Leo M. Cooney Jr., MD, the Humana Foundation Professor of Geriatric Medicine, was honored this month as the recipient of the annual David J. Leffell Prize for Clinical Excellence. Dean Robert Alpern, MD, Ensign Professor of Medicine, presented Dr. Cooney with the award at a ceremony in the Beaumont Room in the Sterling Hall of Medicine.
“I’ve received a few teaching awards over the years,” said Dr. Cooney, a 1969 Yale School of Medicine (YSM) graduate who joined the Yale faculty in 1976. “But this is the first time I’ve ever been formally honored as a clinician, and it means a lot to me. This award validates my approach to medicine, which is very different from the way many doctors now practice.”
Over the years Dr. Cooney adopted and refined an approach he jokingly called “low- tech medicine. I go to the bedside to examine, observe, take histories, and evaluate my patients, focusing on their mobility, activity, functions, and desires. I don’t focus a lot on lab tests and diagnostic imaging procedures.” He doesn’t dismiss the “high-tech approach,” which he admits is “helpful and important.” But he believes that over-reliance on technology can result in a break in the “essential connection between physician and patient,” a bond he says is “paramount” in high-quality health care. “The two approaches are complementary,” he said.
Dr. Cooney is an attending physician at the Dorothy Adler Geriatric Assessment Center, and medical director of both the Yale Acute Care for the Elderly Unit at Yale-New Haven Hospital (YNHH) and the Yale-New Haven Nursing Home Practice. A past president of the American Geriatrics Society, he is passionate about helping elderly individuals attain the highest level of independence possible, and he has focused his research interests on efforts to ensure that health care resources are applied to the neediest patients.
High praise from colleagues, students
A colleague who nominated Dr. Cooney wrote, “He is a doctor’s doctor... a role model for how to care for patients and teach subsequent generations of clinician educators.” A student who had completed an internal medicine rotation with Dr. Cooney commented, “He would stop at nothing to ensure that we understood our patients, worked through the problems appropriately, learned physical exam skills, and developed the attitudes that will carry us in good stead throughout our careers. Dr. Cooney is one of the best teachers and mentors to which I have been exposed thus far at medical school—perhaps the very best.”
Dr. Cooney began his education at College of the Holy Cross before attending Yale School of Medicine. He was chief resident at Boston City Hospital, where he embraced geriatrics. “The thing that struck me was that we did a terrible job caring for older patients,” he said bluntly. He recalled lectures on exotic diseases, but nobody talking about bedsores, dementia, delirium, and other problems that affected elderly patients on a daily basis.
He endeavored to find ways to remedy the situation, and, after completing a fellowship in rheumatology at Boston University Medical Center, he returned to YSM at the invitation of mentor Robert H. Gifford, MD ( then section chief of internal medicine), to establish a program in geriatrics that would build on the Continuing Care Unit (CCU). The CCU was founded in 1968 on the eighth floor of YNHH to provide comprehensive care for acutely ill elderly patients.
Teacher of the year
The first job on Cooney’s plate was convincing skeptical medical residents that a clinical rotation in the CCU, established by Samuel O. Thier, MD (then chair of the Department of Internal Medicine), could be both educational and enjoyable. “My third day here, the chief residents were trying to ‘sabotage’ Sam’s efforts by combining the rotation with the coronary care unit,” Cooney recalls. But Cooney turned the situation around, saying with some pride that, “three years later, I got the house staff’s teacher-of-the-year award.”
The geriatrics program is now one of the best in the country, and Dr. Cooney is noticing a renewed interest among medical school graduates in specializing in internal medicine in general and treating the elderly specifically. “When I think about the students and residents I teach and work with, I’m incredibly optimistic and excited about the future of medicine,” Dr. Cooney said. “Their hearts are in the right place.”
The David J. Leffell Prize for Clinical Excellence was established five years ago with a gift from David Leffell, MD, and his wife, Cindy. Dr. Leffell is the David P. Smith Professor of Dermatology and Professor of Surgery, deputy dean for clinical affairs, and section chief of dermatologic surgery and cutaneous oncology. Each year, the Leffell Prize recognizes a faculty member who best exemplifies clinical expertise, a commitment to teaching, and the highest standards of care and compassion for patients.
Dr. Cooney was chosen from among 19 nominees based on the recommendations of a review committee chaired by Ronald Vender, MD, chief medical officer of Yale Medical Group; and including Richard Edelson, MD; Thomas Hanson, MD; David Greer, MD; Thomas Balcezak, MD; and last year’s Leffell Prize recipient, Ronald Salem, MD. The winner receives a check for $1,000, and his or her name is engraved on a plaque to be displayed in the Sterling Hall of Medicine.