2015 APA presidential candidates answer questions about practice

The five candidates for the 2015 APA presidential election answered the following two questions pertaining to the future of professional practice and the APA Practice Organization (APAPO).

  • How would you encourage membership in the APA Practice Organization?
  • What would you identify as your priorities for ensuring that psychologists will have a pivotal role, front and center, in leading and implementing health care reform?

The five candidates are (listing alphabetically):

  • Barry S. Anton, PhD
  • Kurt F. Geisinger, PhD
  • Rodney L. Lowman, PhD
  • Jeffrey J. Magnavita, PhD
  • Steven J. Reisner, PhD

To read each candidate’s reply, click on their name below.

Candidates’ statements reflect their own views and do not represent the position of APA or APAPO.

Anton

How would you encourage membership in the APA Practice Organization?

The APAPO's mission is vital to the practice community and requires sustained support as the APAPO is the only national organization that advocates solely for practicing psychologists. Expanding membership opportunities to college students, the American Psychological Association of Graduate Students (APAGS) members and early career psychologists at a reduced fee is an entré to the APAPO and the benefits of belonging to an organization that strongly advocates for practice. Providing guidance through continuing education, publications and social media in navigating the Affordable Care Act (ACA), dealing with Medicare and Medicaid reimbursement, and the new CPT® codes, is an incentive to support the APAPO. Sharing ideas at health care reform summits sponsored by state psychological associations can inform, recruit and retain psychologists into the APAPO.

APAPO membership is also an opportunity for psychologists to advocate and become state and national leaders. 

Because my proposed International Summit on Psychology and Integrated Care will showcase the valuable work that the APAPO engages in, a new membership category can be created to allow international affiliates to join the APAPO and become actively engaged. By joining, they will receive the innovative and valuable publications, advocacy strategies, and access to experts. International affiliates can contribute their ideas as active collaborators. Using webinars, social media and virtual meetings, international colleagues can contribute their perspectives on how integrated care has worked in their countries and add value to APAPO membership. 

What would you identify as your priorities for ensuring that psychologists will have a pivotal role, front and center, in leading and implementing healthcare reform?

The ACA offers psychologists leadership opportunities by demonstrating that our extensive education, training and effectiveness are part of our “value-added” traditional and innovative treatments and techniques that are essential to integrated care. The ACA is a great opportunity for psychologists to demonstrate leadership by effectively publicizing that many visits to primary care providers are mental health-related and can be effectively treated by psychologists. 

We must raise public and provider awareness of our value as change agents and demonstrate that our treatments are cost effective, valid and accessible. Psychologists have data that validates our treatment effectiveness which informs employers, educates health care administrators and the public. 

Our perceived value will benefit from wide dissemination through the APA Public Education Campaign, social media outreach, op-eds, print and media advertising and webinars. 

We must demonstrate our critical role as valuable, effective, available and flexible providers who treat mental health issues and provide interventions that improve health and wellness. Lifestyle choices, such as overeating, substance abuse, lack of exercise and stress are amenable to psychological treatments that can prevent physical illness, reduce health care costs and improve quality of life. These outcomes must be publicized to insure our inclusion in health care reform.

Current procedural terminology (CPT®) copyright 2011 American Medical Association. All Rights Reserved.
Geisinger

How would you encourage membership in the APA Practice Organization?

I have two general approaches. The first is educational. We need to inform psychologists that APAPO is the single best vehicle for federal advocacy. Furthermore, it provides exceptional support for state-level advocacy. All practicing psychologists working in health and mental health benefit from this advocacy. We must communicate to psychologists the criticality of such an advocacy presence and help psychologists to understand that without this advocacy psychologists and psychology suffer. 

Many consider advocacy the single most important activity both of APA and APAPO. To effectively communicate to psychologists about the value and importance of APAPO, we need still closer links with state associations and their members. APAPO needs a clearer governance system, with voting by its members determining its leadership. APAPO has strong relationships with the leaders of state associations and provides them support, but this relationship is not always well understood by their members. While open to other suggestions, I would like to suggest a 24/7 online webinar describing the advocacy efforts of the APAPO.

