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Orthodoxy was introduced in America by Russians in Alaska and California and the Orthodox Church in America was part of the Russian Orthodox Church. After the communist revolution in Russia, the Church outside of Russia broke off with the Church at home and established the so-called Russian Orthodox Church Outside of Russia (ROCOR). The two are now in the process of reconciliation. The American branch did not break with ROC. Eventually, Moscow granted Americans independence which became OCA but this independence is not recognized by most of the Orthodox Churches in the world. In fact only Russia and I believe Bulgaria do.

Patriarch is not installed by the size of the Church but by its maturity. The problem with ROC, as Gar says, is that they do some things Orthodoxy doesn't -- and Orthodoxy is a very traditionalist Church, about as traditionalist as it gets.

Trying to "fit in" with the rest, many Greek Orthodox have adopted what can be termed "Protestant" or "Anglican" outwardly look -- clean-shaven priests and pews in the churches (uniformed choir, even electric organs!). All this was done so as to become more "American" and to be accepted.

The Greeks are now pulling back to traditional ways, and I understand some OCA. The OCA has a lot of Protestant converts who brought with them some of the Protestant mindset and who are not keenly in tune with the fact that Orthodoxy is a way of life and that worship is not something that is subject to radical change. Consequently, this mindset is what is preventing the communion of Orthodox Churches from recognizing OCA as a true and fully developed Church, but rather one is the stage of development and growth.

Typically, this takes time -- for all Churches. At which time they elect a Patriarch and become autocephalous (self-headed) rather than just being independent. So, the OCA is now headed by an Archbishop. It's pretty uch akin to a state that is a principality (i.e. Monaco) rather than a kindgom.