Academic psychiatry in the political marketplace.

There is pressure for all medicine to be publicly accountable and for there to be public manifestations of professional responsibility. The expectation of an immediate return on the public's investment in education is matched by cries for"relevence" in research. The generation and transmission of psychiatric knowledge is not compatible with such a direct telelogic approach. Yet, public accountability is necessary, considering the public monies involved. Academic psychiatry should become familiar with the political marketplace--a high-pressure environment where fiercely competing interests vie for the politician's attention through votes and contributions, and where the "squeaky wheel gets the grease". Psychiatry can ill afford to adopt a passive posture in this political marketplace. Psychiatrists bear responsibility for informing the public about the relevance of psychiatric research and education. The profession must accept--even embrace--the concept of public accountability as a synchronous extension of our professional responsibilities.