Massachusetts Medical Society: New PHS Director Plans to Bring Prevention Focus

New PHS Director Plans to Bring Prevention Focus

Vital Signs: March 2013

Steven Adelman, M.D., Takes Top Post; Luis Sanchez, M.D., Retires

 PHS Steven Adelman, MD and Luis Sanchez, MD

Steven Adelman, M.D., incoming PHS director (left) and Luis Sanchez, M.D., (right). Photo by Doug Bradshaw

As a child, Steven Adelman, M.D., was mystified by his mother's years-long battle to quit smoking. "How could this intelligent, health-conscious woman struggle with this chronic addiction? This captured my interest in a deeply emotional way," Dr. Adelman recalled.

Dr. Adelman, 58, went on to become a psychiatrist and an expert in addiction at a time when scientists were just beginning to understand the interplay between biology and addiction and before the term "addiction medicine" had even been coined.

Three decades later, the former director of Behavioral Health and Addiction Medicine at Harvard Vanguard Medical Associates is set to become the new director of Physician Health Services (PHS), one of the most influential programs of its type in the country. PHS, a nonprofit corporation founded by the Massachusetts Medical Society, provides confidential consultation and support to physicians, residents, and medical students facing behavioral or physical health concerns.

"I thought if Dr. [Luis] Sanchez ever retired, this is a job I'd be very interested in," said Dr. Adelman, who worked closely with PHS while at Harvard Vanguard. "This job fits with everything I've been doing for the past 20-30 years."

Dr. Adelman, who officially assumes his new duties March 18, believes that the services provided by the 20-year-old nonprofit are needed more than ever now, as medicine has become an increasingly high-stress profession.

"I would put it up there with the military, law enforcement, and air traffic control," he said. "The pace is grueling and a lot [more] is being dictated down to doctors as ever before. The result is an unprecedented number of doctors experiencing burnout."

An Emphasis on Prevention

Dr. Adelman said he would like to see PHS intensify its work in the area of prevention. "PHS will always focus on providing assistance to struggling physicians, but I'd like to see us place an even greater emphasis on physician health

and wellness, self-care, work-life balance, resilience, and stress management," he said. "The presumption is that physicians who take better care of themselves and support one another throughout their careers will manage the vicissitudes of medical practice more effectively."

Medical training equips physicians with the skills and knowledge to deliver superb care, but not the "personal tools they need at the front lines," said Dr. Adelman. "How do you stay calm under fire, deal with the next set of complex requirements foisted on you by various third parties, while adroitly juggling your work with your personal life?"

Dr. Adelman envisions PHS developing some of these tools for physicians -including innovative materials and experiences that promote physician wellness. Some of these might have commercial possibilities, providing revenue to support the mission of PHS. One example might be

a smartphone app that prompts physicians at daily intervals to assess their level of stress and suggests activities (such as a quick breathing exercise) to defuse tension. Dr. Adelman dreams of piloting the tools in Massachusetts, then offering them more widely.

"I think that the successful, mission-driven non-profit that is PHS has the potential to develop and hopefully to market a new set of innovative functions around prevention," he said. "I'd like to leverage the expertise of PHS in ways that help us grow, so we can do even more good."

Dr. Adelman says he is taking over PHS at a time when the program is widely known and respected, thanks in large part to Dr. Sanchez's leadership. "He's done it with a lot of grace and a great deal of clinical sophistication. He's also built a great team. PHS radiates a sense of mission and I think Dr. Sanchez epitomizes that mission."

Board-certified in psychiatry and addiction psychiatry, Dr. Adelman completed his internship, residency, and chief residency at McLean Hospital. He is a clinical associate professor of psychiatry at the University of Massachusetts School of Medicine and a graduate of Harvard College and the University of Pennsylvania School of Medicine.

Luis Sanchez, M.D., Looks Back

It's at the annual dinner for monitored doctors that Luis Sanchez, M.D., 70, sees the work of PHS in all its glory. "It's great to see these physicians with their spouses," said Dr. Sanchez, who recently retired from PHS after nearly 15 years at its helm. "They are so different from when we first met them. They have completely [turned] their lives around."

Dr. Sanchez said that in the years he led the organization, PHS has broadened its mission to address the changing needs of its physician clients. "Programs like ours originally focused on alcohol and drugs," he said. "Over the years, we've expanded to other areas such as stress and interpersonal conflicts within medical settings." More and more, physicians are arriving at PHS without a definitive diagnosis, like substance use or depression. "We're getting increasing numbers of referrals for physicians saying, 'I'm stressed. Practicing medicine is no fun anymore,' " said Dr. Sanchez. "They're feeling overwhelmed and out of balance."

Under Dr. Sanchez's leadership, PHS stepped up its efforts in prevention, sponsoring a yearly conference on caring for the caregivers and a course on workplace conflict - work that Dr. Adelman plans to expand.

Dr. Sanchez says he is leaving PHS in very able hands. "PHS has done well, has a terrific team, and helps a lot of people," he said. "This is a good time to move on and turn over the reins to someone who is younger, has fresh ideas, and might move PHS in a different direction. I've known Steve Adelman for many years and he is the perfect person to keep the mission moving forward."

While he plans to continue practicing psychiatry, Dr. Sanchez looks forward to having more time to indulge in his wide-ranging hobbies, including gardening, refinishing furniture, and playing the guitar.

- Vicki Ritterband

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