We make good care better

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

Laurel Milberg
Emerita Councilor
2012 - present

Trained in a very 1960’s counseling psychology program at the University of Pittsburgh, my PhD concentrations were in group work and clinical supervision. My doctoral dissertation was a phenomenological study of impasses in therapy, focused on the therapist’s experience of being stuck. This was a perfect recipe for Balint work I, as yet, knew nothing about. When I returned to Pittsburgh in 1977, looking for a job where I could apply my training in therapeutic relationships to a profession other than traditional counseling, I wondered if physicians might be interested in learning these skills. Naively, I approached Obstetrics and Gynecology, Surgery, and Internal Medicine residency training programs, which were not interested at the time.

Then an internist friend introduced me to Dr Nicholas Toronto, a family physician charged with starting a Family Medicine Residency Program at Forbes Regional Hospital in a suburb of Pittsburgh. Dr Toronto had practiced for many years north of Pittsburgh and participated there in a Balint group led by Dr Rex Pittenger. Dr Toronto needed a behavioral science faculty person and an in-house educational consultant to help structure the soon to be born program. He gave me the position, his only directive being, you will lead Balint groups for the residents. Thus, Balint work became an inauguration into my new role as a psychologist teaching family medicine. It became the single most potent tool I had for creating a safe but challenging environment where trainees could learn and grow to be competent personal physicians.

Balint work created a place where what a psychologist knew and what young doctors could benefit from learning, came together and made sense. Best of all, Balint work transformed at least an hour and a half a week into something more positive, affirming, divergent, creative, supportive, verbal, thoughtful, emotional, intuitive, and humanistic than medical education in general appeared to be.

In 1995, I was elected ABS President, serving for four years, an unusually long tenure. During my time as president, I concentrated on creating policies, procedures, and revising the bylaws for operating the new Society, as well as researching the Essential Characteristics of Effective Balint Group Leadership with Dr Don Nease, Alan Johnson and Ritch Addison, PhD. I then turned my attention to structuring the process by which the ABS trains and credentials leaders and became the first chair of the Credentialing Coordinating Committee, created in 2000.

Retiring from my posts at the Family Medicine Residency at Forbes and the University of Pittsburgh School of Medicine in 2010, but not from Balint work, I continue to lead Balint groups. One is a faculty Balint for the University of Connecticut Family Medicine Residency Program and one for their second-year residents.
Like others, I blush at this compendium of Balint experiences because it sounds like, look what I did. However, what lies beneath is gratitude for the opportunity to build and teach and share the creation with a wonderful group of passionate colleagues and friends.

For a narrative of Dr. Milberg's work with the ABS, consult her Emerita Nomination.