As part of our “Meet Yale Internal Medicine” series, today’s story is on David Rosenthal, MD, assistant professor of medicine (general medicine) and medical director, H-PACT VA Connecticut Healthcare System.
Raised in a family of four children with a physician father and lawyer mother, David Rosenthal, MD, joked that the four kids split the family professions: two became lawyers and two became doctors.
“I was interested in everything,” admitted Rosenthal. “I loved history and chemistry, but I fell in love with documentary filmmaking as an undergraduate, so I completed my degree in Visual and Environmental Studies and worked as a filmmaker for three years post-graduation.”
But when Rosenthal was creating a film recording his grandfather’s Alzheimer’s, he started to become fascinated in the science of the disease and the care received at the nursing home where his grandfather resided.
Rosenthal’s six years of filming his grandfather became a 27-minute short video entitled, “Witnessing Death: A Grandson’s Reflections on Alzheimer’s.”
He started taking medical school classes at night in Cambridge and Los Angeles while working during the day as a filmmaker and teacher. He thought he might follow in his father’s footsteps into emergency medicine, but noted that there was something ‘wonderful’ about internal medicine.
“In internal medicine, I found my tribe,” explained Rosenthal. “I think internal medicine people are the nerdiest in some way. We are fascinated by diagnostic dilemmas and trying to figure out clues and put things together. One of the joys of general medicine is knowing a bit of everything.”
But Rosenthal’s road to medicine would turn again when he became involved in health information technology. He dropped out of his residency match to create a company with a fellow medical student, knowing later that he would have to finish his internal medicine training. Rosenthal and his wife moved back to the east coast, Boston specifically, for him to complete his residency. Following his residency, he had opportunities in California and Boston, but decided that a job at Yale School of Medicine (YSM) was what he would choose. The challenge was deciding which career path to pursue.
“I had two wonderful opportunities at Yale,” said Rosenthal. “One was working with Yale New Haven Health on its rollout of Epic and the other one was very different from what I had done before: to start a clinic for homeless veterans with the VA Connecticut Healthcare System. My mentor at the time, Chris Ruser, MD, asked me to take another look at the position and I thought, ‘What better mission is there to try and do this?’”
In internal medicine, I found my tribe. I think internal medicine people are the nerdiest in some way. We are fascinated by diagnostic dilemmas and trying to figure out clues and put things together. One of the joys of general medicine is knowing a bit of everything.
Dr. David Rosenthal
Nearly seven years ago, Rosenthal jumped into the position, looking at best practices from other states, like Rhode Island, who already were using an open access model of care for veteran support. At his clinic, veterans in need can show up when care is necessary but had continuity across the physicians, nurses and support teams, drastically different from these patients seeking care at an emergency department.
“There is continuity with care in this model. In Rhode Island, they published that rates of emergency room use, hospitalization and inpatient psychiatric hospitalization dropped, and the quality of their care improved for this population,” Rosenthal explained. “Patients improved their diabetes scores, cholesterol scores, and all the things that primary care physicians care about. In Connecticut, we started humbly seeing patients with a team of four to six people and it's been wonderful.”
The CT homeless patient aligned care team model (H-PACT) team received a grant from the Department of Veterans Affairs (VA) to start the program, which has been helpful in ending chronic homelessness in veterans. He credits his ‘great’ team, a larger group focused on homelessness efforts at the VA, and their community center partner with resources such as social workers and housing specialists.
Rosenthal admits that he is still a ‘techie’ and looks at ways to improve care. One specific area of focus was addiction medicine. Rosenthal thought that a mobile phone application might work better for patients receiving suboxone therapy. So he partnered with two YSM medical students and Theddeus Iheanacho, MBBS, DTM&H, assistant professor of psychiatry to create an app to guide patients through the first few days of treatment. To learn more about the app, read “Yale Experts Develop New Free App to Tackle Opioid Addiction.”
In addition to his VA responsibilities, Rosenthal is the director of the Capstone course and teaches Yale medical students in a variety of subjects such as ethical responsibility and professionalism.
Rosenthal admits that there are many wonderful things about YSM.
“What I tell resident and students is that I’ve lived in many great cities, Miami, Boston, Chicago, LA and San Francisco,” said Rosenthal. “With Yale and New Haven, you have access to world class everything in terms of reach, impact, scientific inquiry and clinical care, but within 10 minutes, you can get outside to wonderful small-town New England. It is a wonderful place to raise kids. It can be difficult in those other cities, it's very unaffordable in most of them now. Yale and New Haven is a wonderful place to be.”
For more information on the work of Connecticut’s H-PACT, read “Yale and the West Haven VA's "H-PACT."