Ultimately, I think that we should consider a revised dues structure. All APAPO members should continue to be members of APA, but the costs of membership should be divided in a more equitable manner.

What would you identify as your priorities for ensuring that psychologists will have a pivotal role, front and center, in leading and implementing healthcare reform?


First, we must continue to be at the table of discussions currently held by the American Medical Association (AMA) regarding reimbursement codes. Our advocacy at that table should lead to our ability to have critical input on a vast number of issues. We need to campaign for the following:

  • To position psychologists as primary-care practitioners for mental health, health and addictions;
  • To maintain meaningful reimbursement levels for patients served under Medicare, Medicaid and ACA; 
  • To secure reimbursement for psychological services provided by interns;
  • To advocate for psychologists as experts on behavior change, treatment compliance and body-mind interface; and
  • To assist psychologists with proper training to obtain prescription privileges where appropriate. One prescription that is not often considered is the prescription for psychotherapy.
We also need to stress the importance of the doctoral degree in the health care system. The time is now for psychologists to assume center stage in treating distress and promoting health as part of the new healthcare systems. If we cannot establish fair and equitable reimbursement codes, we may need to find ways to work around the AMA, but it is always better to collaborate if possible.
Lowman

How would you encourage membership in the APA Practice Organization?

As a 501(c)(6) organization, the APAPO serves different but overlapping purposes from APA’s 501(c)(3). However, the principles for attracting and retaining members in voluntary professional membership associations are similar. Such organizations must continuously provide services of value to the members and prospective members. Thus, for psychologists to pay the APAPO Practice Assessment they must be convinced that their money is well spent and will benefit them personally. 

Reviewing APAPO’s website from the potential customer’s perspective can be instructive. After a brief description emphasizing technical IRS issues there follows a lengthy statement about making payment. Only in the third paragraph is anything substantive presented about the personal benefits of paying the assessment. 

To attract and retain members, APAPO can advocate with potential customers the importance and complexity of its mission and its successes. But despite the website’s stating that APAPO addresses the professional interests of psychologists “in a wide variety of practice settings” only a narrow range of types of psychological practice are actually discussed. APAPO could also consider what it can do to appeal to all psychology practitioners and understand that the issues differ for alternative types of psychological practice. Psychologists united around a common mission are a powerful force.

What would you identify as your priorities for ensuring that psychologists will have a pivotal role, front and center, in leading and implementing healthcare reform?

I recently wrote (APA Monitor, July/August 2013): “The Affordable Care Act (ACA) expands coverage to more middle and low income individuals, emphasizes quality of care and treatment outcomes, and prioritizes early intervention and integrated care. Psychologists need to take their rightful place as full partners in their respective areas of competence. Additionally, non-health-care psychologists are positioned to contribute to building effective interdisciplinary health care teams and organizations and in creating evidence-based organizations that are so essential to the new health care delivery system. Strong advocacy by APA is needed to assure that we are not viewed as tangential in the changes created by these new models.” Properly implemented, healthcare reform can be a boon to psychologists. 

Psychology’s health service provider training models will need to adapt to ACA-related changes to assure that our graduates will be able to practice effectively in interdisciplinary teams, to use protocol-based treatments, and to demonstrate the efficacy of their assessments and treatments. By making use of multiple areas of relevant expertise in psychology APAPO can help maximize psychology’s relevance to the ACA. Through integrating a wider range of applicable psychology expertise, APAPO can also broaden its appeal and support. Psychologists united around a common mission are a powerful force.

Magnavita

How would you encourage membership in the APA Practice Organization?

