It Is a Pleasure to Welcome You to My Website!

It is a great honor and privilege to be a candidate for President-Elect of our Association, and I appreciate your taking the time to visit this site. Here you will find all of my campaign postings to the openlist and the electionlist as well as the regular mail letters I sent to each member of APsaA. I have highlighted here my positions on ten very important issues about bringing psychoanalysis into an even more rewarding future.

• Our Politics of Old Are Inadequate, 11/19, 9/30, 8/12


• Certification/TA Link, Goals, Letter 2, 9/21


• Less Central Regulation, Goals, Letter 2, 11/13


• Strengthening Executive Council, Goals, Letter 2


• Development, Goals, Letter 2, 11/15


• Do We Become an Incubator or a Museum?, 11/2


• Transparency, 11/2, 9/9


• Diversity, 10/10


• My Background and Track Record, Letter 1, Biography, 8/21


• Advocacy, Goals, Letter 2

Medicare Reimbursement Reductions

Dear Colleagues,

I hope all of you had a very happy Thanksgiving holiday.

Many thanks to Jon Rosenfeld for bringing the Medicare fee schedule cuts to our attention. I reviewed the reimbursement rates for the LA area and found decreases ranging from 6-13% for the services Jon referenced, similar to his findings for Manhattan. I echo Jon’s plea to all of us to immediately contact members of the Senate Finance Committee in an effort to reverse these cuts.

For now there are three points I’d like to make regarding this issue and I will be brief.

First, I think it goes without saying that we need to keep our seats at the appropriate third party reimbursement negotiating tables. We must remain vigorous in our advocacy efforts for the benefit of both psychodynamic psychotherapy and psychoanalysis as treatment modalities. Many of our colleagues work in these systems and these are pathways for many who need our assistance.

Second, we must also fight for parity of reimbursement among all psychoanalytic practitioners. After reading Lori Post’s note I looked again at the reimbursement rates in LA and discovered that Social Workers are reimbursed at a rate about 25% less than that of psychiatrists for the same services. This is not acceptable and we must attempt to correct this. Psychologists, at least in the Medicare system in LA, are reimbursed at rates similar to physicians.

Third, given the major secular changes occurring in the insurance industry, changes such as; ever declining treatment dollars, ever increasing and more stringent utilization review procedures, and ever fewer units of service provided, we must continue to look for other ways to support psychoanalytic treatment among potential analysands. One small example is that we need to direct the results of our efficacy studies not only towards potential third party reimbursers but also towards members of the public who need our services.

We also need to keep in mind that some of our members wish to work entirely outside of these third party systems and they need to be assured of appropriate confidentiality protections. We must support them as well.

My background has given me the skills to deal with issues such as these. I am a longstanding member of our Committee on Government Relations and Insurance (CGRI) as well as its former Chair (97-00). While Chair I participated in direct discussions with national level Medicare officials including the national Medical Director. As Treasurer for the past five years I have vigorously advocated that we provide CGRI with as much financial support as our budget allows.

You can count on me to put my energies and experience as well as our organizational resources behind efforts such as these.

Warren R. Procci, Candidate for President-Elect, APsaA

Our Diversity: Openness, Honesty and Reconciliation

Dear Colleagues,

Our organization has moved well beyond the rancor that accompanied the lawsuit which permitted psychologists (and, ultimately, social workers) the freedom to train at APsaA institutes. I am proud of this fact, but disturbed by what I have heard from some of you during this campaign via phone calls and emails.

It is perplexing to me that some members, perhaps many, do not feel fully accepted as equal partners in our organization. Some social workers and psychologists, as well as some of our CORST colleagues, have felt they receive fewer analytic case referrals than their medical colleagues. Others have felt excluded from key committee assignments. Some have felt they were not ‘tapped’ for TA/SA roles at ratios comparable to their medical colleagues. And a number of our social work members have pointed, with some pain, to the fact that a few of our institutes still do not accept licensed social workers for training.

We can add to this the residual animus felt by our mental health colleagues who have not trained at our institutes. Just a few years ago, our expensive market research revealed a strong reluctance by these colleagues to refer patients to us, even and especially those patients who could profit from analysis.

