Injury Prevention

A Road Less Traveled: A Clinical and Academic Opportunity

By: Garry Lapidus, PA-C, MPH

I am occasionally referred to as Dr. Lapidus, despite my lack of a medical or other doctoral degree. I am the director of Connecticut Children’s Injury Prevention Center (IPC), as well as a physician assistant (PA) in Connecticut Children’s Emergency Department who also holds a master’s degree in public health. I am proud that my professional success includes promotion to associate professor in the Department of Pediatrics at the University of Connecticut School of Medicine, which is the senior rank of academia. I am relatively unique among the faculty there, by virtue of my not holding a doctoral degree and still rising to the senior academic rank. It is a path that many others could pursue, but may not realize is an option. I see that among my colleagues at Connecticut Children’s Office for Community Child Health (OCCH), where few pursue or hold academic rank. I also see this among fellow physician assistants and nurse practitioners, whether they work at Connecticut Children’s or elsewhere. My experience suggests this is a lost opportunity for many people. I am hopeful that my story will motivate students and professionals to discover their own path to leadership, service, and academic success.

After graduating from the Emory University PA program in Atlanta, Georgia in 1978, I began my clinical work at Mount Sinai Hospital in Hartford, Connecticut. At the time, Sinai was a small, independent, 250-bed hospital with a pediatric department staffed by four pediatricians and 10 PAs. There were no pediatric residents, so the PAs functioned as the “house staff”, guided and supervised by our physician colleagues. We staffed the Emergency Department in the evening and evaluated sick and injured patients deemed appropriate for hospital admission to our 20-bed inpatient pediatric unit. We also staffed the newborn nursery, attending difficult deliveries and cesarean sections to provide immediate newborn care and resuscitation and provided care to sick newborns in our modest Neonatal Intensive Care Unit. We provided pediatric care at an urban ambulatory care clinic (Burgdorf) and at a clinic in Windsor Locks, Connecticut for children in the custody of the Department of Children and Families. It was a remarkable experience to learn pediatric medicine and begin to understand the importance and impact of social influences and adverse childhood experiences on child health and development. I also witnessed the terrible impact of so-called accidents on children and their families. About one-third of our admitted patients were due to so-called accidents. They were frequent, often severe, and costly.

I brought my questions and concerns about the many accident victims to my department chair. He welcomed my interest and suggested I visit the hospital library to educate myself about “accident prevention.” It was transformative. I discovered the science of injury prevention that was rooted in public health principles and practice. I learned a valuable lesson that would shape my career – injuries are not accidents, they are predictable and preventable. I believed it and wanted to learn and do more to address this problem. I recognized the need for public health training so, in 1986, I enrolled in the University of Connecticut Master of Public Health program. I was fortunate to learn from wonderful teachers, including Drs. Holger Hansen and David Gregorio, who guided and supported me. I read as much of the injury prevention literature as I could. One notable text, “The Injury Fact Book,” was authored by Sue Baker, MPH, Professor of Public Health at Johns Hopkins University. I was inspired by her work and academic accomplishments at such a prestigious institution. I wondered how it was possible for someone to be a professor without earning a doctoral degree. In 1987, I was accepted in a summer institute in injury prevention at Johns Hopkins and met Professor Baker. It was a terrific experience. She was kind, encouraging, and introduced me to many of our injury prevention leaders and scholars. I left with the impression that I could also work toward a life of academic scholarship and service in Hartford and at the University of Connecticut.

In the 1980’s, I had the good fortune of meeting and developing close professional relationships with several physician leaders, including Drs. Leon Chameides, Len Banco, and Paul H. Dworkin. They also believed in the value of injury prevention as an important avenue to promote child health and well-being and in my potential to contribute to this effort. As a newly minted MPH, I was recruited in 1989 as the first PA in the pediatric department at Hartford Hospital. I spent half of my time on clinical work in our busy Pediatric Ambulatory Care Center and devoted the rest of my time to developing and launching the IPC.

In 1990, the IPC was established with its mission to reduce unintentional injuries and violence in the state. Our four core activities (research, education and training of students, community outreach programs, and policy/advocacy) would be the foundation to meet our mission. With the hospital leadership behind us and the kind guidance and support from my physician colleagues, I seized this wonderful opportunity. There was much work to be done. Using the public health approach, we organized an injury surveillance system to provide data to help us understand the epidemiology of injury in the state. We identified priority injury areas and trends. We began to write and submit research and program grants and evaluated their impact. Our first initiative, supported by the American Academy of Pediatrics, was a $4,000 grant to launch a community-based bicycle helmet program. We developed research protocols and initiated studies. We presented our results in peer-reviewed scientific meetings and published our results in academic journals.  In 1996, Connecticut Children’s opened and the IPC became an integral part of this a new academic children’s hospital. As we achieved success, we secured more resources to hire staff. We built collaborations and partnerships with those working in the community and in government. I secured permission to design and teach a course in injury and violence prevention at the University of Connecticut Graduate Program in Public Health. I started teaching the course in 1992 and continued teaching the course through the years, with the latest section offered in Fall 2019.

Read additional blogs from Connecticut Children’s Injury Prevention Center here.

I was astounded in 1990 when I received a letter from the Dean informing me that I was faculty and an “Instructor” in Pediatrics and Public Health at the University of Connecticut School of Medicine. With more work and success came academic promotions to Assistant Professor (1994) and my achievement of senior rank as Associate Professor (2002).

Academic appointments celebrate an individual’s efforts in teaching, service, research, and advocacy. Academic advancement requires excellence in teaching and contributions in at least one other area of emphasis. I have had the great fortune of collaborating with many physicians at Connecticut Children’s in research activities and in teaching and mentoring many students from diverse disciplines. One of my greatest hopes is that trainees might integrate injury prevention into their professional careers. The field needs the next generation to tackle the complex injury and violence problems we are confronted with like needless traumatic brain injury resulting from ineffective motorcycle helmet laws, the opioid epidemic, intimate partner violence, gun violence, and suicide. Just last week, I received a message from a former college student of mine who spent a summer at the IPC several years ago and is now a fourth-year medical student. She wants to pursue a pediatric residency program and hopes to “…get involved in injury prevention and wanted … advice on how she could best pursue this.” I was thrilled!

There is so much opportunity in academia for those who do not hold doctoral degrees. Just within OCCH alone, many talented individuals work on a wide array of critical contemporary issues. Our staff has much to share through their teaching and training efforts. Furthermore, staff contributions to program development, research and evaluation, and advocacy deserve the recognition and incentives offered through academic appointments. Such appointments elevate the stature and significance of our work and bring credibility at the local, regional, state, and national levels. Such recognition honors our institution and academic partner.

I often reflect on how unusual my professional trajectory is for a PA. Then, I consider how I benefited from meeting Professor Baker. I am eager for students, physician assistants, and even my OCCH colleagues to consider how becoming engaged in the process of academic appointment and advancement may enhance their career success and satisfaction. The path is not one many pursue without a doctoral degree, but it’s one I strongly urge you to consider.

Garry Lapidus, PA-C, MPH, is the director of Connecticut Children’s Injury Prevention Center, which is a program of Connecticut Children’s Office for Community Child health. Lapidus is also an associate professor of pediatrics and public health at the UConn School of Medicine.

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