We make good care better

"At the center of medicine there is always a human relationship between a patient and a doctor."
Michael Balint

Don Nease
Emeritus Councilor
2018 - present

My first exposure to Balint Groups came in the summer of 1987, as I began my residency training in Family Medicine at the Medical University of South Carolina in Charleston. In those days, we had a month of introduction to Family Medicine, which included Balint. I vaguely remember Dr Clive Brock giving the barest of descriptions of how the group was to work before we got started. I was very intrigued by the group work as I had been trained as a peer support group facilitator in medical school at Kansas, so jumped in with a great deal of curiosity. We were, I think, an unwitting part of an experiment as there had not previously been a first-year resident group. Needless to say, I was hooked fairly early on. I can still recall cases from those early groups, including one in particular that I presented where I had felt threatened by a patient.

Following residency, I moved back to Kansas and took a fourth year fellowship position at the University of Kansas (KU) program in Kansas City, followed by an additional two years as faculty. There I began efforts to introduce Balint into the program. It was fits and starts, but I had support from afar from Clive and Alan Johnson, PhD.

When I moved to the Family Medicine Department at the University of Texas Medical Branch Galveston, the climate for Balint work was more warm and inviting. It was very exciting to meet people from around the country doing Balint work, and I had the feeling of a movement coming into being.

It was in Galveston that I had the idea to start Balint-L. Family-L was an active STFM listserv at the time, and it seemed to me that the Balint movement could benefit from a similar service. Being a bit of a geek, I managed to fire up the service using a spare Mac, and we were off and running. Balint-L provided my initial entree to the ABS Council, as it was decided that the service was important enough that the Balint-L moderator should have an ex-officio presence.

In 1998, I moved to the University of Michigan in Ann Arbor. There had been a history of Balint groups going back to the founding Chair, Dr Terry Davies, who came from the United Kingdom and was quite aware of Balint and its importance for primary care doctors.

Over the course of my career as a part of the Balint movement, I’ve seen the ABS evolve from a beginning organization, sorting out training and leader credentialing and also trying to decide what it wants to be when it grows up. The dilemma to me is between an organization mostly focused on training and supporting Balint leaders versus spreading the movement beyond medical educational settings. Of course, it’s not an either/or, but shading of purpose between the two.

Within the ABS and IBF my most gratifying work has been in helping to encourage younger participants. The Balint 2.0 collaboration with the World Organization of Family Doctors, Young Doctors Movement, is a highlight of that effort. Through it, we are bringing the Balint process to young family doctors who might otherwise never be able to join a group by creating that opportunity through the Internet.

For a narrative of Dr. Nease's work with the ABS, consult his Emeritus Nomination.