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Healthcare PlexusCall: Leadership Skills for Physicians, Better Care for Medically Complex Patients
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When: Wednesday, January 15, 2014
1-2pm ET

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Healthcare PlexusCall
Wednesday, January 15, 2014, 1:00 pm ET/10:00 am PT
Topic: Better Leadership Skills for Physicians, Better Care for Medically Complex Patients
Guests: William Gunn and Andrew Valeras

MP3 File


Systems Framework (pdf)

For many physicians, their most challenging patients are medically complex, with one or more chronic illnesses, perhaps mental health or substance abuse issues, economic issues, and social isolation. They may not trust the healthcare system, and resist seeking care until a crisis takes them to the emergency room,

They are better served by a Medical Home approach, providing a place where they can work with a team of healthcare providers who know them and their situation. NH Dartmouth Family Medicine Residency has developed a longitudinal, seminar style [Systems] curriculum and an experiential Complex Continuity Clinic at the health center to better meet the needs of patients, and to provide residents with skills needed for patient care and the growing need for collaboration and teamwork in the practice of medicine. NHDFMR has also partnered with Dartmouth Hitchcock Medical Center to offer the Leadership Preventive Medicine Residency that further builds upon these skills and focuses on adaptive leadership.

William B. Gunn Jr. PhD has been a faculty member at the NH Dartmouth FMR in Concord, NH for the past thirteen years. He holds a clinical appointment at Dartmouth Medical School and is on faculty for the Leadership Preventive Medicine Residency Program. Dr. Gunn was the principal investigator on a research study of the prevalence of psychological distress in a primary care population, a project funded by the Endowment for Health in New Hampshire.

Dr. Gunn received his doctoral degree at Virginia Tech in 1986 in family therapy. In 1986 he began teaching in family medicine and continues in that capacity. He was the Director of Behavioral Science in Fort Collins, Colorado from 1986 to 1992. While in this position he developed curriculum in a wide range of clinical areas related to helping family practice residents screen and treat their patients for mental health and substance abuse issues. Part of this curriculum has been the development of leadership skills for residents. A longitudinal curriculum teaches skills involved in communication, team development, situational leadership, working with personalities at work, team membership and leadership, negotiation, and conflict resolution.

Dr.Gunn is a co-author of Models of Collaboration; a book designed for mental health professionals working in medical settings and has published articles around the integration of behavioral health into primary care. He is also co-author of a book published in 2009 by the American Psychological Association last year, The Collaborative Psychotherapist. He is a licensed psychologist in New Hampshire and an approved supervisor with AAMFT.

He is particularly interested in chronic illness including cancer. He has the experience of being a father of a son diagnosed at 17 years old with lymphoma. This gave him a particularly personal perspective on the struggles family members go through during this process.


Andrew S. Valeras, DO, MPH received his undergraduate degree from Boston College and his Doctor of Osteopathic Medicine from Midwestern University. After his training at NH Dartmouth FMR, he obtained his MPH at The Dartmouth Institute while completing the Dartmouth Hitchcock Leadership Preventive Medicine Residency. The focus of his quality improvement practicum was decreasing avoidable utilization among "high utilizers” of the Emergency Department by approaching it as a symptom of complexity.

Since then, Dr. Valeras has published and presented nationally on incorporating complexity theory and quality improvement into patient care and resident education. Dr. Valeras currently coordinates the [Systems] curriculum, which entails 320 hours over three years of Family Medicine training that is focused on expanding residents’ mental models of what is patient care, team-based care, and change management.

Bill and Andy will join the January call to talk about their work. Please add your voice to the conversation with your own experience creating appropriately complex approaches with complex patients.


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