Post-residency appointment as a Clinical Assistant Professor in the Department of Psychiatry at the University of Maryland Medical School, Psychophysiological Clinic and Laboratories. Served as liaison for the medical evaluation of patients, participated in varied clinical and research programs, became comfortable with use of alternative modalities of therapy including biofeedback, hypnosis, stress reduction and psychotherapy, and coauthored several papers on psychophysiological monitoring, and on loneliness and death. Gained experience with a variety of chronic pain syndromes, labile cardiovascular problems, vascular headache, and various musculoskeletal problems. The director of the clinic was James J. Lynch, Ph.D., who performed pioneering studies delineating the necessary role of human interaction in health, summarized in his first book, The Broken Heart, the Medical Consequences of Loneliness. From him, I learned countless valuable lessons on the importance of dialogue in disease and health. At that facility, I was also actively involved with the use of computers for monitoring a variety of physiological functions, providing biofeedback, and many applications. From this initial exposure, I have constantly searched for creative ways to use technology to optimize and personalize the care of the patient.

Was active in the inception and development of one of the largest and first managed care plans in Florida, Avmed, and served repeatedly on their IPA Board of Directors. Became familiar with the mechanisms and politics of cost-effective Managed Care operations, and the then-difficult relationship with the medical community. Lobbied in multiple congressional offices in Washington regarding the importance of primary care practice in health care reform.