I am the Psychiatry Chief of Service for both campuses of the University of Washington Medical Center. I also direct our Psychiatric Consultation and Telepsychiatry Program. My clinical focus is on patients who are hospitalized with simultaneous psychiatric and medical issues. Academically, I most often teach psychiatry trainees about psychopharmacology for refractory mood, anxiety, and psychotic disorders.
Having always been interested in wholistic care, I completed a Med-Psych residency with board certification in both Internal Medicine and Psychiatry. My career has focused on integrating care to improve access to those who suffer from mental disorders. I have experience in developing, implementing, leading, and evaluating integrated Primary Care Mental Health programs. This work led to the development and national implementation of integrated care known in the VA as Primary Care Mental Health Integration (PCMHI).
At VA Puget Sound, I led a team that implemented and developed the first PCMHI program which has been rated as one of the top 10. It was through this integrated PCMHI work that I realized rural populations lacked access to mental health care and I became interested in how the emerging digital technologies could be leveraged to provide care. With the goal to improve mental health care for this population, I developed, implemented, and led the first Telemental Health Service at VA Puget Sound known as Promoting Access to Telemental Health (PATH). This program focused on implementing digital health into routine mental health care, evaluation of implementation efforts, and digital health curriculum design. PATH has been fully implemented into VA Puget Sound Mental Health Service Line.
As a researcher, I have served as a principal and co-investigator on numerous research projects that focused on the development and implementation PCMHI and Care Manager programs. More recently, my research has focused on evaluation and implementation of telemental health programs. Current work focuses on improving virtual integrated care in rural VA clinics, integrated care curricular design, evaluating mental health service delivery for the national VA Telehealth Clinical Resource Hubs, and supporting the UW Behavioral Health Institute to develop Digital Health Training programs. In addition, I am proud to serve as a Captain in the United States Navy Reserve and I am an Operation Iraqi Freedom Veteran.
I am a board certified psychiatrist and work at Fred Hutchinson Cancer Center. I am a Clinical Assistant Professor of Psychiatry and Behavioral Sciences at the University of Washington. I obtained a fellowship in consultation-liaison psychiatry, a specialty that focuses on providing psychiatric care for people with complex medical conditions. My primary clinical focus is people with cancer.
I love my work. Being ill is a vulnerable time and my goal is to ease suffering and provide a sense of connection and understanding for all I work with. I believe in working collaboratively with patients and families. We work together to identify what the goals of treatment are. I have expertise in diagnosis, psychopharmacology and psychotherapy and adapt my recommendations to best serve the goals of the person before me.
I am also passionate about education. I am the site director at Fred Hutch Cancer Center for our Psycho-oncology Fellowship Program. I supervise Cl fellows, addiction fellows, psychiatry residents and provide education to social workers and psychology trainees.
I am a consultation-liaison psychiatrist and health services researcher in the Department of Psychiatry and Behavioral Sciences and Adjunct Professor in the Departments of Rehabilitation Medicine and Epidemiology. I am also Medical Director of the Department of Psychosocial Oncology at Fred Hutchinson Cancer Center.
My research interests are in psychiatric epidemiology, health services research, psychiatric oncology, and neuropsychiatry. In my clinical practice, I use a comprehensive, multifaceted approach that may include medications or counseling to help patients achieve their goals. My primary interest is helping people who are coping with medical illness. I am particularly interested in developing better approaches to delivering person-centered psychiatric care to these populations.
I have pursued a career at the intersection of mental health and primary care, training in both family medicine and addiction psychiatry. I currently practice in various integrated care settings as a consulting psychiatrist and in the outpatient adult psychiatry clinic. I am the co-medical director for the University of Washington Psychiatry and Addiction Case Conference (UW PACC), a weekly online learning collaborative to help community providers across the state improve their psychiatric and addiction clinical skills. My area of interest is focused on improving addiction and psychiatric treatment to primary care settings. I also spend a significant amount of time training both family medicine and psychiatry trainees and fellows on integrated treatments for substance use disorders.
I am a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. I received my MD from New York University and completed my adult residency at the Harvard Massachusetts General Hospital/McLean Hospital program where I was chief resident. I then went on to complete a fellowship in psychosomatic medicine at the University of Washington. I am currently on faculty at Harborview Medical Center on the inpatient psychiatry consult service.
I have a longstanding interest in the intersection between medicine and psychiatry, and am the author of numerous published articles on topics ranging from the neuropsychiatric effects of steroids to managing borderline personality disorder in the primary care setting. I have a particular interest in the use of electroconvulsive therapy, including in the treatment of catatonia. I am currently involved in research projects in conjunction with the division of nephrology and the neurosurgery department. In addition to my clinical and research interests, I am also an associate program director for the UW Adult Psychiatry Residency at Harborview Medical Center.
My clinical service and research focuses on the interaction of mental and physical illness, especially in patients with chronic pain. Much of my research in recent decades has focused on the risks of treating chronic pain with opioids. I have developed educational programs and outcome tracking tools to assist with opioid treatment of chronic pain. I have published a book about patient empowerment in chronic disease care, The Patient as Agent of Health and Health Care (Oxford, 2017). I have another book written with Jane Ballantyne forthcoming, The Right to Pain Relief and other deep roots of the opioid epidemic (Oxford, 2022).
I completed my Residency in Psychiatry with the UW in 1982 and since then have worked at Harborview Medical Center in the Psychiatry Department. I am a Clinical Associate Professor and provide weekend and on-call coverage for 5MB on the Intensive Psychiatric Unit.
As a psycho-oncologist at Fred Hutchinson Cancer Center (FHCC), I serve patients as a psychiatrist specializing in mental health issues arising during the course of cancer and hematologic diseases. My approach to care is person-centered, focusing on your story as a person as well as a patient, and combining psychotherapeutic and pharmacologic approaches to help you navigate your journey with medical illness.
I bring fellowship training in consultation-liaison psychiatry to understanding the interplay between medical conditions and mental health issues, and I believe that partnering with both patients and their medical teams is essential to create a successful plan of care. While I often oversee psychiatric medications during cancer treatment, I also have a background in supportive, psychodynamic, CBT-focused, and meaning-centered psychotherapy, and I incorporate psychotherapy elements into each appointment.
Within the field of psycho-oncology, my specific interests include working with palliative care populations, supporting existential issues that arise during journeys with cancer, and strengthening collaborative care models in oncology settings. I am also fortunate to teach outstanding UW psychiatry residents and fellows who complete clinical rotations at FHCC.
