From the Editor

This quarter, I decided to run a guest Editor’s Column written by our Council Representative, Stanley Graham. Stanley is a private practitioner in New York and has been both APA and Division 42 president.

Stanley writes about a topic that was very much on our minds at the recent Division 42 Board of Directors retreat held in February in New Orleans. We spent nearly three days discussing the ideas that Stanley describes below. Since that meeting, I have been thinking about how to convey this important discussion to our membership. Because Stanley said it so well, I decided to lend him the editor’s column.

Stanley’s title is written in irony: Do we want our Division to be merely a smaller version of the larger APA, with all its baggage and diffusion of energy, or do we want our Division to be a strong, focused voice for Independent Practice? Do we want to use the Division’s resources for a wide range of activities, similar to those carried out by APA, or do we want a sharp, practitioner focus and commensurate expenditure of our resources? Stanley says it well…

Note: C-3 and C-6 refer to sections of the tax code. Both C-3 and C-6 organizations are non-profit. The former exist primarily to serve the common good and are exemplified by the APA, a C-3 organization. The latter, the C-6, has more leeway to promote guild interests and is permitted to engage in certain kinds of political contributing. The new APA Practice Organization is a C-6 organization.

The Little APA
Stanley R. Graham, Ph.D.

When we started the Division of Independent Practice a couple of decades ago the purpose was quite simple. We opted to protect and advance the lot of those of us who practice independently. It has been a long and difficult process. We have had some success and a good deal of frustration. The advent of the practice directorate has been a great help and the recent development of the C-6 organization is an excellent move that allows practice to compete with the special interests that control and exploit us (i.e., the managed care companies and insurance industries, etc.)

The Division itself has made a great mark in APA, filling the Board of Directors with Practice members (eight presidents of APA) and a score of members on APA Boards and Committees. And we have helped the state associations, which are largely invested in practice issues, become players in APA matters.

However, because of our C-3 status we have not been able to contribute to the political and legal battles that determine the viability of our practices. We have become like the man who lost an expensive ring in the dark bushes and prefers to look for it under the street light many feet away. Thus we can see very well what we are doing but we have strayed from our goal.

The Division manages to spend more than 250,000 dollars a year but can not spend any money directly to influence the legislatures who participate in the lawsuits that challenge the incursions of managed care. We have a rainy day fund of about 300,000 dollars that has existed for many years. If this is not a rainy day, must we wait for Noah’s flood?

The sickness of our profession is reflected in the fact that less than three percent of our people participate in political giving, and two thirds of these are older men, many of whom are planning to leave practice shortly.

The solutions offered i.e., reduced the dues, created a section of members without licenses, become a little APA serving academic, social, educational and incidentally practice issues, merely served to take us deeper into the bushes.

We must create a Division 42 C-6 organization and direct the members cash flow away from our benign services ( How do we manage to spend more than $250,000 without directly attacking managed care?). We do not need to emulate APA’s elaborate committee structure. We need to make that $250,000 and that $300,000 of savings available for major lawsuits against the managed care companies and political activities in the legislatures to advance the course of practice.

There has been some comment relative to the concept that practice has become quite diffuse and that independent practice is no longer the way to go. This is based on the idea that the psychologists can no longer work the way they used to work in a dynamic, analytic, one-on-one treatment modality. I am not sure that is true but, however that psychologist works, he or she should not have to split the fee with unmanageable managed care. Our practices should not be controlled by clerks who operate from manuals created by business people who are only interested in expanding their own profits. Whether I do neuropsychology, business consultation, psychopharmacology or any form of application of psychological science and principles, I want Division 42 to represent me forcefully.

Div 42 needs some reconstructive surgery and a sharpening of our goals and purposes. It does not need multiple committees, and it certainly should not be giving up its leadership in the fight to save and preserve our practices. Don’t change the name, change the game for it is ours to win.

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