In order to commemorate the 50th Anniversary of the specialty of Med-Peds, the MPPDA would like to spotlight individuals throughout the year who have played a part in the development of the MPPDA and have contributed to the rich history of Med-Peds in the past 50 years.  This month’s “Legends of Med-Peds” features Dr. J. Thomas “Tommy” Cross, MPPDA President, 1999.

Current position: President, A-Cross Medicine Reviews (a Live-course CME Company) 2012-present.

Previous Positions: Director of Medical Education, MedStudy Corporation 2002-2012—wrote and edited the original Pediatric MedStudy products as well as an author and an editor for the Internal Medicine products and live courses.

Associate Professor of Internal Medicine and Pediatrics, Med-Peds Program Director, Division of Infectious Disease 1994-2002. Med-Peds ID Fellowship 2002-2004, University of Arkansas and Arkansas Children’s Hospital. Med-Peds Residency 1998-2002, University of Arkansas and Arkansas Children’s Hospital.

What has MPPDA meant to me?

I went to my first MPPDA meeting in 1995 as a 34-year-old faculty member (having completed fellowship in June 1994) and brand new Med-Peds Program director of a program with one (1) 3rd year resident. It was the first time I had ever met other Med-Peds faculty physicians. It was incredible!! I immediately felt like I was “home” with family and I met life-long friends (well, 22 years worth!). I vividly remember the afternoon before my 1st MPPDA meeting, running into (literally) Betty Lo on the treadmill in the hotel gym and talking to her for probably an hour—about life and our favorite New Orleans hangouts.

I think this 1st meeting I attended might have had 30 people and I remember meeting Mary Ciccarelli, Keith Boyd, Mary Duke, and Dale Newton for the first time. Carole Lannon had interviewed me for Med-Peds residency as a medical student and it was really surreal to see her again; this time, with me being an “adult” at a meeting.

For me, as a young faculty person, it was the first place where I felt like I belonged to a group. I was Med-Peds, but also combined ID trained and until that point, I was always going to IM or Peds or ID meetings, and never really been able to talk to other Med-Peds faculty. It was a little schizophrenic in a way, attending these other meetings and not being able to discuss the nuances of being Med-Peds in these categorical worlds.

So, MPPDA provided me a home for 8 years while I was program director at LSU-Shreveport. My next job in medical education allowed me to continue to attend the MPPDA meetings and see my old friends, but this time on the exhibitor/”Dark” side and also as Chair of the Med-Peds section; thus, I was able to continue to liaison with MPPDA.

MPPDA was instrumental to me as a young faculty to “figure out what the hell am I supposed to do with these residents and this recruiting stuff.” We were all fairly young and the number of programs grew quickly in the 1990s and early 2000s. It was also a time when many programs didn’t have combined Med-Peds program directors, so instead 2 separate categorical program directors attended. During this time you saw a quick transition where combined program directors became the norm and those of us who were “newbies” became mentors rapidly to the next group.

MPPDA definitely helped me advance in my career, and I know it was instrumental in my promotion from assistant to associate professor by being able to have a “national” office. The unique (crazy?) thing is the depth of the friendships that I have developed over the years by just seeing people for 2-3 days/year. Beginning with Betty through the 22 years, I have added a lot of friends who I absolutely love to spend time and catch up with on what’s new in their lives. Sadly, I’ve also lost several good friends over the years from Walt to Alex to Brendan, but it’s all part of life—and I wouldn’t trade those joyous experiences for anything (well maybe a few of the experiences could have been a bit less joyous!).

How has Med-Peds Changed Over your Career?

I’m not sure it has changed. When I went into Med-Peds in 1988 it was with a goal of being a primary care doc in a rural practice. When I finished residency in 1992 I ended up doing a combined ID fellowship and in 1994 started at LSU-Shreveport running a Med-Peds program and establishing a Maternal-Child HIV clinic. In 2002, I left academics and ended up working in medical publishing and teaching and left that in 2012 and ended up doing Home-Health and starting my own CME company.

The key for me with Med-Peds in 1988 was that it seemed like you could make your own opportunities and forge your own path. I don’t think that has changed in 2017. I continue to witness new residents going out and starting new projects or tackling new problems with a definite Med-Peds focus. The key is to be flexible and probably any type of practice or position is possible if you persevere. I don’t think Med-Peds per se has changed; but, it has changed as all of Medicine has changed. But, the key for Med-Peds graduates is you have so many opportunities and you can make a lot of life changes during your career.

How has Med-Peds training helped you throughout your career?

My initial Med-Peds training taught me how to juggle lots of balls in the air and somehow keep them all up at the same time. Along the way I occasionally discovered there were knives mixed in with the balls so you have to be careful!

For me, Med-Peds training I think made me a much better problem solver and I think I see “the big picture” better than many of my colleagues. There definitely is a “Medicine” mentality and a “Pediatric” mentality and I think over 30 years I’ve been able to switch back and forth when I need to as each situation presents itself. Now after 30 years I feel more like a multi-colored chameleon and I feel that I’m truly Med-Peds and not just “Medicine” or “Pediatrics.” It is hard to describe….sort of like restless legs syndrome.

What do you see for the future and opportunities for Med-Peds going forward?

I think it is as infinite as it was when I started nearly 30 years ago. The “kids” today are definitely more interested in global health issues than my generation and that has presented new opportunities and challenges for this generation. I do think that there will be a refocus on health care for the inner city and more opportunities for those interested in serving the poor and underserved here in the United States. In 1998, the health care threats and funding were centered around HIV and new, exciting technologies (people my generation might remember how rare it was to have an MRI machine and High-res CT or PET didn’t exist for most of us). With effective health care today, the Maternal-child HIV clinic should no longer need to exist.

I think Med-Peds physicians will be useful for forging new health care policy and plans, because we understand the continuum of care and the need to start preventative care early in childhood and continue this focus into adulthood. Unfortunately, the billions of health care dollars spent on heart failure and COPD and other preventable diseases haven’t really seen much improvement in the last 30 years. I hope that Med-Peds physicians can be at the forefront for change that actually makes “prevention” and transition of care from pediatrics (where we do outstanding preventative care) to adult medicine (where somehow we change to a disease-based approach from a preventative approach) more seamless. I am excited 30 years later that I chose Med-Peds…I think today’s graduates have even more opportunities. The key is persistence and willingness to work for what you strive for!! (But…don’t forget to have fun along the way and enjoy being with your friends and family!).

Thomas Cross, Jr., MD, MPH, FAAP, FACP aka “Tommy”