Here is our challenge: Health Care as a Trillion Dollar Industry is running amok, creating obscene profits for managed care organizations and their executives while we are reduced to "providers", trivializing the decades of education and training we have invested and violating our ethics and ideals. The de facto rationing through cost management has now spread to the public sector, leaving exposed our most vulnerable patients and their families including children and minorities. Under these conditions, many of us get disillusioned, become disinterested and view our APA as yet another big business with a $31 million budget, heavy in bureaucracy but aloof, distant and unresponsive to the individual member's plight. Why pay almost $1,000 in combined local and APA dues when one can hardly pay debts, mortgage, malpractice and the kids' tuition?

My answer is that we are fighting for survival. The enemy is not us nor APA. If ever we needed APA, it certainly is NOW. We must stay UNITED and avoid fragmentation and infighting.

In my many years of service as your representative in APA, I have worked with others for change and for solutions to difficult problems in ethics and legislative and public affairs, always being guided by the need to preserve the fundamentals of our identity and integrity. Our APA stands for all I am committed to:

preserve the doctor-patient relationship as the core of all medical healing

safeguard patient confidentiality and insure patient privacy

ensure the freedom of patients to contract with the psychiatrist of their choice outside any system of care

ensure universal coverage with real full parity

insist on realistic payment rates for psychiatric care in all systems of care

ensure ethical and scientific national standards of care

ensure public accountability of corporate systems as to the quality of care they provide

require full public disclosure of executive compensation and profits

ensure high standards of training of psychiatrists

prevent the discrimination of IMG's in all settings

work for the integration of neuroscience and psychotherapy

provide expanded research into the causes and treatment of mental disorder

place a high priority on the psychiatric needs of children and minorities and address the psychiatric aspects of domestic violence and racism.

I am proud of my record. Members who have been close observers of my work view me as effective and constructive. During my years on the APA Board, I worked on Phase One (the transition to the new medical director) of APA restructuring. No fundamental APA restructuring could ever be implemented without Phase One because the bulk of our budget is in our central office. Decades of sustained membership growth and innovative expansion into publishing, into standards-setting for our profession and into excellence in legislative and public advocacy for our patients and their families have left us with the clear imperative for fundamental central office and member-leadership restructuring to meet the reality of a shrinking membership base and severe economic hardship for members in this turbulent and greedy health care environment.

As your treasurer during Phase Two of APA restructuring, I will:

provide watchdog skills, ensure fairness, promote member representation and guard fiduciary integrity throughout the restructuring process

demand accountability through performance standards

ensure continued openness of APA finances

work to achieve maximum efficiency and cost reduction through integration along needs/priorities that are consistent with our mission

avoid blind, ax-wielding downsizing

expand APA's ability to fund operations from nondues income

make dues reduction a stated goal of APA restructuring

work for a dues-sharing formula that will reflect APA's close intraprofessional coordination within our psychiatric subspecialty organizations and the AMA

ensure that dues-setting considers members' income variations

ensure the best possible investment strategy to maximize gains for our $18 million in liquid assets while preserving capital

support our office staff through the restructuring process

educate our members about APA's finance

In the meantime, dear colleagues, dues should be frozen at current levels, and Phase Two should be completed in four years.

I'm deeply honored with the nomination, ready to serve you with energy, persistence and devotion. I actively seek your support to preserve our profession and build our future