Initially, someone might perceive Dr. Wade Douglas’s career to revolve around operating rooms, published research, and surgical residencies. After two decades in medicine and currently serving as a Professor and Program Director at the Florida State University College of Medicine, Dr. Douglas operates from the core of academic surgery. However, engage him in a discussion and a different thread soon emerges, one that would take us beyond cancer care and clinical practice guidelines. That thread is mental health.
For Wade Douglas, mental health is not separable from physical wellness. Mental health is fundamentally tied into recovery of patients, coping for families and functioning for medical teams. Further, it is central to how physicians themselves remain grounded in our field characterized by long hours and emotional workloads.
This is a personal perspective, one shaped not only by professional experience but moments of challenge outside of the hospital, such as supporting a loved one engaged through a mental health crisis. That journey opened his eyes to the lack of training any of us receive on psychological support to guide individuals through care, even as we treat people at their most vulnerable.
Surgical Oncology and the Emotional Weight of Diagnosis
In Dr. Douglas’s specialty of surgical oncology, he finds himself sitting directly opposite a patient who is often processing highly impactful news. A diagnosis of head and neck cancer or a diagnosis of pancreatic cancer does not come with only physical questions; It evokes anxiety, alters family systems, and can result in isolation, anxiety, and depression.
With a similar perspective, Wade Douglas carves out time to talk with families, not necessarily about the technicalities of surgery, but instead how they are managing it all. On operating days, he starts his day early by visiting with patients prior to surgery and always loops back after surgery to provide an update, answer any questions, and ensure that we do not lose sight of the human aspect of the care he provides.
“I think many of us assume that someone else will tend to the mental aspect, to address the psychological needs,” he shares. “But then you are the doctor that families trust, and your statements and words have consequences.”
This sense of awareness extends to how he teaches residents as well. At Florida State University he conveys simply, and clearly, that communication, empathy, and patient-centered dialogue are not soft, ancillary skills for surgery, but rather, requisite surgical skills for practicing medicine and moving patients toward healing.
It Is Also a Physician Concern
While attending to the needs of patients is his main focus, Wade Douglas is also conscious of the mental toll that medicine does take on the health of practitioners. Burnout during one’s residency is real. As well are the feelings of hopelessness when one tries to navigate their own emotional health or that of colleagues.
The recent experience with Dr. Douglas’s own friend trying to support during their mental health breakdown crystallized much of this awareness. The crisis was challenging, multilayered, and unpredictable. “The discharge is still uncertain,” he explains, “and I found myself uncertain how to actually help. That surprised me.”
The experience stuck with him as well.It showcased the lack of mental health literacy that many physicians have, particularly in high-stress specialties such as surgery. “I wish I had more tools,” he says. “Not only to understand what was happening for myself, but to also take care of myself through it.”
Since that event, he has been more deliberate in learning. He talks more openly with colleagues about stress. He includes HelpCare Plus and mental health topics in resident education days. And he actively encourages younger physicians to seek assistance when they are in need, reminding them that strength in medicine does not mean going through everything alone.
Primary Care Settings as a First Line of Mental Health Support
Dr. Douglas advocates for addressing mental health in primary care settings, where patients will most likely begin their health journey. For many patients, especially those who are uninsured or do not have easy access to a specialist, the family doctor is the only entry point into the healthcare system.
“There is no reason for silos,” he says. “When someone comes in for diabetes, the person could be also dealing with grief, anxiety, or trauma. We should be able to identify those signs through training.”
He advocates that basic mental health screening should be commonplace, and primary care providers should feel comfortable simply bringing up the concern around emotional health, even if the provider is not a mental health professional. He feels the most critical aspect is visibly creating a culture that makes talking about these things normal, in the exam room, in the physician lounge, and in the medical curriculum. The Obstacles of Creating Balanced Education for Residents
As the Program Director for a General Surgery Residency, Dr. Douglas engages with emerging physicians who are still developing their own identity in the profession. He recognizes the angst they take on, especially when the clinical experience does not go as expected and personal life begins to behave like practice.
Dr. Douglas hopes to create a deliberate learning experience where residents feel acknowledged and cared for. This entails making time for learning experiences related to self-care, ethical complexity, and alignment with personal life. It also means being present in a mentoring role, not only as someone who assesses and grades an individual’s skill, but also as a model of resilience and honesty.
“I’m oriented on the mission. It’s like any good soldier; once I know the aim, I can channel my focus,” he says. “But, something I attempt to help residents with is not believing success to mean being unshakeable; it’s to be steady and unapologetically open.”
To this end, Dr. Douglas acknowledges that he has given thought to feedback. He prefers not to start from a judgmental angle, he prefers to start from a reflective space where problem-solving and curiosity is evoked. While the expectation of each resident is to grow; they are also expected to care about their patient, their co-worker, and themselves.
Understanding Systems that are Slow to Change
Wade Douglas understands systems in medicine can be slow to change. Electronic medical records continue to be a challenge to public health practitioners. The model for reimbursement is often based on the time to be able to offer skilled mental health services, rather than providing an understanding of meaningful delivery.And while medical school curricula are evolving slowly to incorporate more of the psychosocial aspects of care, there is hope with the next generation of physicians. They are willing to discuss mental health. They ask about balance. They come to the field with a wider scope of what healing is.
And Dr. Douglas believes that faculty should encourage that perspective; not level it into tradition, but help it grow. “We aren’t just training surgeons,” he says, “we’re training people that are leading teams, supporting families, and living in communities.”
What Keeps Him Grounded
Dr. Douglas has made time for family, fitness, and reflection despite all of his academic obligations being the program director of a residency program and researcher studying cancer disparities, etc. On days he is in the clinic, he wakes up and works out, checks email, and sees patients. On days he is doing administrative work, he has half-day teaching sessions before transitioning to meetings for planning and paperwork.
This is a rhythm he has figured out over years of practice. Early on in his career he was working hard to prove himself. Now he is working hard to be present for his patients, his students, and his family. He believes that presence is what keeps him effective.
When asked about what makes him successful, he does not cite titles or awards. “I am mission- and task-oriented,” he says. “I get a sense of a clear mission, and I am focused on it.”
Staying Steady for Those Who Depend on Him
Dr. Wade Douglas does not see mental health as someone else’s priority, he sees it as part of the whole picture in the patient’s room or in their home, and in the depths of the heart of every patient and provider.
His work reminds us that even the most competent hands need to have understanding to lead them. That even during surgery it is important to listen. And that at its best, leadership is not about perfection. It is about being present for those that depend on you. In this case, Wade Douglas presents a model of care that trails deep into life after the operating room.
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