APA Election: Board of Trustees, Area III
Nominated Sept. 2009 for upcoming election, American Psychiatric Association Board of Trustees
Candidate for Area III Trustee
(representing PA, NJ, DE, MD, and the Washington Psychiatric Society)
- Change is urgently needed in our APA Board of Trustees. Recent BOT decisions drastically slashing the Components greatly reduce the number of members able to participate in the life of our Association. We need inclusiveness again. Meeting short-term budget shortfalls by taking a meat-axe to the components, the Assembly budget, as well as by cutting area representation on the Board itself-- all these recent acts of the BOT will lead to a small, poor, weak organization with a few elites at the top.
- We need to give the APA back to the members. If you elect me to the Board of Trustees, I will dedicate myself to this task.
- Our APA needs to move toward a rational relation with the pharmaceutical industry, rethinking the interests of our patients and our profession, and reestablishing an adequate flow of money from industry to psychiatry. APA needs to be neither "drug dependent" nor avoidant of a healthy, mutually rewarding, strong relationship with this crucial industry. Too much of APA's recent behavior seems founded on "avoiding sin" and maintaining an illusion of purity, or on trying to appease critics in Congress and elsewhere who have their own agendas.
- There have been terrible abuses:research projects perverted from honest science to a mendacious marketing device when industry "support" leads to distortion of data; ghost-written papers in journals; colleagues paid by a company giving a tilted spiel for one drug at a dinner meeting, rather than (as happened in the past) offering a balanced, reasonably fair view of treatment options for a particular condition.
- I think we are strong and smart enough to think our way through to a new policy which will maintain our integrity as practitioners of the science and art of psychiatry while working with Pharma and its resources.
- An experience from my prior APA service convinces me that we can develop the know-how to deal with Pharma with strength and fidelity to our principles. In the 1980s I served on the APA Committee on Advertising. We had standards for industry ads in all APA publications; the staff monitored the proposed ads. Then the committee demanded changes, or prevented publication, in cases where an industry submission did not meet our standards for accuracy, fidelity to evidence and current science, as well as for taste. There were some cliff-hanging battles, but the result was good, honest, and fair ads in APA publications. And a continuing, constructive relationship with Pharma. This committee, I'm told, still functions well along the same lines.
- Let’s recast our relation to industry while using needed funds appropriately to benefit psychiatry. We can do it!
- Respecting the real honor which this nomination means, I ask you to elect me so that I can work hard for you to implement these needed reforms on the Board of Trustees.
---Brian Crowley, M.D., D.L.F.A.P.A.
Statement to APA Colleagues in New Jersey, Dec. 2, 2009:
I welcome this chance to tell my New Jersey colleagues why I’m running hard to be your next Area III Trustee of our APA.
While largely in private practice in the DC area for 46 years, I’ve always also held part-time jobs-- for the last 15 years seeing soldiers returning from combat zones at Walter Reed. I’ve been president of the Washington Psychiatric Society, currently chair the WPS Ethics Committee, and Just completed ten years of service on the APA Council on Psychiatry and Law.
My medical school was Yale, I trained in psychiatry and psychoanalysis in Washington, served in the Navy Medical Corps a couple of years, and am active in the private practice of forensic psychiatry, mostly civil cases.
Recent decisions by the Board of Trustees (BOT) of APA have included marked reduction in the Components, slashing the budget for the Assembly, laying off staff, and a general meat-axe approach to human cost items. Falling revenues, especially from advertising and industry, are cited as justification. These acts have markedly reduced the number of members (including new and minority members) able to participate in the life of our Association and move up. Current trends will in my view lead to a small, weakened, poorer APA ruled by a few at the top of the BOT.
We need inclusiveness again. We need to roll back these recent actions. Let’s give the APA back to the members.
To address temporary budget shortfalls – when DSM V is published revenue will again peak— we need to seek new revenue streams, and rethink our relationship to the pharmaceutical industry. In our effort to end real abuses, we have thrown the baby out with the bathwater. It is unnecessary to end all industry-sponsored symposia, support for legitimate CME programs, to make psychiatrists feel that accepting medication samples to give patients in need is somehow an unethical crime.
Let’s recast our relationship to industry using our personal strengths and fidelity to principles, not a pathological black-and-white moralizing. Let’s recreate a constructive working relationship with Pharma and its financial resources for the benefit of our patients.
Respecting the honor of your nomination, I ask you to elect me so I can work with others to create a new direction for our APA.
To all Area III Members January 14, 2010
First, my warm appreciation to those who’ve responded with enthusiasm and offers to help in this campaign to “give the APA back to the members.”
And I also thank those who’ve written or called with questions, debate, and thoughtful ideas. I even have a warm spot for the few who’ve said they can’t go with my ideas for reform, or said go away and don’t bother me further.
I first joined APA in 1962 and was proud when I reached the rank of Distinguished Life Fellow in 2003. Most of those years I was happy with our Association.
Lately I’ve been very troubled by the direction in which the Board of Trustees is taking us.
- The meat-axe decimation of the Components, the Assembly budget, and the laying off of staff;
- The shrinking of the organization, especially its main resource, human;
- Thereby making it harder for new, young, and minority members to participate in the life of our Association, and move up;
- The black-and-white pathological thinking which has led to an irrational separation from useful relations with the pharmaceutical industry;
- The resultant move to what I believe will be a smaller, weaker, poorer APA, able to do less, and headed by a few elite folks at the top, on the BOT. They can busy themselves by rearranging the deck chairs. And by more statements of how much they are doing for the rest of us.
So many are joining in this genteel revolution to help the BOT correct course.
For the next few weeks, until Feb. 5, we need to get out the vote. Over 60% of
APA voters do not vote, even in a large-turnout year. If you can reach a few each, we can win this election.
The prior campaign statements may be read at my website, https://www.briancrowleymd.com/.
Thank you yet again, and finest regards.
Brian Crowley, M.D., D.L.F.A.P.A.
February 18, 2010