Educate and advocate—a mission to enhance C-L Psychiatry
ACLP’s new president says there are three areas of C-L Psychiatry that are “critical to focus on.”
Maryland Pao, MD, FACLP, aims to:
No.1—Ensure that C-L Psychiatry clinicians are focused on delivery of good patient care by attending to the whole patient’s medical, psychiatric, and social needs. To help maximise this pledge, the Academy must liaise with the many other services involved in the care of patients with complex medical disease. “We are educators and advocates,” she says.
No. 2—Secure the best evidence-based research to deliver the best evidence-based care. Dr. Pao’s concept goes beyond case reports and case series to enhancing the broader C-L Psychiatry field through the development of research to deliver “generalizable knowledge.” She says: “We must go beyond our individual hospital systems’ needs and create networks to be able to scale up our interventions.”
How will we do that? Dr. Pao hopes to create small grants for early-career psychiatrists and others to conduct quality improvement projects and provide evidence-based research on specific treatment areas. She plans to invite insurers to attend next year’s Annual Meeting to communicate with them and provide the evidence needed to increase payments for C-L Psychiatry treatments.
The 2023 Annual Meeting in Austin (November 8-11) will herald Dr. Pao’s theme: Integrating Care and Evidence Across the Lifespan.
No. 3—Open the Academy’s doors to pediatric C-L psychiatrists in particular—her own bedrock subspecialty. In particular, she wants to enhance cooperation with the American Academy of Child and Adolescent Psychiatry.
Dr. Pao’s core research interests are in pediatric oncology, pediatric HIV, and other primary immunodeficiencies. She studies distress and its correlates, including suicidal thoughts and behaviors, in medically ill children.
Dr. Pao serves as clinical director of the National Institute of Mental Health (NIMH) Intramural Research Program at the National Institutes of Health and as deputy scientific director, NIMH. She was chief of the Psychiatry Consultation Liaison Service at Hatfield Clinical Research Center from 2008 to 2019. She was also acting clinical director of the National Center for Complementary and Integrative Health from 2020-2022. Her career followed a BA/MD program at Johns Hopkins University School of Medicine where she completed Pediatric and Psychiatric Residency training as well as a Child and Adolescent Psychiatry Fellowship.
With increasing technological health advances, there are more survivors of childhood (and adult) medical conditions than ever, says Dr. Pao. “In the US, more than 40% of school-aged children and adolescents have at least one chronic health condition, such as asthma, obesity, other physical conditions, and behavior/learning problems (see report). The health care needs of children with chronic illness can be complex and continuous and include both daily management and addressing potential emergencies.
“Take the example of childhood cancer. In 2019, there were an estimated 16.9 million cancer survivors in the US. As of 2018, at least 483,000 cancer survivors were first diagnosed when they were under the age of 20. Advances in cancer treatment mean that today 85% of children diagnosed with cancer are alive at least five years after diagnosis. Many ultimately will be considered cured. As a consequence, interest is growing in the long-term health of these survivors (see report).”
“I have a lot of other ideas as well,” says Dr. Pao, smiling. “But I don’t want people to think I’m manic!” They’re not just her own ideas, either. Before taking up the presidential role, she surveyed past-presidents, Board directors, SIG chairs…asking each of them about major advances in C-L Psychiatry and accomplishments they believe the Academy has achieved over the past decade. Several added directions they would like to see ACLP to move toward.
Nearly 45% of respondents spoke to the advancement of ACLP’s educational curricula—webinars, board exam readiness, textbooks, self-assessment credits, model didactics, and clinically relevant meetings—”an abundance of clinical and organizational tools to promote and expand C-L Psychiatry services.”
You’ve guessed it—Dr. Pao wants to do still more within her “educate and advocate” mission. Not just for current ACLP members, but, again, out into the wider world of an increasing number of allied professionals operating within interdisciplinary teams who are practicing C-L Psychiatry methodology—resources such as “toolkits on C-L Psychiatry for primary care practices in non-hospital settings” and community health care clinics.
“In the coming year, I hope to expand our membership; grow our resources to further develop and disseminate our outstanding virtual educational content to reach more disciplines; and enhance scientific scholarship and training, particularly in research, within C-L Psychiatry. For this last goal, I hope members will consider donating to the ACLP Foundation to establish funding for small pilot research grants for our members and perhaps establish the first award for excellence in Pediatric C-L Psychiatry.”
The Academy should play a major role in educating and advocating into the wider field of C-L Psychiatry so that all integrated professionals can achieve the highest of standards of C-L Psychiatry practice.
Dr. Pao acknowledges: “We have strengthened partnerships with the APA and the AMA under the leadership of our three past-presidents. There is more we can build upon with EAPM and AACAP and other subspecialty and primary care professional organizations.”
Dr. Pao concludes: “As president, I will be applying the lens of diversity, equity, inclusion, and accessibility to our annual meeting as well as across reviews of our awards processes, our leadership selection, and our activities across standing committees, subcommittees, SIGS, and forums. Should we develop an advocacy SIG this year? We strongly encourage our new members to get involved, especially in SIGS and forums, and let us know.
“I also want to emphasize that I believe ACLP is a professional organization, the ‘Home’ if you will, that trains, fosters, and supports our identities and career trajectories as C-L psychiatrists, and is also engaged in pushing the field of C-L Psychiatry forward through research, education, advocacy, and innovation.
“We rely on the engagement and energy of our members to address issues— from whether Psychiatry residents should be able to fast-track into C-L Psychiatry fellowships to address workforce issues; to how best to include our allied professionals in C-L Psychiatry teams and beyond; to what are best practices in all the communities in which we serve.
“C-L Psychiatry is here to stay! There is clearly more need than ever for our care and our psychiatric skills to help patients cope and adapt to physical illness as well as to identify comorbid psychiatric illness. I am confident that together we can overcome any challenges we meet as we deliver integrated, humanistic care to our patients across the lifespan.”