1. Describe your current activities.
My “day job” is service as the Chair of the Department of Psychiatry and Behavioral Sciences and as the Katharine Dexter and Stanley McCormick Memorial Professor at Stanford University School of Medicine. As the chair of a major department at a prominent institution, I have the opportunity to work with wonderful colleagues and to oversee and grow many extraordinary academic and clinical programs. It is amazing to see the good that is accomplished every day by creative and dedicated people from many different disciplines who are at all stages of their professional lives.
I love my role as Chair for many reasons. Every day I feel I am helping the people around me to do work of genuine consequence and meaning. I also love serving shoulder-to-shoulder with other academic leaders who, like me, gravitate toward roles in which they assume responsibility, feel a sense of purpose in contributing to a greater whole, and take on decisions that demand rigor and integrity.
I take seriously the responsibility that the field of academic medicine has in our world. We are entrusted with creating the path to a better future through advancing science of importance to human health, through innovation in clinical care and systems of care, by educating scientists and clinicians across diverse disciplines, by engaging with communities to address the hardest problems we face in real-time, by inventing strategies to enhance population health, and by leading in a manner that has impact and ensures that we fulfill the ideals of our profession.
My second “day job” is serving as editor-in-chief of Academic Psychiatry, a journal that is similar in its mission to Academic Medicine, but focuses more on the disciplines of psychiatry, psychology, and behavioral sciences. I fell in love with the work of an editor when I was an intern in psychiatry and the then-editor of Academic Medicine, Addeane Caelleigh, gave me the opportunity to guest edit a special issue of the journal focused on ethics training in medical education. Other than my stint as editor of my high school newspaper, this was my first real experience with the work of an editor. It sounds corny, but my professional life changed because of this extraordinary experience with Academic Medicine twenty years ago.
My final “day job” is conducting research that focuses on ethics and policy issues in clinical care and research involving vulnerable populations. My earliest work pertained to medical student health, illness, and the link with professionalism and compassion. It is exciting to see this important area develop to the point where the wellbeing of physicians and physicians-in-training is becoming understood for its significance in the optimal care of patients and patient care outcomes. My first NIH-funded study looked at informed consent in clinical research involving people with diverse physical and mental illnesses, such as HIV, cancer, diabetes, schizophrenia, depression, and anxiety. My later work has explored the ethical use of genetic and health information in the workplace, on rural and urban health disparity issues related to stigma, and specific ethical issues in genetic research involving vulnerable groups. All of this work engages with broad stakeholders and seeks to bring forward underrepresented perspectives. I feel fortunate to have been able to perform work that has been inspired by my patients and my students over the years.
I also write and edit books and textbooks in the areas of professionalism and ethics, clinical psychiatry, and innovative research approaches, such as community-based participatory research. Beyond these topics, mentorship and leadership in academic medicine has emerged as a central theme in my scholarship over the past decade. This work is wonderful because it involves writing and working with language. I love the quote by Isaac Asimov in which he said that if he knew he only had six minutes to live, he would type a little faster! I get this. A good day for me will always mean that I had the chance to write. A great day is one in which I have been able to craft a wonderful sentence, taking an experience or idea and making it clear through the precise use of narrative.
2. What gaps do you see in today’s scholarship?
Frankly, there are so many gaps in the academic medicine scholarship that it is hard to create a thick enough catalog. Many issues encountered in academic medicine merit deep inquiry, and even more require or would benefit from relevant empirical evidence.
One main barrier to the advancement of scholarship across academic medicine has been the lack of appropriate funding for research on education, organizational best practices, and practices and policies that have outcomes pertaining to human health. Other barriers include the lack of sufficient interdisciplinary engagement that would allow robust methods from the social and quantitative sciences to shape our thinking and to strengthen our approaches to investigation.
I am worried that the pressures in academic medicine are so great that faculty, especially clinical faculty, are working to the point of exhaustion and in isolation. Our capacity to reflect on our practices in real time—let alone to innovate or to mount careful studies to document and test the impact of our work—is being lost. So many of our nation’s approaches to governance in medicine and in medical education should be studied so that we can better understand their impact, and better articulate their value in fostering the health of individuals, communities, and populations-at-large.
3. Why do you read Academic Medicine?
I have read Academic Medicine for more than two decades, and I love its mission as a peer-reviewed academic journal that “serves as an international forum for the exchange of ideas, information, and strategies that address the major challenge facing the academic medicine community as it strives to carry out its missions in the public interest.” Perfect!
The combination of perspective pieces and commentaries, empirical studies, review pieces, and special features, such as AM Last Page, is balanced and always very high caliber. Every issue touches upon leadership, professional development, and important aspects of the public accountability of medical schools, academic hospitals, and health care systems. Learners, teachers, and leaders find value in the work presented in the journal. The theme issues have, in my view, special and enduring value to the field of medicine.
As an author, reviewer, and editorial board member of the journal, I also appreciate that the journal stands for integrity in the field of medicine through its policies and practices. I tremendously admire the fact that the journal is a publication of the AAMC, but that there is clear editorial independence. Submissions are evaluated on the basis of their quality, clarity, and rigor—true excellence, rather than conformity to a particular politic. The journal, in my view, is impeccable in this respect, and in many others!
4. What issues will we be reading about in five years?
I hope to be reading about:
- The expanding numbers of brilliant applicants to medical schools and about how the physician-scientist “pipeline” is flowing rapidly.
- The improvements in care and, as a result, the enhanced quality of life experienced by people with severe and disabling conditions.
- “Smart” health care systems that are oriented around patients, not around what was once characterized as the “medical-industrial complex” and completely devoid of humanity.
- The eradication of stigma associated with mental illness, addictions, and infectious diseases, as we have seen in the past century of enlightenment about cancer.
- Evidence-based best practices in medical education that allow young physicians to embody and sustain the highest aspirations of our profession.
- Essays inspired by Francis Peabody and William Osler.
- Brilliant scholarship of my mentees and, with any luck, the writing of my children who awe and challenge me at every turn.
5. What book(s) are you reading right now?
I am working on three edited books right now. Every day I am reading chapter drafts, including manuscripts about how international medical graduates can flourish in the rapidly-evolving health care systems in the United States, about professionalism and ethics in the care of veterans, and about optimal approaches to leadership and negotiation in academic medicine. I just finished reading The Myths of Happiness by Sonia Lyubomirsky, which provides an interesting overview of recent social science literature and, in a very intuitive and engaging way, disrupts many of the inaccurate beliefs people have about how to find joy in their lives. I also just finished Creatures of a Day, the newest book by my treasured colleague, Irving Yalom. It is a beautiful text in which each chapter tells a story of psychotherapy, told from the perspective of an astute, insightful, and very human psychiatrist who shares his inner process. He makes plain the way in which this unique doctor-patient relationship can be transformative. I am also reading, How the French Invented Love by Marilyn Yalom, Irv’s wife of fifty years, which is quite a page-turner! Another recent favorite was Geography of Thought by Richard Nesbitt, which was especially salient for me in the entrepreneurial leadership space of Silicon Valley. Last week, spending lots of time traveling on planes, I read two David Baldacci “airport” best sellers, which were completely addictive. Tonight I have the delicious chance to crack open Donna Leon’s newest detective novel!