I hope you will enjoy reading through the preliminary program of APA’s 2000 annual meeting as much as I have. You are aware that "The Doctor-Patient Relationship" is the theme for the meeting. I chose this theme because of the centrality of our therapeutic relationships with patients to all of our work, to assure that the future practice of psychiatry integrates the best of our humanistic traditions with the latest scientific advances, and to emphasize this timeless core of psychiatry.

We all know the relationship with our patients provides the context for all our therapeutic interventions. The last century has been marked by tremendous advances in our understanding of the importance of this unique relationship to the process of treatment and recovery from illness. Our ability to foster the skills necessary to observe, understand, and maintain a therapeutic partnership with our patients has been aided by the expansion of our knowledge from clinical research, combined with clinical wisdom.

The enduring centrality of our therapeutic relationships is obvious to every clinician and patient. In recent years, however, we all know that restrictive managed care practices, and government and industry interference with the privacy of communication with patients and the confidentiality of medical records, have impinged significantly on the sanctity of our relationships with patients. Changes in medical and psychiatric education also have understandably focused more curriculum time on technological and scientific advances, but at the expense of attention to our role as healers.

The beginning of the new millennium is an extraordinary time to refocus our attention on the timeless importance of our relationship with our patients. This focus is essential to assure that the future practice of psychiatry integrates the best of our humanistic traditions with the latest scientific advances. We are dedicated to enhancing all aspects of the doctor-patient relationship: in psychiatric and medical education, research, treatment, ethics, the expanding importance of the patients’ rights and patients’ advocacy movement, and our use of public education and government relations to enhance and preserve this central and essential aspect of our therapeutic role.

Our annual meeting this May will focus on all these aspects of the doctor-patient relationship. I especially hope that you plan now to make time on your schedule for the Presidential Symposium, which will cover aspects of the doctor-patient relationship. This year’s presidential symposium will be held on Monday, May 14, at 2 p.m.

I don’t share the opinion of those who feel that delivery system changes are going to make it impossible for psychiatrists to continue to provide psychotherapy to anyone other than those who might be willing to pay out of pocket. In fact, research findings in the area of neural plasticity and brain-cell generation, with clear evidence that developmental experience alters brain structure and function, definitely reinforce the view that a biopsychosocial model for understanding and intervention should lead to optimal outcomes. Thus, our ability to establish and maintain a therapeutic relationship and to use psychotherapeutic skills, no matter what the treatment intervention, will continue to be essential for optimal treatment. We must redouble our efforts to ensure that APA remains a strong advocate for educational programs that continue to train the next generation in the skillful understanding and use of the doctor-patient relationship in our therapeutic endeavors.

The advances in electronic communication and information technology pose important opportunities and challenges for psychiatrists as we contemplate the future of our profession and the nature of doctor-patient relationships in the information age. We know that the way this technology will influence psychiatry will continue to unfold, but it is already clear that control of such technology will likely become one of the most critical societal decisions of the information age.

We have an unparalleled set of opportunities and concerns to address as information technology and psychiatry intersect, and there is tremendous excitement as we explore meaningful ways of using this technology in our research, education, and clinical missions. But we must remain vigilant about the uses of this potent technology. Our profession of psychiatry, placed in the role of arbiter of sanity and reality, both by virtue of our training and by societal sanction, must face the challenge of preserving the human and humane aspects of care within an increasingly mechanistic world. This makes the need to continue to focus our attention on the role of the doctor-patient relationship of critical importance. And, this task will become of more and more central importance as our world undergoes the continuous changes brought about by further evolution of the information age.

I am excited that this year’s annual meeting occurs following the 1999 White House Conference on Mental Health and the 1999 release of the first Report of the Surgeon General on Mental Health. These are clear indicators that there is increased public awareness of the importance of good mental health to good general health. It is an opportune time to increase our public education and advocacy efforts to further decrease the stigmatization and unfair discrimination directed toward those with psychiatric illness, their families, and their caregivers. Of the many important messages of the White House conference and the Surgeon General’s report, none is more important than the clear recognition that good psychiatric care can occur only within the context of a stable and meaningful doctor-patient relationship.

Show your commitment to your patients by planning now to attend APA’s annual meeting in Chicago. Many sessions will highlight aspects of the doctor-patient relationship, and I have no doubt that this will be one of the most exciting APA annual meetings ever.

I look forward to seeing you this May in Chicago.