Not many people can say they’ve known what they wanted to do for a living since the tender age of 5, but Dr. Stephen Cosby remembers the moment vividly after receiving a toy doctor’s kit from a relative.
“I would go around giving pretend shots and dispensing pretend pills to my family,” he said.
As one of 13 kids who grew up in Louisville, Ky., he had plenty of “patients” to practice on.
“When I first entered medical school at University of Cincinnati I had no idea what specialty I wanted to pursue until I completed my pediatric psychiatry rotation,” he said. “I was impressed with how caring the staff was in dealing with the medical, social and emotional well being of the patients and it was something I could see myself doing.”
After completing a 5-year tour of duty in the Air Force serving as an adult psychiatrist – including a 2-year stint in Alaska – Dr. Cosby applied to pediatric fellowship programs thinking he would stay in Ohio to be near family. However, the universe had other plans.
“I was out in California visiting a friend who encouraged me to look at Stanford for my fellowship,” he said. “The only problem was it was very late in the process – matches had been made and their program was full.”
In a twist of fate, Stanford had an applicant drop out and offered Dr. Cosby the one open spot.
“Rather than regretting not doing something, I try to embrace new experiences – it’s a refrain I live by,” he said. “Living in California was very enriching because it was a cultural oasis and it opened my eyes to people and cultures I had no experience with.”
Following his fellowship, his first job as a pediatric psychiatrist took him to Harding Hospital in Columbus where he saw the landscape of healthcare start to change as managed care dictated lengths of stay in acute hospitals from 3 weeks to 3 days. Three years later a fortuitous encounter with a healthcare recruiter led him to a 6-year period working in Hawaii where he had his first foray into leadership as both a clinical director and chief of the medical staff.
“Hawaii was another great cultural and leadership experience, but after 6 years it was time to come home and be near family,” he said.
After working for 2 years at Child Guidance and Family Solutions in Akron, he accepted the role of medical director of the Division of Pediatric Psychiatry and Psychology at Akron Children’s teaming up with Dr. Georgette Constantinou, division administrative director who retired earlier this year.
Over their 15 years working together they added innovative programs like the Psychiatric Intake Response Center (PIRC), a 24-hour, 7-day-a-week triage and referral service that links families to behavioral health services in Summit County. Additionally, they introduced the Partial Hospitalization Program (PHP); Behavioral Health Emergency Unit; Intensive Outpatient Programs, Fellowship Training Programs; Telepsychiatry Program; and most recently, behavioral health services in primary care offices.
“The addition of mental health therapists in Akron Children’s Hospital Pediatrics’ (ACHP) offices lets primary care providers screen patients for behavioral issues, like ADHD, at well child visits allowing for earlier intervention,” he said. “We hope by having therapists available in primary care offices people will feel more comfortable seeking services in an environment that is familiar and comfortable.”
Dr. Constantinou described Dr. Cosby as the ‘big picture’ person who envisioned programs that worked in other places working at Children’s. One example is the PHP program which is modeled after a similar program at his former employer, Harding Hospital.
“This is one of the programs we are most proud of because it allows us to treat very high-risk kids on an outpatient basis,” he said. “As a matter of fact the PHP and PIRC won an award from the Margaret Clark Morgan Foundation (now called Peg’s Foundation) for community excellence. These programs are our babies and we are proud of them and our talented providers who do the work.”
While society is quick to point the finger at social media, overscheduled children and the demise of family meals as reasons behind the uptick in behavioral health issues, Dr. Cosby says change is inevitable.
“Society evolves, technology evolves, and parents and children are discovering the need to learn how to form new interpersonal relationships,” he said. “Those of us in pediatric medicine understand that face-to-face communication between parents and their children, and education regarding discipline when using social media responsibly, makes a huge difference in achieving physical and emotional well-being.
“Additionally, the evolution of psychotropic medications means they are safer and better targeted at symptoms rather than the illness,” he added. “Many diseases are hereditary so knowing a family’s history is important. It’s not uncommon that a child being treated with medication for Attention Deficit Disorder (ADD) might lead to the parent realizing that they, too, have the disorder and subsequently seek treatment themselves.”
Recruiting residents to pursue child psychiatry as a sub-specialty can be challenging because it tends to be less lucrative and not as attractive as some of the more popular aspects of medicine. It’s one of the reasons Dr. Cosby started a Child & Adolescent Psychiatry Fellowship Training Program at the hospital in 2006.
“If we train them, we are more likely to keep them,” he said. “Healing the mind, body and spirit – I love that Akron Children’s has that as the core of its essence. We look at the whole person and it’s been my privilege to be a part of it.”
Dr. Cosby says there are fewer stigmas attached to seeking help for mental health disorders than when he first began practicing, but they still exist.
“It’s encouraging to see role models like pro athletes and professionals in the entertainment industry come forward to talk about their struggles with mental health issues and how interventions made a remarkable difference in their lives,” he said.
Subscribing to the mantra that we’re all part of a bigger picture, Dr. Cosby says having a global perspective is humbling and he jogs and practices meditation to deal with the stressors of life and work. His plans for retirement include traveling with his partner, Cynthia, spending time with his 3 adult children and 3 grandchildren and being open to what’s next.
“I feel like another phase is yet to come helping and serving others,” he said. “It’s nice to be able to look back and say you are proud of what has occurred in the past, but something else is calling me, I feel it.”