Of course, no organization is without unhappy members, and perhaps these problems are not widespread. To some they may even seem like old news. But those of us who would be elected to our highest office have a special and unremitting responsibility to resolve any and all problems that arise from our organizational struggles with change and diversity. Here are three ways I believe we can catalyze this important process:

First, we must, as an organization, openly and non-defensively acknowledge the errors of our history and the hurt our exclusionary policies have caused.

Second, we must initiate a forum (and a concomitant task force) to explore, discuss, and report on the issues and conflicts that our diverse backgrounds and training may still engender.

Third, we must reach out humbly and respectfully to the psychoanalytic arms of all major psychology and social work organizations, as well as to psychoanalytically-interested academic groups from the humanities and sciences to explore and pursue together areas of common interest and concern.

Some would prefer that we sweep these issues under the carpet. Others would say we are doing the best that we can, or that we must move slowly. And others, sadly, proclaim when these issues are addressed, as I have been addressing them, that it just creates further conflict and hostility. What kind of psychoanalytic attitude is that?!

We must not be afraid to face the errors of our ways, to pursue unhesitatingly our goals of equality and openness, nor especially to work assiduously to resolve the problems and concerns of our many and varied members. With open eyes and honest debate, I think we can continue to be proud of our organization and help it evolve into the larger umbrella of diverse and creative people and ideas that is its full potential.

Please let me know if you would like to discuss these issues further.

Sincerely,
Warren R. Procci, Candidate, President-Elect, APsaA

We Must Deal with the Real World

Dear Colleagues,

Sunday’s very pertinent article about psychoanalysis in the New York Times
Week in Review section has led to several notes on our member’s list. All of these postings strongly suggest the need for us to be far more actively involved in very real world issues such as: demonstrating the validity of our ideas, validating the utility of our treatment, and working together with other colleagues in the academic, psychoanalytic and mental health communities. I completely agree with those sentiments and I have expressed that view any number of times in the past and during this campaign.

Unfortunately there has for many years now been a major impediment to our ability to turn our eyes towards these outside communities, namely the continuing divisiveness of our struggles over the current centrally mandated link between certification and TA status. I have consistently stated that we need to solve this dilemma so we can finally move on to deal with the kinds of crucial problems facing psychoanalysis as described in the NY Times article and the responses to it.

Since this will be one of the last times I will get to write to you prior to the mailing of ballots next Monday I’d like to reiterate my position on this issue. I believe that certification in its current form, at least as an absolute prerequisite for TA appointment, must be laid to rest. Period! It has caused too many hurt feelings, raised too many questions about reliability and validity, and has simply been the source of far too much organizational ill feeling and stasis to continue in this form. Attempts to rehabilitate or resurrect mandatory certification for TA appointment in some externalized facsimile or by means of “alternative” requirements which reproduce all the same problems under a new guise will only perpetuate our problems and lead to way too much additional organization demoralization, thus setting us back ever so much more.

Here are a few recent facts which support this. First, two years ago, in a record turnout, a strong majority of 57% of the members of APsaA voted against maintaining BOPS’s ability to require certification for TA appointments. Let me repeat this for emphasis, 57% voted against our current system. While this wasn’t a sufficient vote to enable the proposed bylaw amendment to pass anyone can see the organizational peril of attempting to maintain a very key procedure which is opposed by a robust majority of the membership.

Second, in a survey concerning certification conducted by the Association about five years ago there was already strong opposition expressed to any external certification process, and a mere 50%, consisting predominantly of those already certified, supported having any kind of a certification process within APsaA. Any of you who are interested can request a copy of the results of this survey. I recommend you do so.

Third, the current process must be considered a “market failure”. Our recent graduates are voting “with their feet” on the issue of certification and their feet are indicating a very decided “no” vote. It appears that only about 15-20% of these colleagues are choosing to pursue this process at all.

Should we continue to put so much organizational support behind a process that such a paltry fraction of our graduates now finds sufficiently meaningful to take seriously? I think not.

I have made clear my stance on this issue throughout this campaign and I have reiterated it here for all of you as we prepare to receive our ballots.

Warren Procci, Candidate for President-Elect of APsaA