Thankfully, Tom Tape, MD, loves dogs. Otherwise, it's unlikely that his brilliant 35-year career at UNMC would ever have happened.
In 1985, Dr. Tape was doing a fellowship in general internal medicine at the University of Rochester. He was in the market for a new dog -- specifically, a Great Pyrenees.
The art of interviewing patients
When Tom Tape, MD, did his internal medicine residency and fellowship at the University of Rochester, he was fortunate to learn from one of the best -- George Engel, MD.
Dr. Engel pioneered the biopsychosocial method for interviewing patients. It encourages physicians to consider biological, psychological and sociological history from patients as a way to better understand their illness and to formulate a successful treatment plan.
"After I met Dr. Engel, I realized that I didn't really know how to interview patients. He would take the four of us general medicine fellows down to the emergency room. Each of us would interview a patient with the others observing and later critiquing. Then, Dr. Engel would interview a patient, and we got to watch the master at work."
The key, Dr. Engel would say, is to start with open-ended questions and immediately follow up on incidental references that the patient might make to significant others, jobs and life events.
"Patients feel more valued and are more likely to share important details that you might not think to ask about," Dr. Tape said, "If a patient was in for a twisted ankle, you should never start by saying, 'So, you're here for a twisted ankle?' Rather, you should start by saying, 'Tell me about your concerns today.'
"Doctors typically interrupt the patient within seven seconds of asking the first question. If you interrupt the patient too soon, they may never come back to what they were saying. The message they hear is that you are too busy to care about them as a person."
It's all about getting to better understand where the patient is coming from, Dr. Tape said. Failure to understand a patient's milieu can lead to suboptimal care.
"For example, it's preposterous to tell someone who is homeless to start working out in the gym," Dr. Tape said. "It's all about building trust and not being judgmental."
Teaching medical students and residents how to conduct better patient interviews has become a passion for Dr. Tape.
"I'm eternally grateful for Dr. Engel. I love sharing his pearls with students and residents," Dr. Tape said. "It's priceless."
He heard about a Nebraska breeder who had a litter of 11 Great Pyrenees puppies for sale. He had never been to Nebraska before, but he decided to check it out.
"I flew out with a breeder friend from New York," said Dr. Tape, who is retiring in September from the UNMC Department of Internal Medicine. "A gentleman picked us up at Eppley Airfield, and we drove for two hours to a farm in Pender, Nebraska. I had no idea where we were going, but Pender rang a bell -- I remembered it was the hometown of Susanna Von Essen, my anatomy partner in medical school."
He scanned the Pender phone book and noticed only one Von Essen listing. "I called and got Susanna's mother," Dr. Tape said. "I learned that Susanna was doing a fellowship in pulmonary medicine at UNMC. I wound up going to lunch with her before I headed back to New York."
The lunch got the ball rolling. Dr. Von Essen arranged a meeting with Robert Wigton, MD, a key member of the UNMC Department of Internal Medicine.
Turns out, it was a perfect match. Both doctors were interested in the same research area -- medical decision-making. By the time Dr. Tape finished his fellowship in 1986, a position had been created for him in internal medicine at UNMC.
Over the past 35 years, Dr. Tape has been instrumental in building the general internal medicine division into a powerhouse as well as creating a program for hospitalists, an area that has exploded over the past two decades.
By the fall of 2020 when hospital medicine was split off as a separate division, the general internal medicine division included more than 100 faculty members -- 10 times the number of faculty as when Dr. Tape began. The general internal medicine division is celebrating its 50th anniversary this year, and Dr. Tape has compiled an in-depth history on the division.
The accolades roll in for Dr. Tape. They include: "selfless servant" . . . "a gift to the internal medicine department" . . . "an amazing mentor" . . . "an extraordinary leader" . . . "someone who always puts UNMC first."
When he retires, Dr. Tape will assume a professor emeritus appointment and will continue to periodically teach medical classes in how to interview patients and in health care policy.
One of the leading experts at UNMC on health care policies, such as the Affordable Care Act (ACA), Dr. Tape gained his expertise primarily through his longtime association with the American College of Physicians (ACP). With 161,000 members, the ACP is the largest medical-specialty organization in the United States.
It all started with a phone call one evening in 2006 when Dr. Tape was walking his Newfoundland dog. The call was from Laurel Preheim, MD, who was a past governor in the ACP. Dr. Preheim encouraged Dr. Tape to run for governor of the Nebraska chapter
A retirement reception is planned for Dr. Tape on Aug. 24, from 3-5 p.m., in the Olson Atrium on the fourth floor of the Wigton Heritage Center.
"Everything I learned about health care policy, I learned from ACP," Dr. Tape said. "It created a career within a career."
Dr. Tape served as governor of the Nebraska chapter (2008-2012). He was encouraged by John Benson, MD, a UNMC professor who was an icon in internal medicine, to seek national leadership positions within ACP.
|Tom Tape, MD|
"I told Dr. Benson, 'You've got to be kidding me. That would mean I'd be running to lead 85 other governors.'"
