are participating in MOC? Do they hold lifetime certificates or time-limited certificates? As voters, we should ask ourselves whether this makes a difference. This is a good time to remind ourselves that leaders in the American Board of Medical Specialties (ABMS) and the Federation of State Medical Boards (FSMB) don’t all participate in MOC—yet require it from rank-and-file physicians.

I agree with what others have said about promotions of candidates on this forum. I think we can do better than endorse candidates, although I acknowledge the importance of that. We could have a substantive colloquy about the jugular issues.

It might be advisable to consider that before voting early. As a reminder, the Academy of Psychosomatic Medicine (APM) will be posting position statements from APA candidates in the next week. Rushing to vote before we’ve taken every opportunity to see what they stand for may leave us satisfied that we’ve fulfilled our duty as APA members so that we may move on to our many other duties, but at what cost?”

All three of the candidates for president have much to recommend them. They have all been leaders in their fields for many years. Take the time to learn more about them. There’s no rush to vote immediately. Again, go to link

Renee Binder, MDAnd Dr. Renee Binder, in my opinion the candidate for President-Elect with the most well-developed position statement on MOC and MOL, reiterated her experience with MOC and her position. See link Update:
Reply to Open Letter on MOC to APA Candidates – The Practical Psychosomaticist


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