Brain Science and Updates From the Field

Stairways doc featured nationally, talks fellowship

Friday, December 18, 2015
Stairways Behavioral Health’s Medical Director, Penny Chapman, M.D., was recently featured in Psychiatric News, a publication of the American Psychiatric Association.

In the Nov. 20 article, Chapman describes the Rural Public Psychiatry Fellowship which connects new psychiatrists with patients in underserved regions of Western Pennsylvania. Chapman co-directs the eight-year-old program with Manish Sapra, M.D., an assistant professor of psychiatry at the University of Pittsburgh School of Medicine.

The University of Pittsburgh School of Medicine houses the Western Psychiatric Institute and Clinic (WPIC), which serves as the academic home to the fellowship program.

According to the article, psychiatrists serving rural areas face the unique challenges of lower salaries and isolation from their peers, which can result in faster burnout. Chapman sees the Fellowship as an opportunity to address those challenges, providing attractive incentives locally for the recruitment and retention of the best new attending doctors.

“We have trained six fellows so far, and they have all stayed in Pennsylvania and are doing community psychiatry,” Chapman told Psychiatric News.

As a partner in the program, Stairways has been the fortunate beneficiary of these new doctors’ talents. Fellows provide Stairways’ clinical programs psychiatric care four days a week and then dedicate a fifth day to completion of their fellowship requirements.

These requirements include attending professional development webinars and networking with and learning from some of the most experienced professionals in the field. Additionally, fellows pursue a self-guided initiative they wish to research, develop and practice for the enrichment of their community practice.

“It’s such a great opportunity for your attending benefits to allow a time to continue to learn and to develop something that provides advantages to the community,” says current program fellow, Joseph Holmes, D.O.

Holmes grew up in rural West Virginia and attended West Virginia School of Osteopathic Medicine in Lewisburg. He is now an attending physician at Stairways’ Erie Outpatient Clinic, where he is developing and testing a new telepsychiatry initiative, which will contribute significantly to the flexibility and availability of doctor time for Stairways’ many clinical programs and locations.

Holmes has found Chapman’s fellowship program to be instrumental as he lays the foundation for his psychiatric career.

“This is a clinically-focused fellowship, which is great,” Holmes said. “The point of being in community psychiatry is that you are active, not an academician.” Through Dr. Chapman I have had access to people with experience in systems, like Rick Seager and James Shuster.”

Chapman is quick to add, “Dr. Sapra and I have received immeasurable support from Dr. James Schuster, chief medical officer and VP of physical health integration for Community Care Behavioral Health Organization.”

Under Schuster’s guidance, the fellowship has been able to set up a bi-weekly webinar series which connect local fellows with others, state-wide, and feature a wide range of experts in the field, teaching about current topics in behavioral health.

Additional support comes from individuals and organizations like David Dinich, executive director of the Pennsylvania Psychiatric Leadership Council (PPLC).

“The PPLC is at the very forefront of psychiatric innovation and recovery-oriented practice,” explains Chapman. “They are able to connect our fellows with leading experts, as well as senior politicians and administration in Harrisburg.”

Dr. Holmes credits the reason he became interested in community psychiatry to a “Systems in Psychiatry” webinar presentation by Rick Seager, CEO of Journey Health System (Stairways is a member of Journey Health System).

“What really struck me about what he said was that understanding public systems allows you to multiply the impact you can have on patient life by thousands,” shares Holmes.

“I can be the best psychiatrist in the world and I can churn through patients all day long, but if I can learn how to put in place systems, if I can advocate for a valuable idea, then I can get funding, and I can turn it from a good idea into something that’s happening. Then I can impact far more good than I ever could, even as the best clinician in the world.”

This desire for greater impact even while providing local value is exactly the type of outcome Chapman hopes to foster through her fellowship program.

“One of the original goals for the psychiatric fellowship program was to ensure that our area receives highly qualified psychiatrists, who can care for, and who care about, people of diverse backgrounds,” says Chapman.

But many locally trained residents are leaving the state after training.

“We need to create more opportunities for new psychiatrists, more reasons for them to stay,” Chapman said.

Meghan McCarthy, D.O. completed two years of the fellowship with Chapman, and has continued to work at Stairways for five years as an attending physician at the outpatient clinic and with the residential programs. McCarthy, an Erie native and LECOM graduate, views the fellowship as an integral extension of her medical training.

“As an attending, I got to work as a doctor, but then I had a day in which I was able to do something I really loved, and then circle back with Dr. Chapman and have great supervision around this,” says McCarthy.

With a few years of experience and perspective, one of the most meaningful outcomes of the program was that it allowed her the space to think about the kind of doctor she wanted to be.

“So many people get out of residency and take a job and they just start working,” McCarthy says. “This challenged me to think, ‘What kind of psychiatrist do I want to be in this community? How do I want to impact my community?'"

McCarthy explored the patient/family doctor/psychiatrist relationship as part of her fellowship initiative. She was aware that a group of individuals in the community fall through a gap; patients are seeing a family doctor but are not getting the right treatment for their mental illness.

McCarthy logged many hours at Community Health Net and in primary care doctors’ offices, consulting with them to determine the best treatment strategy for particularly challenging individuals.

Sharing these experiences with Chapman helped to guide McCarthy in providing the most effective consultation and support for these family doctors, relationships with whom McCarthy formed and maintains to this day.

McCarthy also wanted to explore the benefits of bringing families into the treatment process for greater understanding and assistance with their loved one’s recovery.

In addition to training all of the residential program therapists in structured family therapy, she initiated a regular “family night” at Stairways’ residential treatment facility for adults. In the years following, she has expanded this family focus across the organization.

As McCarthy expanded her view of individual patients to include their family doctor and also their family supports, she came to appreciate the comprehensive mental health system in Erie.

“I don’t think I would have nearly the depth of perspective I have without the fellowship, to understand and see the system as clearly as I have been able to, or to fully participate in that system without the aid of Dr. Chapman and the fellowship,” says McCarthy.

Chapman offers her own admiration for those fellows whom she supervises, including a second, current fellow, DeanAnn Farris, D.O., who serves as an attending physician through another Journey Health System affiliate.

Regarding Holmes and McCarthy, Chapman is effusive.

“Dr. Holmes is intelligent, articulate and brings to his fellowship the particular skill of fluency with IT systems. His passion and enthusiasm is infectious, and he gives the best possible chance of adding the modality of telepsychiatry to the menu of services at Stairways.”

Chapman called McCarthy “an extraordinary psychiatrist to mentor through the fellowship at the start of her career.”

“She brings a combination of clinical skill and great personal empathy to her work with a very challenging population. She is calm, concerned, enormously hard-working, and retains a sense of humor even when times are challenging.”

Chapman believes that Stairways’ return on its investment is beneficial in both the short and the long-term, as the organization retains bright and enthusiastic doctors committed to community psychiatry.

“It is more than just one doctor, working with Stairways as they complete their fellowship,” Chapman explains. “These talented and committed doctors are also mentoring the more junior psychiatrists, helping them to see the importance and advantages of continuing strong work within the community sector.”

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