I’ve been a Consult-Liaison Psychiatrist at The University of Iowa Hospitals & Clinics (UIHC) for about the last 20 years except for very short stints in private practice which didn’t suit me because I like to teach.
I used to say that I’m “board certified by the American Board of Psychiatry and Neurology (ABPN) in both Psychiatry and Psychosomatic Medicine.” I don’t like saying that anymore because I’m not comfortable with the name “Psychosomatic Medicine” and because I no longer believe board certification in its present form of Maintenance of Certification (MOC) is such a great measure of clinical competence. It’s certainly not a marker for excellence.
I’ve spent the last 5 years actively supporting the principle of lifelong learning while opposing MOC. MOC has been a source of controversy for physicians all across America and there is no compelling evidence that it improves patient care or physician competence. You’ll find evidence for other unforeseen and unpleasant consequences of MOC in many places on the internet including the website Changeboardrecertification as well as mine.
I’ve enjoyed teaching medical students and residents although I’m looking forward to retirement in the next few years. Despite the disappointments of managed care, MOC, misguided governmental policies about health care and education, and other pressures on doctors, I’m still hopeful that the next generation of physicians will thrive—as long as they stand up to bureaucrats and politicians who don’t take care of patients but think they know patient care better than doctors.
When I was Chief Resident back in the day, I remember talking to an incoming class of residents about Stephen Covey’s book “The 7 Habits of Highly Effective People” and his principles centered leadership philosophy. I still believe that leadership is a choice, not a position. Unfortunately, some of our physician leaders may go astray. But change is constant. Leaders come and go. And just like the song says, “I’m so glad trouble don’t last always.”
One of my most treasured achievements is the Leonard Tow Humanism in Medicine Award. The Arnold P. Gold Foundation has recently announced they are rebranding the organization and the pin will have a different look. The new pin includes a Mobius loop “…as a symbol of the continuous bond of trust, respect, and communication that connects healthcare professionals with their patients when humanism is at the core of practice.”
I think one of the most helpful things I can do to foster communication with my patients in my role as a C-L Psychiatrist in the general hospital is to sit down and listen to them. Often there are not enough chairs in a hospital room. I used to ask a trainee to find one for me. Lately, I have my own portable camp stool I take with me on rounds. It was a gift from a friend and colleague. Patients get the biggest kick out of it.
Soon enough I’ll stop using that camp stool, when I retire. It would be a shame to just take it home and stick it in a drawer. Maybe I should pass it on when I go.
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