Presentation of the 2012 Don Bloch Award
to Larry Mauksch
October 5, 2012
CFHA 14th Annual Conference Awards Luncheon
(Left to Right) Barry Jacobs, Valerie Ross, Larry Mauksch, Randall Reitz
The Don Bloch Award, CFHA's highest honor, was presented to Larry Mauksch EdD by a group of his colleagues, Barry Jacobs, Valerie Ross and Randall Reitz on October 5, 2012 at the CFHA annual Awards Luncheon. In his acceptance speech, Dr. Mauksch shared thoughts on his experience in the collaborative care movement over the last twenty years.
I want to thank the CFHA board for this great honor. Recognition from one’s peers is about as a high an honor as one can receive perhaps only eclipsed by recognition from one’s family. Today I am a fortunate man as both my professional and personal family members are present.
I feel a deep sense of gratitude receiving this award. I called Don Bloch to express my thanks for his contributions and his influence on me and on the field. My thoughts also go to many others who have in one or more ways helped me learn and grow. I started making a list. Behind me on the screen is a Wordle. When text is inserted, it arranges the words in different ways allowing you to choose designs and colors. One other feature of a Wordle is that it alters the size of the word to reflect the number of times it appears. I listed everybody once, except for Don, in his honor. Many people in this Wordle are in this room. Family members are listed with first and last names, colleagues are listed by last name, sometimes with a first initial. To all of you I wish to express my deepest appreciation for your gifts. I needed your encouragement, your voices, and your care.
In reflecting on your gifts it occurred to me that they affect different aspects of my growth and at the risk of being too personal, I want to share some of this with you. In 1982, when I was fresh out of graduate school, two family physicians took me into their practice and trusted me with their patients. This was truly a gift. The referrals came fast and I sought supervision, at one point from 4 different people at the same time, each with different areas of expertise. One supervisor was a former graduate school faculty member. We met weekly at a local health food cafe. He allowed me to buy him a whole-wheat cinnamon role and a latte but at first would not accept payment. I would tell him about my patients, like the woman who complained about her husband and tried to convince me that he would not participate in counseling. My supervisor suggested I call the husband in front of the woman and say, " Mr. Thompson, I am the counselor who is working with your wife. I can tell she loves you and I know that you two are struggling with some things. I miss your voice and I have no question that your perspective on this relationship is really important. Would you be willing to join us next week?” Then we would talk about theory and strategy. What stayed with me was his voice. He taught me from the inside out, starting with application and demonstration of skill. This gave me confidence, clarity, and direction. I used his words with my patients. As the years went by, I helped patients by sharing my voice. Saying what seemed helpful, then conceptualizing what came out of my mouth, became a way to tap into my own wisdom. I have shared phrases with trainees just like my teacher did with me. In fact, when I now lapse into first person dialog, acting as a therapist or a physician or a medical assistant, I look around and people are writing down my phrases. It helps people get started talking about hard topics like trust and abandonment and inadequacy and risk behavior and love. We need to share our voices to help our clinical team members take the risk of trying new skills. Taking these new steps helps lesser trained clinicians go to interpersonal places that feel uncomfortable. This is part of what one colleague in this room described in a mountain climbing metaphor as "the belay of collaboration1."
If a large part of my career was spent working on finding a voice as a clinician and teacher an equal or greater part of time has been devoted to finding a scholarly voice. Writing is terrifying. It is personal. Comparing myself with those who are well published is intimidating. The prospect of rejection and criticism can be disabling. New knowledge is old before it’s published. Conducting research means accepting incompleteness, uncertainty, imperfection, and compromise. In this audience, and elsewhere, including many anonymous reviewers, are people who gave me the gift of honest, and usually kind, feedback. One life long friend suggested I might benefit from reading William Zinsser’s classic, "On Writing Well”. He was right. I learned to cut out the lard. There are also some in this room and elsewhere who gave me the gift of scholastic opportunity and responsibility. They asked me to co-author papers, write reviews, chapters, and even to a co-author a book. Others taught me research methods. I recall one physician executive who spent hours helping me understand reimbursement models beyond fee-for-service. Hurrah.
I can honestly say that embracing scholarship has taught me to cherish my mistakes as ways to continually learn. Sharing the failures, limitations, challenges and responsibilities of scholarship with collaborators has made my learning easier, more efficient, and much more meaningful.
Collaboration is the last gift I want mention. In this room and elsewhere are many people who have offered me the opportunity to build a new curriculum, transform a clinic system, and lead an organization. These are incredible gifts. They forced me to think at many levels. How do you lead an organization that has a great mission but financially is barely surviving? One of you offered the "pilot light approach” that emphasized holding on to relationships, mission, and conserving resources for the right time. How do you help a clinic system where the biopsychosocial mission and commitment of its providers is inspiring but also leaving them exhausted and frustrated? This clinic, with full board support, brought me in for an entire year. Their clinicians allowed me to watch them interact with patients. The executive leadership agreed to regularly cancel half days of clinic and hire locum tenens support so everyone could participate in my system wide educational sessions. These experiences stretched my intellectual and interpersonal abilities. Eliciting the ideas of others took on new meaning because I at once had to make people feel heard and move forward in ways that might be new or risky. With their trust, I was able to challenge students and fellow board members, medical assistants and physicians, and administrators and faculty, to learn new skills or even entertain new cultural values.
Today, we in CFHA are part of an amazing cultural transformation in health care. People are experimenting with new team designs, financial models, and interpersonal skills. Behavioral health integration is common place in safety net settings and other clinical arenas with a knowledge base that fills the curricula in multiple training programs. We look to broader and deeper impact on systems, families and policies. The collective wisdom in our organization represents incredible potential to learn and make a difference in how health care is provided in our country. I share my experience with you because I hope that all of you can exchange similar gifts with fellow clinicians, teachers, students, scholars and leaders: teach them, share your voices, celebrate their ideas, and help them take on new responsibilities. Once again, thanks for your feedback, your time and encouragement, your trust, your voices, your friendship and so much opportunity.
1. Lorenz, A. (1999). Reflections: The belay of collaboration. Families, Systems, & Health, 17(1), 133-135