Susan Radecky, MD, MPA, leaves Grand Rapids residency position for international practice

After 19 years as director of the Grand Rapids Family Practice Residency Program, Susan Radecky, MD, will be leaving her position to pursue mission work overseas. In a recent interview with April Allison, she reflected upon her plans.

AA: How did you come to the decision to leave the residency program?

SR: For quite a while I’ve thought it was time for something different. I’ve been in this role for 19 years. It has been most of my professional work.

It’s ironic that you can become really competent at what you’re doing, but then consider not doing it. That’s sort of scary — to think “I do that really well and why should I not do it any more?” It took a long time to sort through all of that.

Then came the question of what I would do instead. I’ve been very fortunate over the last 10 years to have done a lot of international short term service. It’s so satisfying, and it became more and more clear that is really what I would like to do.

Once I realized that, I tried to choose a time to leave that would be least troublesome to the residency. I chose the conclusion of our recruitment season. I announced the day after we turned in our matching lists, and I will stay through the end of the academic year.

Springtime is the busiest season in a residency program. I hope to tie up a lot of loose ends before leaving. I’ve already apologized to the faculty that I’m not going to go down quietly, so watch out. I’ve got a sense of wanting to clean that dream up before I leave.

AA: Tell me about the dream.

SR: One of the biggest dreams is our commitment to the Wege Center* and to creating a model of health care delivery that’s more integrative. That’s been the hardest dream to pull off. Depending on my moment, I’ll be at various points of how well we’ve done with that.

There’s a Dana Reeve special on tv called “The New Medicine.” But what they describe is about as innovative as sliced bread. It’s nowhere near the level of integration to which we aspire. This tv special is about psychosocial medicine — being nice to patients, interviewing them. It’s so basic! It’s frustrating to me. People still aren’t getting the new integration. I guess I’m not patient enough.
It’s not complex, it’s so core. That’s why I get so impatient. I can’t understand why people can’t make sense of this, because it seems so basic. It shouldn’t be considered “radical.”

I have no question but what the bio-psycho-social-spiritual model is the right model. It always has been. It’s just the modern view that has split us into smithereens. I know the residency program embraces this model. That’s not a question.

In the residency, there’s openness to listening to people. But we’re still tiny steps away as far as what that really means, and how you can really be respectful of people. How much should you be informed about different modalities? That’s where we struggled. It’s so hard to learn to be a good bio-psycho-social-spiritual doctor!

Sometimes residents have trouble learning this approach because they haven’t experienced enough life. As soon as you experience life — and you’re vulnerable or you’re hurt or you’ve had a tragedy — you know it right away. It’s instant. And 26-year-olds might not have had these experiences yet.

As soon as you learn it, it should just become part of the way you operate as a physician. And then adding the spiritual piece is not that much of a stretch.
I think we overestimated what residents could do in their three years. I now think if they leave here as good whole bio-psychosocial-spiritual-technology family docs, then in five years they will know more about these other aspects of practicing integrative medicine. It’s a process of maturity. If we achieve openness, that should be our goal.

On good days I think we have done it. They know acupuncture is here. They don’t run away from it or laugh about it. But none of them is prescribing herbals during their residency. Still, they’ve been exposed. My bet is that over their lives they’ll make their choices.

AA: How will you take that vision of integrative health care into your international work?

SR: It’s sometimes easy to idealize the simplicity of other worlds when you are there. That’s because our own world is such a mess. So when you leave this world and go somewhere else, it looks idyllic, and I know it isn’t. Yet people in Papua New Guinea or Honduras who live a subsistence life don’t have this fracturing of all of the parts of themselves, because life is more simple.
When people come with health care issues here in Grand Rapids, my role is to help them understand the issues, to teach them, and then to give them options. Part of my role is helping them to make the choices that will keep them most whole. There may be options for high-tech intervention, but if I feel that their basic problem is a functional problem, then I put energy into trying to keep them keep from becoming a victim of the American system. And that’s a good part of family medicine.

My personal view of wholeness includes attention to mind, body and spirit. As a teacher of medicine I have tried to be certain that young professionals include personal wholeness in their growth. A part of that is teaching that wholeness for patients and wholeness for practitioners is all part of the same caring relationship. As my spiritual life has grown I have just desired more time in that service. It doesn’t seem like a change to me, just a change of emphasis!
I’ve loved my work, I’ve loved being a teacher. I never thought I’d be one, I never really aspired to be this. Yet I think the spiritual part of me, my commitment to my spiritual life and what I think God wants me to do is the main reason for leaving In many ways, that’s the prime motivator. It’s not that I think I haven’t been doing the right thing to this point, because I have. I’ve really loved it.

AA: How do you envision what’s ahead?

SR: I’ve done a few trips with World Medical Mission, and there are about 30 hospitals around the world that they have an association with. It’s a nice way that people can go and spend block months. I’ve served twice with them.
In my short term work I’ve just gone and provided medical care. My hope is that we will find one place and continue to go back there. I don’t know what that’s going to look like. I don’t know if I’m going to be more of a teacher or a community person. I don’t know if I’m going to be doctoring or teaching people to take care of their children.

AA: You’ll continue to have a home base here and go out on assignments?

SR: My husband is a subspecialist, a hematologist. The last time he did international work was when we finished medical school almost 30 years ago. He’s always felt that he’s not qualified to do any of the short-term assignments because he’s so dependent on hospitals and technology.

As soon as David is ready, we’ll do a couple of two-month blocks, maybe in different parts of the world to sort of test this out. I really hope that we’ll find a place that grabs our hearts and it will become sort of a six-month home. Then potentially six months in West Michigan.

But I don’t even know about that. When you are part of a mission base, it becomes clear that the people who are committed long term feel differently toward the people who come in for one or two or six months. It immediately becomes ‘how committed are you?’

AA: You are ready for this adventure?

SR: I’ve never been at a point where there were so many unknowns. It’s very exciting. And there’s nothing scary about it.