Ethics, Empathy, and Leadership

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The Article is:
Ethics, Empathy, and Leadership

Ethics, Empathy, and Leadership

I was recently meeting with some fourth-year residents as part of their course on community psychiatry.

Since this was an introductory session, we were focusing on the role of the community psychiatrist.

We thought about this within both the constraints that many psychiatrists practicing in the community

find themselves, and the ideal characteristics and defining features of community psychiatry. Even

as trainees, these folks could see how the scope of what they were being asked to do was shaped

by financial imperatives and was often limited to biologic perspectives on illness management. They

clearly felt discouraged by the limitations on their abilities to practice and learn the more dynamic

and humanistic aspects of psychiatry, and wondered whether there was any way around this. Their

perceptions and experiences were closely aligned with the discussions generated at our winter

meeting in March. (The draft report from that meeting can be viewed on our website, or specifically

here.) And it was not surprising to discover that their exposure to the transformation initiatives that are

currently underway and recovery-focused practice were quite limited, even as they prepared for life

after residency. This made for an interesting discussion, in any case, that was rather thought provoking.

How does one try to convey the essence of community psychiatry in thirty or forty minutes, which was

all that remained of the session after the preliminary part of our discussion? In response to one of the

resident’s questions, I began to think about what makes community psychiatry community psychiatry.

He talked about his clinical rotation, in which he saw public-sector clients in a community mental