Imagine a first year candidate. We'll place her at a medium-size institute. In October APsaA sends her an offer for a great deal—free membership for her first year as an Affiliate. She accepts, and is now a member. Now let's imagine her professional needs over the course of, oh, a 35-year career as a psychoanalyst. And let's imagine her reciprocal relationship with APsaA, the only national professional organization she belongs to for the course of her professional life. She is a life-long member and it is the Association's purpose and obligation to meet her professional needs as best it can. So what are those needs? How can the Association best meet them? How can we thoughtfully plan to meet them better over the long haul?
Before we take a closer look at members' needs, let's consider who we are, APsaA's 3,000 plus members. We practice an arcane profession. The vast majority of us work alone. We usually lack any experience working in teams, competing for jobs, hiring and firing, going on company picnics, getting Christmas bonuses or even salaries. Most of us are small business people, micro business really, with an employee roster of one, and 100 percent of responsibility for everything from producing the product to leasing office space, ordering supplies, keeping the books, and purchasing services from accountants, lawyers, and utilities.
We sit all day, and often hunch over the computer at night. We usually serve as our own IT department and type our own letters. We are our own marketers and advertisements. We make a decent income as long as we keep working, but generally our income flattens out early in our careers. We don't have paid sick leave or vacation days. Increasingly, we may have an ever harder time securing health insurance.
With this sketch in the background, I would like to review various categories of member needs and assess how we're doing at meeting them. Where there are significant shortfalls, I'll pose questions. I hope you will have the answers, which will lead to new programs and solutions.
Members need thriving practices requiring marketing, advertising, and self-promotion.
Our practice surveys have taught us that most analysts have about one or two psychoanalytic patients at a time. This is not necessarily a terrible thing. Most of us use our psychoanalytic knowledge and technique with every patient, even those that see us infrequently. Nevertheless, we often wish we had more patients in analysis. Many of us have observed that though the mean number of analytic patients is low, there are a small but identifiable group of colleagues that have very busy analytic practices. The other APsaA officers and I have been talking about tapping into this cohort to see if they can teach the rest of us something. You will hear more about plans to address practice development over the next year.
I would like to review various categories of member needs and assess how we're doing at meeting them. Where there are significant shortfalls, I'll pose questions. I hope you will have the answers, which will lead to new programs and solutions.
Members need intellectual stimulation and continuing education.
I think we do a pretty good job in this area, with JAPA, our scientific programs, TAP, and local scientific meetings. We have good relationships with other psychoanalytic groups that also offer services that meet this need. I personally would like to have the opportunity to attend updates in psychopharmacology and psychiatric diagnosis at our annual meetings, since I don't have the time to attend non-psychoanalytic professional meetings. I am curious to see if any other members see this as a need.
Members need facilities and equipment to conduct their practices.
Couches, stationery, computers; we don't require much. But I'd like to hear from members about any specific questions you have. Do you want your national organization to help you “shop” for the best couches, ergonomic chairs, hardware, and billing programs?
Members need to manage their practices efficiently and prudently.
Practical matters of record keeping, dealing with third parties, billing and collections can be done well and properly or haphazardly, leading to a smoothly running business or stress and frustration. We have started to provide brief articles on these kinds of topics in the Practice Toolbox section of the Members section of the APsaA Web site. I hope you've visited it at . We already have articles on opting out of Medicare (if you wish), writing a professional will, obtaining a national provider identification number, and more. Our elegant, thorough, and invaluable “Practice Guidelines,” published by the Committee on Peer Review, provide a deeper look at complex practice issues such as:
Charting Psychoanalysis,
Interacting with Third Parties, and
Psychoanalytic Clinical Assessment.
The complete “Practice Guidelines” have been collected and can be found at .
Prudence L. Gourguechon, M.D., is president of the American Psychoanalytic Association.
Members need assistance with occupational stress and health issues.
How does your back feel after 20 years of practice, sitting in a chair craning your neck forward? After 35 years? What are the effects of stress on our coronaries, blood pressure, immune systems? How many of us quietly suffer a mild degree of work-related secondary PTSD? How many of us with chronic illness or personal loss struggle silently with the impact on our professional lives? Is there anything realistically that APsaA can do to help with these issues?
Members need opportunities for affiliation and collegiality.
Concern about this issue seems to have been the root of the distress expressed recently over the possibility that our spring meetings, losing almost $200,000 per year, might not survive. If it does prove to be necessary to drop the annual spring meeting, what can we find to replace it at a less disastrous financial cost? Regional meetings, topical, and/or research meetings? Our work life is isolated, team-less, and sometimes friendless. How can local, national, and international organizations best (and financially prudently) meet members' needs for affiliation and collegiality?
Members need information.
As in all professions, members need a constant supply of information—about practice, theory, research, the basic body of knowledge of the profession, and the way it links to other fields of thought. I think we do a pretty good job in this arena but there is a constant need to maintain and improve quality and widen the scope of focus. Our committees are exploring new communications methods, with increased and more sophisticated use of the Internet. Survey Monkey, podcasts, social networking sites, Wikipedia, and other knowledge sites and services all offer promising dividends in our ability to manage and share information.
We are left with a great number of questions about how to better meet members' needs. Together with the rest of the Executive Committee and the staff, I want to construct an e-mail questionnaire to send you by early spring to help obtain answers to some of the questions posed. The data from the Members Needs survey will tell us what directions to take in improving old services and inventing new ones. The basic question is this: What do you, APsaA's member, need over the course of your entire career, and how can we meet those needs?