Recently returning from the 2025 Annual Meeting of the American Medical Association (AMA) in Chicago this summer, I can’t help but reflect on the journey that led me there. I serve in the AMA House of Delegates as the inaugural representative from the Academy of Consultation-Liaison Psychiatry (ACLP) (along with our alternate delegate Anna Dickerman, M.D.) in part due to the early groundwork laid by our 2018 ACLP President, Rebecca Brendel, M.D., J.D. (later an APA president, 2022-23).

I was appointed by the ACLP leadership in the fall of 2020 to begin the process of House of Delegates membership. It starts with three years of provisional status which allows participation in some aspects of the Annual Meeting, and after several strict criteria are met, culminates in full membership. One of the areas of participation is attendance in the Section Council on Psychiatry. It consists of delegates from APA and the American Academy of Child and Adolescent Psychiatrists (AACAP) (section sponsor and co-sponsor) as well as the American Academy of Psychiatry and the Law (AAPL) and the American Association for Geriatric Psychiatry (AAGP).

With the elevation to full membership of both the American Academy of Addiction Psychiatry in 2023 and the ACLP in 2024, all major psychiatric subspecialties were finally represented in the Section Council and in the AMA House of Delegates for the first time in its history! This feat was not accomplished overnight. In fact, it was the product of a strategic plan laid down more than two decades ago.

In 1996, I was an APA/Glaxo-Wellcome Fellow (the forerunner to the current APA/APAF Leadership Fellows) and a non-voting member of the Joint Reference Committee, blissfully unaware of the initiative unfolding around me. That year, Harold Eist, M.D., then president of the APA, asked Joe English, M.D. (APA president 1992) to attend the AMA Annual Meeting in Chicago as the sole APA representative to the House of Delegates. At that time, the AMA was essentially a federation of state representatives with a small number of specialty organization representatives in attendance. A review of the proceedings from 1996 reveal that other psychiatric specialists were also in attendance. Devoted to advocating for access to quality care for our patients, Dr. Eist recognized the critical need for the APA to have a presence in the policy making body of the largest, and arguably the most influential, medical association in the nation.

Four years later, following intense lobbying by specialty societies including the APA, the AMA modified the structure and composition of the House of Delegates resulting in a more balanced membership of representatives from specialty organizations, state medical societies, and federal services (e.g., Public Health Service). This immediately expanded diversity with greater numbers of women and minoritized physicians participating. For psychiatry, that meant that the Section Council membership swelled to seven delegates (and seven alternate delegates).

That was also the year, under Dr. English’s leadership, that the Section Council on Psychiatry developed a long-term strategic plan to enhance psychiatry’s visibility and influence in the AMA House of Delegates. Simultaneously, during the 1990s and early 2000s, a number of psychiatrists across the country also became heavily involved in their state medical societies, affording the opportunity for psychiatry to liaison with the House of Medicine via these state delegations as well. Jeremy Lazarus, M.D. tells me that he recalls doing so in Colorado, along with Steve Brown, M.D., from Wyoming; Jerry Halversen, M.D., from Wisconsin; Art Traugott, M.D., from Illinois; and Dudley Stewart, M.D., from Louisiana.

This plan would set the stage for psychiatry to command a presence not only in the fundamental operations of the House of Delegates such as committees and councils, but also in high profile AMA leadership positions. Jack McIntyre, M.D. (APA president 1993-94) would take the reins as Section Council chair in 2003 and continue to advance this mission, supporting numerous campaigns for section council members seeking placement on committees and councils, some as chairpersons, while others sought higher office in the House of Delegates and on the Board. As a result, Carolyn Robinowitz M.D. (APA president, 2007-08), appointed in 2010 as the next chair, would witness AMA Speaker of the House Jeremy Lazarus, M.D. become the third psychiatrist elected AMA President in 2012 following a 73-year hiatus without a psychiatrist at the helm. Seven years later, Section Chair Dr. Halverson would see AMA Board Chair Patrice Harris M.D. rise to the AMA presidency as the first Black physician and the first Black woman to do so.

The AMA was founded in 1848, four years after the APA, with a focus on medical education. Pliny Earle II M.D., a psychiatrist, was one of the founders and later served as president of the APA. The AMA elected its first psychiatrist president, Hubert Work, M.D., in 1921, and its second, Rock Sleyster, M.D., in 1939. It would be over seven decades before the AMA would see another psychiatrist as president, with Dr Lazarus. The foresight of Eist supported by the hard work of English, McIntyre, and Robinowitz, along with others such as Jay Scully, M.D., Melvin Sabshin, M.D., and Saul Levin, M.D., M.P.A., have produced an esteemed and influential Section Council on Psychiatry, now comprising 14 members plus alternates.

Nowhere is this more evident than the annual meeting of the Psychiatry Caucus where all psychiatrists attending the House of Delegates, including those representing states, the military, residents, students, and other groups, join together for introductions, networking, and sharing of priorities. Psychiatrist members of the caucus total at least 40, and attendance reaches almost 70 when students, residents, and relevant staff are included.

Over the years, psychiatry has been a visible and influential contributor to the policy discussion on pressing issues such as eradicating discriminatory licensure requirements, firearm violence, mental health parity, Medicare reimbursement, advances in telemedicine practice, issues around physician burnout, scope of practice, and more.

As I conclude the first year representing ACLP as a full member of the House of Delegates, I feel humbled and privileged to have been a part of this historical journey—initially on the sidelines but finally joining with delegates from the other major psychiatric subspecialties to close that loop. I’m extremely proud to be the newest member of the Section Council—a team of advocates promoting and advancing the issues and solutions salient to our patients and our profession in the House of Medicine!

I would like to acknowledge Brendel, Harris, Lazarus, and Kristin Kroeger for reviewing an earlier draft.