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Open Letter to a Student

Posted By Randall Reitz, Friday, November 18, 2011
Dear New Collaborator:

I pen this letter on an airplane flying westward across our fare land—from Philadelphia to Grand Junction. I’m leaving the CFHA conference where it was announced that CFHA had hired my successor as executive director, the fantastic Polly Kurtz. So, the mood of my flight from the bustle of the CFHA conference and back to my day job at the St Mary’s Family Medicine Residency is frankly nostalgic.

I recently turned 39. By my calculation, this allows about 1 more year of relevance to the rising generation of collaborative clinicians. Our field is fast-evolving and in the very near future my ideas will seem quaint and my experiences obsolete. Given that my stock is eroding faster than the US economy, please allow me the timely presumption of sharing my CFHA story as a model of how this association can benefit your own professional development.

My journey is a trail of serendipitous turning points that connect extended periods of intentional activity and ambition. CFHA was a catalyst for advancement at each of my turning points.

My affinity for CFHA began years before I attended my first conference or formally joined the association. In the fall of 1996, as a family therapy student at Indiana State University, I attended my first professional conference: AAMFT in Toronto. The steps I took to attend on a very limited budget will sound familiar to many:
  • Unable to afford the registration fee, I procured free attendance through volunteering;
  • The ISU cohort crammed into a minivan borrowed from one of our parents and drove 12 hours overnight to Toronto;
  • 8 of us spooned in 2 hotel rooms "within walking distance” of the conference hotel;
  • I brought along an electric frying pan to save on at least 1 restaurant bill each day.

My last duty at the conference was to assist in breaking down the exhibit hall. I spent most of my time in the Basic Books booth. At the time this imprint published the best literature in our emerging field. As a thank you, the exhibitor game me an unlimited pick of the unsold books. I squeezed at least 15 books into the minivan, including Medical Family Therapy, Models of Collaboration, The Shared Experience of Illness, The Body Speaks, Collaborative Language Systems, Conversation, Language, and Possibilities, and Beliefs: The Heart of Healing in Families and Illness.

I had no idea of the treasure-trove I’d stumbled upon. Having a younger brother with diabetes, I was interested in family dynamics with chronic illness, but had no idea that the collaborative care movement was being formulated by the authors of these books and that they were also founding a professional association (CFHA) to unify their efforts.

I read just about every word of these books in the next few months. I quickly discovered that the author of "Beliefs”, Dr Wendy Watson, was an RN therapist on Brigham Young University’s MFT faculty—the school I hoped to attend for my doctoral studies. We began an email correspondence that resulted in my acceptance in the program.

While I was preparing my literature review for my dissertation, a large percentage of the articles I reviewed were published in Family Systems Medicine and Families, Systems, and Health—CFHA’s official journals, including my favorite clinical article of all time: Michael White’s treatment of Sneaky Poo in "Pseudo-encopresis: From avalanche to victory, from vicious to virtuous cycles”.

Within a few years I was seeking out a doctoral internship site. I was granted interviews by John Rolland’s program in Chicago and Susan McDaniel’s program in Rochester, but didn’t secure either of these positions. I returned to my cache of books from CFHA-affiliated authors and sent out emails regarding possible internship sites. Melissa Griffith, a co-author of "The Body Speaks” forwarded me a CFHA email blast regarding a job-opening at Marillac Clinic in Grand Junction, CO.
It turns out that Larry Mauksch had just completed a year-long sabbatical at Marillac where he had trained the medical staff in collaborative care and had successfully applied for a 4-year RWJ grant to hire 3 mental health clinicians and a case manager. I was the first hire for this grant and ended up staying with the clinic for 5 more years after my internship. Larry’s years as president of CFHA and chair of the Seattle conference overlapped with my time at Marillac. Larry became my beloved collaborative care mentor. We published research together and presented together at the CFHA conferences in Minneapolis and Seattle. Since that time, at every major turning point I have sought Larry’s advice. He was a reference when I applied to be the behavioral science faculty at my residency and he wrote my nomination letter when I applied to be a member of the CFHA board.

Six weeks into my board term, CFHA’s newly hired, first-ever executive director died at a young age from a heart attack. I was on the highly unsuccessful task-force to hire a new ED. After 8 months of frustration, and out of sheer desperation, Frank deGruy asked me to consider leaving the board and joining the staff as a "half-time” executive director. Splitting time between leading CFHA and continuing my commitment to the St Mary’s Residency has been my biggest, and undoubtedly most rewarding career challenge. I’ve never sent as many 4 a.m. emails in my life. I’ve never had a role that required such creativity, determination, and discernment.

As in previous experiences with CFHA, the richest aspect has been the collaborative relationships with CFHA people. The board of directors and committee members are wonderful, visionary, generous people. I especially want to tip my hat to Jennifer Hodgson and Ben Miller who have been my early morning email co-conspirators. The staff, Bill Steger and Steffani Blackstock, are shockingly good at what they do. My dear friend Pete Fifield has created an amazing blog that stimulates conversations across the nation each week.

As this is a letter to the next generation of collaborators, I will end it by observing that my experience with CFHA is far from unique. The association is full of people who have committed themselves to a cause and have been richly rewarded for it—people who saw beyond the walls of their own disciplines to create a vision for a healthcare system where people actually enjoy working with the colleagues and family members who inhabit our medical homes and healthcare neighborhoods.

Yes, last week’s conference was again the annual nexus of collaborative care, but the vast majority of the creativity and energy will be created outside the conference. Just like my experience with my first ever professional conference back in 1996, you stumbled upon great caches of information at the conference, but the most important connections you will make will come from sending out follow-up emails, from getting involved on a CFHA committee or work group, or from contributing to the conversations at our blog. If you will make these small steps, you will discover that at each turning point of your career, there will be a CFHA person there to guide you, to promote you, and to buoy you up.

Warm Regards,


The view expressed in the blogs and comments should be understood as the personal opinions of the author and do not necessarily reflect the opinions and views of the Collaborative Family Healthcare Association (CFHA). No information on this blog will be understood as official. CFHA offers this blog site for individuals to express their personal and professional opinions regarding their own independent activities and interests.

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