Be Your Authentic Self: Part 1

Patrice: I don't think there's anything I would have done differently. I had many detours and some setbacks. Some people discouraged me from going to college and getting a medical degree. I earned my master's degree; worked for my alma mater, West Virginia University, got involved in issues around equity; and started learning about advocacy and policy. From launching a private practice to doing policy work at the American Medical Association and now being an entrepreneur — all those experiences brought me to the place I am today. I would tell my younger self to be true to your authentic self. I tell young folks all the time to find out who you are and be the best at that.

I do wish that I had read more. As much as we read in medical school, I wish I had read even more back then. I tell students when you think you've read enough, read more. Be curious. Always be in that space of continuous learning.

Patrice: At the very beginning, physicians on the frontlines worked long hours. They were updating their wills and living in isolation from family members.

We came into this pandemic with a huge physician burnout crisis. We have done some great work to understand that systems need to better support our healthcare professionals. Now we need to make seeking help routine––particularly mental health care.

There used to be a question on state licensing applications about whether you had ever been treated for a mental disorder. It is a fair question to ask if your ability to practice medicine has been impacted by a health issue. But whether there's an absence or presence of diabetes, depression, or anxiety is not the right question. It discourages many of our colleagues from seeking help.

We've unfortunately seen an increase in medical student and physician suicides, which has continued during the pandemic. It is such a privilege to earn the trust of your patients. In some communities of color, we have more work to do to earn that trust. But we must also do better at supporting our physicians.

Patrice: We do not have an adequate mental health system in place for children or adults. We go from crisis to crisis, from diagnosis to diagnosis. We need to step back and think about the continuum of services, from prevention to intervention. We need better data, especially around predictive analytics. Might data be able to tell us when someone is getting more anxious, more depressed, and perhaps be at higher risk for suicide?

Mental health infrastructure needs to include an understanding of trauma, particularly for children. When I was inaugurated as president of the AMA, there were three things I wanted to amplify during my presidency:

Patrice: The ACES, or the Adverse Childhood Experiences Study, was landmark work by CDC and Kaiser. It demonstrated that the more adverse experiences children were exposed to, such as physical abuse or witnessing intimate partner violence, the greater the risk for later issues. Some of those later issues someone might say are predictable. But some are not, such as increased risk for diabetes and other chronic diseases. As a child psychiatrist, I see folks come in with symptoms that appear to be attention deficit hyperactivity disorder but in fact are issues related to trauma. There’s an excellent TED talk given by a pediatrician about how trauma affects us throughout our lives.

By the way, this is true for someone who has personally experienced or witnessed trauma, including living in a neighborhood where folks might be witnessing violence. This connects to what happened this summer regarding police brutality, which disproportionately impacts communities of color. Trauma is a key through line to a lot of issues that we must address.