Note: David Parker had the pleasure of talking with CRG adolescent and adult psychiatrist, Dr. Joshua Lowinsky, about the Foundation Dr. Lowinsky co-founded. The PCPF is dedicated to educating healthcare professionals about mental health issues to enhance the medical community’s ability to address behavioral healthcare options within the context of brief doctor visits where mental health issues are not typically the primary focus. The Foundation gives Dr. Lowinsky an important opportunity outside of CRG to collaboratively influence the next generation of health care providers, thus fulfilling his love of teaching as well as continuing his own learning.
DP: Briefly describe the PCPF.
JLMD: The Primary Care Psychiatry Foundation educates and trains primary care physicians, other professionals, and individuals within systems of care, in the early identification, accurate diagnosis, effective treatment and appropriate referral of patients with psychiatric disorders.
DP: Why is mentoring important to psychiatry?
JLMD: In psychiatry, we suffer from a chronic shortage of child/adolescent/adult/and geriatric psychiatrists. This is one of many reasons why psychiatrists have to do the best job they can to attract promising medical students to the field. Medical students need to see psychiatric professionals whom they respect and whom they see as getting excited by their work. Additionally, they need to see and hear about patients benefitting from psychiatric treatment, as this is not always how psychiatry is portrayed by the media or viewed by the rest of the medical establishment. What is becoming clearer to all, inside and outside of medicine, is how common and impairing psychiatric disorders are. Similarly, we are all gaining greater appreciation for how early identification and treatment can improve not just mental health, not just medical health, but functioning in the workplace, the family, and in society in general.
DP: How have you been mentored across the years in your own practice?
JLMD: I’ve been very lucky to have had mentors throughout my career. This began early, even before I completed college, in a social work setting in an inner city Chicago hospital, in a crisis intervention setting in Springfield, Massachusetts, and in a free medical clinic setting in Cleveland, Ohio taking care of indigent patients with both medical and psychiatric. I continued to have powerful mentors in medical school, both in consultation liaison psychiatry and child inpatient psychiatry residency, fellowship, and at CRG. My mentors have all been role model clinicians, outstanding teachers, and generous with their time and knowledge to help me grow and develop! They asked for nothing in return, but I now understand how the process is mutually enriching to say nothing of how critical it is in improving patient care over time.
DP: How has the Primary Care Psychiatry Foundation, which you co-founded, embraced mentoring as part of its mission or operations?
JLMD: The PCPF has always been particularly interested in reaching out to, and mentoring, students from an array of disciplines both inside and outside of medicine. After all, these students will become future leaders in medicine, nursing, and pharmacy. Their experiences with mentors in mental health will help shape their views and responses to the health challenges of the future. As educators, we have a long way to go to produce cutting-edge, evidence based, exciting educational events that individuals can learn from and make their own in a powerful way in their practices. In medicine, we learn “See 1, Do 1, Teach 1.” We realize that, in continuing medical education, we need to give more opportunities during conferences for individuals to become actively involved in such a process. One of the things the Foundation wants to work on is producing conferences in which multiple forms of active learning occur so that the audience can take away powerful, evidence-based information they can immediately apply in their practices on Monday morning. By extension, these interventions can create improved health and functioning in their patients.
For this kind of learning to occur within a half-day or full day period, we must create an environment in the room where it is safe to try new things and to be wrong. This tends to occur within a community of learners where audience and presenters learn from one another. For instance, working with difficult and emotionally consuming patients can cause disillusionment and burn out among us, causing us to act in ways that are less than helpful. Understanding that difficult patients may “inject” into us the feelings of impotence, despair, and rage that they are feeling at the moment, can help us take a step back, reflect on, and empathize with what it must be like to be that patient right now. This, in turn, can lead to our responding in a more useful fashion. This type of learning takes time and can occur effectively within mentoring relationships.