Dr. Benson knew best. Dr. Tape was elected chair of the ACP Board of Governors (2012-13) and chair of the ACP Board of Regents (2016-2017).
"Health care should be non-partisan -- what's best for the public," Dr. Tape said. "We're the only industrialized nation that doesn't treat health care as a right. Most people don't know what's in the ACA -- it has become a political hot potato. But, they love some of the elements in the ACA, such as coverage for preexisting conditions and children being able to stay on their parents' policy until age 26."
At age 65, Dr. Tape said the time was right to retire. "I like to use the example of the opera singer Beverly Sills. She said the best time to retire is when you're at the top of your game. You don't want to hang on after you start going downhill.
"But, more than that, there's a three-year-old granddaughter in Minneapolis who is calling to us. With the pandemic, it had been a year between visits. That's way too long."
Dr. Tape and Elizabeth, his wife of 38 years, are planning to move to Minneapolis. Both their two sons, Sam and Ben, live there along with that granddaughter, Emilia, and a daughter-in-law, Jess. A second grandchild is expected in November.
Beverly Sills would totally understand.
Dr Tape, congratulations on an wonderful career, and thank you for inspiring thousands of physicians-in-training to include me! Your lessons in leadership, selflessness and caring remain in practice with all those you taught!!
Congratulations on your retirement. Tom, you will truly enjoy the time with grandchildren (I know I have). Wishing you and Elizabeth the very best.
Tom you have personally had a profound impact on my career and will be greatly missed. From the moment I stepped onto campus, you have been instrumental in my professional development. First, you were my clinic attending and first wards attending during residency helping to shape me into the physician I am today. At the completion of residency, you then became my boss and mentor as I joined the faculty as an academic hospitalist. In this role, you consistently looked out for opportunities for me and encouraged/championed my involvement. I'm confident that my leadership within ACP is a direct result of your support and advocacy for me along the way. Thank you for your leadership, your devotion, and your passion for investing in others. Enjoy your well deserved retirement and hoping our paths will continue to cross at ACP gatherings.
Tom, Congratulations. What a remarkable career. Clinician, teacher, scientist,leader and mentor to all to whom you have worked. I have appreciated working and learning from you over all these years. Best wishes to you and your wife( and dogs) for a smooth and safe transition. Mike
As a standardized patient, I witnessed first hand how effective Dr. Tape is with students. He is an amazing instructor, and one who I will miss.
Enjoy your well-deserved retirement, Dr. Tape! Good luck on your move to Minneapolis, enjoy those grandchildren and continue having fun with those beautiful Newfoundlands! Lucie Case
Tom, Thank you for your friendship, mentorship and for your passion. You challenge us all to do better and to be better. You very graciously welcomed me to our campus and made me feel part of the department though my primary focus is health system administration. I'm so very happy that you will be closer to family and be able to see your grandkids and kids continue to grow. Michael Ash
Congratulations, Dr. Tape. Have a great retirement and enjoy!! With very best wishes. Nizar Mamda ni
You have given me so many gifts that I will treasure always. By watching you exhibit kindness, knowledge, empathy, advice, generosity, and by hearing your stories that brought me to tears laughing at times, every day--especially this past year--I have changed as a person, because being around someone like you gives me hope for a better world. Truly. You have come to mean more to me than just being my boss, kind sir: You are forever now one of my heroes, and I will brag to others when your name is mentioned in any conversate that I saw first-hand a doctor who TRULY, SINCERELY, AND DEVOTEDLY cared about his patients first! Dr. Tape, you are one-of-a-kind, and I will dearly miss you. Take care, and best wishes... always. LBJ
Congratulations to you! I wish you and your family a wonderful retirement.
Faculty Development thanks Dr. Tape, too! Before the age of Google, we called Tom whenever we needed a cover image for some book or project, and he generously delivered every time! For anyone who wants to study how to build a career or a personal "professional brand" just study Dr. Tape. His influence is broad and deep, from photos to policy. Nebraska has had a great run--I guess we can share with Minnesota.
It has been a pleasure getting to know you over the years. I am going to miss you!
Tom Tape, "a gift to the internal medicine department" . . . "an amazing mentor" . . . "an extraordinary leader" . . . "someone who always puts UNMC first." And if I may add on, a wonderful overall human being. Final note, this is just one more reason dogs are the best. Thank you Tom! All the best!
Congrats Tom! It has been great learning from you as a student and working with you for the past 25 years. Have fun in retirement. You deserve it!
Always engaged with current actions and situations. Glad you will still teach.
Congrats Dr. Tape & enjoy your retirement!
There are no words that would come close to describing what you have meant to Internal Medicine, UNMC, the State of Nebraska and the field overall. You will be missed beyond measure. I wish you and Elizabeth many happy years in Minneapolis. Take good care my friend.
One of the best. A great listener and mentor to so many, he will be missed!
Congratulations! Enjoy your retirement with your family and your dogs.
Congratulations Dr. Tape.
You will be missed Dr. Tape!