As a full-time practitioner for over 30 years, I have some ideas about how to encourage membership. The APA Practice Organization’s (APAPO) recent efforts to radically expand APAPO by offering a wide range of relevant clinical and behavioral health information on their website have been incredibly useful to me. I recommend expanding the user-friendly website with clinical tools, on-line learning, and critical briefs on important issues such as new psychotherapy codes and national policy issues. The approximately 55,000 practicing psychologist members of APA, as well as prospective members, will appreciate the services and products offered to practitioners. Making relevant and accessible information available to the practice community will support our membership and attract new members. 

The idea of advancing practice by ensuring that psychology is at the forefront of science research, in having a solid evidence-base for practice, as well as having leaders who are developing and advancing new treatment approaches, is necessary. It is essential to continue to creatively develop new methods so that we can be on the forefront in advancing both our practice and our science.

What would you identify as your priorities for ensuring that psychologists will have a pivotal role, front and center, in leading and implementing healthcare reform?

Psychologists must not resist the radical changes in healthcare that characterize our time. We must assume a leading role in implementing healthcare reform based on our knowledge of clinical science and practice. The advances in practice, science, and technology are so rapid and knowledge is accumulating at such an accelerated rate, that psychologists must embrace the change, or risk being left behind. 

In my decades of involvement with APA, I have been impressed by the intelligence, creativity, knowledge, and passion of our members for advancing the mental and behavioral health of our nation. As the newly appointed vice-chair of the Clinical Guidelines Advisory Committee, I assert that a critical mission to contribute to healthcare reform is for APA to develop, disseminate, and implement the best and most relevant clinical practice guidelines possible. By becoming the leading organization for developing and disseminating the highest quality clinical practice guidelines, we can have a powerful influence on healthcare reform. We must initiate change to ensure that the best behavioral and mental health treatment is delivered to our nation.

Reisner

How would you encourage membership in the APA Practice Organization?

APAPO must return to being an advocacy organization that psychologists would be proud to support. The current crisis in membership resulted from mistakes that led to mistrust. Many left APAPO when they discovered that voluntary contributions to the Practice Organization had been misrepresented as mandatory dues. Then, to raise revenue in the face of these defections, APAPO partnered with “Life Line Screening” to offer “specially discounted rates on preventative health screening tests that could save your life.” But these tests have been condemned by leading medical groups because, if given without justification, they result in high numbers of false positives and additional unnecessary tests and procedures. One authority asserted that recommending these tests for healthy people is unethical.

As APA president, I would push APAPO to stand for what is uniquely valuable and trustworthy about psychologists: that we don’t answer to corporate interests, we don’t think only about our wallets, and we don’t simply toe the government line. Advocacy on behalf of psychological practice is inseparable from advocacy for the needs and dignity of the people we treat. When APAPO restores its voice as the advocate for ethical, honest, transparent and compassionate psychological practice, psychologists will again recognize its importance. 

What would you identify as your priorities for ensuring that psychologists will have a pivotal role, front and center, in leading and implementing health care reform?

To be honest, I dislike jargon like “pivotal role, front and center, in leading and implementing health care reform.” Furthermore, this question is basically fanciful. If health care reform continues along its current path toward integrated, homogenized, and manualized care, corporations will profit and practitioners will suffer or be replaced by the lowest-cost alternatives. Responding with ‘pep-talk’ language rather than with substantive alternatives simply undermines what truly empowers us: our genuinely authoritative collective voice combined with the hard-won public trust. 

If we add courageous leadership alongside these two qualities, then APAPO can be well positioned to advocate for a truly representative and egalitarian health care system, one that promotes human dignity and well-being over profits, and person-centered treatment over symptom-focused treatment. To attain these goals, we must challenge the current health care zeitgeist that claims to combat rising costs when in fact it is commodifying suffering, increasing consumer debt, and eliminating practitioners as a source of overseeing individual health and well-being. I believe psychology’s future lies in a transformative system of universal health care available to all, where skilled, humane and well-trained individuals — independent of corporate or government pressures — work for the good of all. For more on these and other issues, visit the Reisner for President webpage.