Reflections on the APM Annual Meeting 2015

Well, time to wrap up the Academy of Psychosomatic Medicine (APM) Annual Meeting 2015 properly with a few comments on the last session I attended and some other thoughts.

Dr. Jeanne Lackamp

Dr. Jeanne Lackamp

Yesterday afternoon’s workshop was “Doc to Doc: Maximizing the Impact of Consultation Documentation,” led by Drs. Jeanne Lackamp, Vicki Kijewski, and Zafar Zaidi. Dr. Lackamp, MD, FAPA was the leader and it’s easy to see why because she’s been promoted to several leadership positions in consultation psychiatry at University Hospitals Case Medical Center in Cleveland, Ohio. She always gives me credit because I was one of her teachers during her psychiatry residency at The University of Iowa Hospitals and Clinics (UIHC). But her genius and hard work are all her own.

Anyway, the main message was cleaning up our act as consultation psychiatrists in communicating our assessments and recommendations to our colleagues in medicine and surgery. The co-presenters, Dr. Zafar Zaidi, MD of Michael Debakey VA Medical Center, The Woodlands, Texas, and Dr. Vicki Kijewski MD, FAPA, FACP from the UIHC, gave excellent examples of consultants’ notes which could use..a little work.

The Electronic Health Record (EHR) took a few well-deserved knocks because it more often gets in the way of clear communication than facilitates it. Reflecting on what we’ve written and maybe reading our notes aloud before we click the “Accept” button would probably help.

Dr. Lackamp also highly recommended adding a link to the Gomerblog, a medical news website which has a satirical style similar to Wisconsin’s Onion. I trust her judgement so I’m adding it immediately.

Posters! Wow, how could I not mention the outstanding Poster Session? I found a couple that intrigued me. A couple of residents in our department have expressed an interest in consultation psychiatry (once bitten, there’s no cure!). One of them even asked me about starting a Psychosomatic Medicine interest group. Wouldn’t you know I’d find a poster about this topic? The title was “Evaluation of a Psychosomatic Medicine Interest Group: A Survey of Current and Former Residents.” The presenting author was Robin Valprey and there was a reference article “Introducing a Psychosomatic Medicine Interest Group,” published in Psychosomatics 2013. I haven’t had time to look it up yet, but maybe an inquiring resident…

Another very interesting poster “Financial Savings of Embedding Full-Time Social Worker on Inpatient Psychosomatic Medicine Service” by Howard Forman, MD et al, was an outstanding work, not just because of the great idea.

The presenters were one of the very rare groups who actually made big posters as handouts!

social work embed on CL service poster 2015

This gives you only the barest idea of the poster show–lots of talented trainees.

As we sped through the city at breakneck taxicab speed to the airport this morning, I reflected on what little I had seen of New Orleans and marveled at the contrasts. Even in the cab, the images were a little jarring: the woman shivering on the side walk in the brisk morning air outside a tall building, naked apparently except for a large white bath towel, flanked by a couple of police officers, followed by the modern, sophisticated university health centers, followed by what looked like a shack with a sign on which, in large block letters, “CLINIC” was painted. It was like that the whole trip.

The hotel was old but clean and had many cutting-edge electronic amenities for travelers. And then, the vast majority of the service employees were people of color, mostly African Americans, older, bent, even limping–serving our food, cleaning our rooms, hailing our cabs.

While I was in meetings all day, my wife visited the the sights everyone comes to see in New Orleans, such as The Garden District, The French Quarter, The River Walk and more. However, a gardener at one of the Garden District’s beautiful historic mansions warned her not to stay out alone at night on Bourbon Street.

The APM Program itself had cautionary advice in a section entitled “Safety,” including suggestions to keep wallets in front pockets (to discourage pickpockets), to wear purses strapped across the body rather than over the arm; to avoid walking alone, especially at night, to avoid Bourbon Street after midnight. An interesting warning was to be wary of con games by strangers who open with lines such as, “I bet I can tell you where you got your shoes.”

France had given a magnificent statue of Joan of Arc to New Orleans several years ago. But then we watched on the TV news the horrific scenes unfold in Paris over the last couple of days as terrorists killed the innocent, prompting one mourner to leave a poignant note posted at a massacre site memorial, asking, “In the name of what?”

I’m just an old man. I don’t know what all this means: My former student, who praises me as though I were a mentor when I only wish I had been so; the city, both proud and tarnished; the country’s blameless, old and young, slaughtered…the world spinning while we grieve the loss of those we loved, and the loss of our innocence.

We’re doctors because we hold on to hope. We’re psychiatrists because we are fascinated by ambiguity. We’re human because we all need each other.

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Comments

  1. The link to the “Financial Savings of Embedding Full-Time Social Worker on Inpatient Psychosomatic Medicine Service” poster is http://www.eventscribe.com/2015/posters/APM/SplitViewer.asp?PID=MTY5MjkxMTAyNQ

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  2. Pursuant to the Psychosomatic Medicine Interest Group topic mentioned above, I just located the paper published as a result of the poster presenters’ efforts (link to poster http://www.eventscribe.com/2015/posters/APM/SplitViewer.asp?PID=MTY5MDg1NDQwMA:

    Puri, N. V., et al. “Introducing a Psychosomatic Medicine Interest Group for Psychiatry Residents.” Psychosomatics 56(3): 268-273.
    Background: Having gained subspecialty certification in 2003, the field of psychosomatic medicine (PM) addresses the mental health needs of individuals who suffer from general medical conditions. The rising prevalence of chronic illness, along with trends in medical delivery toward more collaborative models of care, underscores the value of recruitment to PM specialty programs.

    Objectives
    To foster interest and education in PM, we have developed and implemented a Psychosomatic Medicine Interest Group for trainees within a psychiatry residency program.

    Results
    Participants have found the Psychosomatic Medicine Interest Group to be an enjoyable experience that has improved their clinical practice and interest in PM.

    Conclusion
    The Psychosomatic Medicine Interest Group has also been a successful vehicle to enhance clinical knowledge and mentoring opportunities during training, while bolstering residents’ desire to pursue a career in PM.

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