Psychiatry

  • James Amos, MD

    James Amos

    What is your hometown?

    Mason City, Iowa

    When did you join the University of Iowa faculty?

    I first joined the University of Iowa faculty in 1996 after my finishing psychiatry residency here. I also went to medical school here as well. It just seemed natural to join the faculty at Iowa, though I have made a couple of very brief forays into private practice.

    How/when did you become interested in science and medicine?

    I got interested in science and medicine during my time at Iowa State University. I initially thought I might be interested in engineering. I had worked as a draftsman and survey crewman for consulting engineers in Mason City for a number of years. They were years well spent and I still have great respect and admiration for those I worked with there. However, I was more interested in biology than mathematics and physics, so I switched to a combined major involving biology, zoology, and chemistry. This major led to a very brief, but enlightening stint as a medical technologist. It didn't take me long to figure out I wanted to be more involved with patients themselves than with their specimens.

    What interested you to pursue a career in psychiatry?

    I remember my psychiatry rotation being a fascinating time because of the opportunity to be involved with what I believe are the most interesting patients in clinical medicine. Many of them suffered from both physical and psychiatric illness and the challenge was to help them move forward despite how their mental and emotional anguish interfered with the management of their medical problems.

    Is there a teacher or mentor who helped shape your career?

    I don't know if Roger Kathol, MD, sees it the same way or recognizes it, but he was one of the most importance influences on my career in psychiatry. Although I never considered pursuing a combined residency program in both internal medicine and psychiatry, I was always most challenged by and interested in patients who struggled with both physical and psychiatric illness. Kathol built the Internal Medicine-Psychiatry Residency Program and the Medical-Psychiatry Inpatient Unit at the University of Iowa Hospitals and Clinics. He used to read to us on rounds in the morning. Would you believe it, he read us the works of Galen! He was dedicated to both/and thinking and integrated health care a very long time before it was cool. Another teacher who shaped my career was Jenny Lind Porter-Scott who taught English and Literature at Huston Tillotson College in Austin, Texas. She is the niece of O. Henry and has published a great deal herself, including her own poetry, such as The Lantern of Diogenes and Other Poems. She was a true classicist and a leader among women, even named Poet Laureate in 1964 by Texas Governor John Connally.

    How or why did you choose the University of Iowa?

    I decided to pursue medical school and psychiatric residency at the University of Iowa because I was born and raised in Iowa and it's my home. More than that, the University of Iowa is recognized around the country as a leader in academics and medical practice and attracts great minds from all over the world.

    University of Iowa’s faculty members are united to provide exceptional patient care while advancing innovations in research and medical education. How does your work help translate new discoveries into patient centered care and education?

    As a professor on the clinical track, I firmly believe that patient care and teaching are the best ways to prove to patients, health care policy makers, and health care providers that the research done here can be put to practical use in the real word of clinical medicine.

    What kinds of professional opportunities or advantages does being a faculty member at an academic medical center provide?

    I think that the wonderful opportunity to teach the next generation of doctors is one of the best reasons to work in academia. I've worked briefly in non-academic areas as a psychiatrist and, while I respect my colleagues in community and private practice a great deal, the main reason I returned was because I missed teaching.

    What are some of your professional interests?

    I'm a consulting psychiatrist, which has been called psychosomatic medicine for many years. You could call me a psychiatric hospitalist. I am very interested in teaching my colleagues and trainees about how important it is to prevent delirium. I try to promote being alert for delirium in hospitalized patients and how to recognize it and manage it when it occurs. I also co-staff the Medical Psychiatry Inpatient Unit where patients with complex, comorbid physical and psychiatric illness receive high quality care in an integrated effort—a unique offering in health care delivery systems.

    What lead to your professional interests?

    I will always believe that my mentors (whether or not they knew they were my mentors at the time) were my role models for integrating the practical with the theoretical, medicine with psychiatry, classical poetry with a sense of humor and the good sense not to take yourself too seriously. They ultimately shaped me into what I am today.

    What are some of your outside interests?

    Explore The Practical Psychosomaticist, a blog that Amos maintains.

    I've always been interested in writing. Over the last couple of years, I have been having a lot of fun with blogging. My blog is called The Practical Psychosomaticist. While it is mostly about work, I occasionally write about more personal subjects and dabble in humor. It has been one of the most enjoyable activities I've ever done.

    Do you have an insight or philosophy that guides you in your professional work?

    Any insights I have are borrowed from thought leaders I have admired over the years. One of them is Stephen Covey, a business leader and champion of principle-centered living. I try to live by one of his most popular books, The Seven Habits of Highly Effective People.

    If you could change one thing about the world (or the world of medicine), what would it be?

    I hope that in my lifetime leaders in medicine, health care policy, and insurance will realize how critically important it is to provide integrated care for patients with both medical and psychiatric illness. Doing that would go a long way toward erasing the stigma of mental illness, enhancing physical and mental health, and driving down the volcanic cost of health care in America.

    What is the biggest change you've experienced in your field since you were a student?

    I have to say that it's the advent of more complexity in medical education and clinical care, especially the electronic health record. Adjusting to this has been a major challenge for me and many other health care providers. By and large, I think electronic health care records will improve the quality and safety of medical care for patients.

    What one piece of advice would you give to today's students?

    I would say that it's very important to "begin with the end in mind," as Stephen Covey would say. It is very easy to spend a great deal of energy learning skills, cramming knowledge, building processes, networking—and then find out that a definite goal was never given enough thought at the start.

    What do you see as "the future" of medicine?

    I hope that the future will bring true integration of mental and physical health care, not just in clinical care but in the processes and outcomes we build into our health care system. If we focus on outcomes and pay equally for treatment of both medical and psychiatric illness, not out of separate pots of money with overly complicated reimbursement budgets but from one source, we really can improve the health of our people. This is something that visionary leaders like Kathol have been talking about for decades.

    In what ways are you engaged with the greater Iowa public (i.e. population based research, mentoring high school students, sharing your leadership/expertise with organizations or causes, speaking engagements off campus, etc.)?

    I'm a big fan of the free and open access route to dissemination of scholarly research and clinical education. I like to think that my blog, The Practical Psychosomaticist, plays a small part in making medical education more available to the public as well as health care professionals. It is open to the public and reaches not only to those on our campus, our community and our state, but reaches around the world.