April 2024
Seth Eappen, M.D.Q&A with Seth Eappen, M.D.
Founder
Eappen Clinic
Dr. Eappen is a board-certified adult, child, and adolescent psychiatrist. A native of Orland Park, Illinois, he studied history and completed his pre-medical coursework at the University of Wisconsin-Madison where he was elected into Phi Beta Kappa and graduated in two and a half years with distinction. He completed his medical education at the University of Illinois at Chicago on a partial scholarship, graduated with Outstanding Honors in General Surgery, Pediatrics, & Psychiatry, and was selected as an Arrie and Estelle Bamberger Scholar.
After medical school, Dr. Eappen trained at the University of Michigan for an adult psychiatry residency and concurrently completed a psychodynamic psychotherapy fellowship at the Michigan Psychoanalytic Institute. Following his residency, Dr. Eappen trained at the Institute of Psychiatry at the Medical University of South Carolina in Charleston, SC for a child psychiatry fellowship, where he served as the chief fellow in his final year of training.
During his training, Dr. Eappen recognized the divergence in the quality of psychiatric care from his residency and fellowship programs and the hospitals and clinics he rotated in as a medical student in the Chicagoland area. Based on his intent to narrow this gap in care, he founded the Eappen Clinic.
Where are you from?
I was born and raised in the suburbs of Chicago.
Why did you choose the University of Michigan and Michigan Medicine for your training?
I was fortunate to receive interviews at nearly every top ranked program I applied to including Yale, Johns Hopkins, and Harvard. I chose to rank Michigan #1 above these and other programs, for several reasons.
First, the psychiatry department has generally been within or near the top ten in NIH funding every year for decades. I also liked the sheer volume and variety of cases Michigan Medicine gives you during residency, objectively exemplified by the opportunity to do a post-residency fellowship in every subspecialty that exists: addiction, forensic, child, sleep, psychosomatic medicine, pain medicine, geriatric, etc. In addition, every department at Michigan Medicine that I am aware of is ranked within the top ten of their field. This may not seem important to candidates, but half of your first year of psychiatry residency at any institution is spent doing rotations outside of psychiatry, within inpatient neurology, inpatient internal/family medicine, urgent care, etc. Further, your collaboration with fields outside of psychiatry occurs frequently throughout residency—especially with your CL and PES rotations. I truly believe that part of what helped me become the psychiatrist I am today is learning from not only some of the best minds in psychiatry, but also some of the best minds in medicine outside of psychiatry as well.
Next, when I was applying to residency programs, I was very interested in becoming a forensic child psychiatrist, and was also interested in the prospect of doing research within this field while in residency. I found that Dr. Elissa Benedek was the authority in the field, and on the day I matched at Michigan, I emailed her asking if I could work with her. She emailed me back immediately, and was so gracious with the opportunities she gave me, that they culminated in a first author publication with her while I was still in residency. I still consider her to be a mentor and friend to this day.
Lastly, the only other programs in the same league as Michigan are either on the east or west coast. I strongly preferred to be within driving distance of my friends and family in the Chicagoland area at the time, so that forced Michigan to rise to the top of the list as well.
What was most memorable about your psychiatry residency at the University of Michigan?
There were so many great memories; it would be tough to choose one. Looking back, I think the vast improvement in skills that occurred between the end of intern year and the end of second year was quite memorable. I recall toward the end of my intern year asking one of the chief residents if he felt capable of handling any psychiatric issue that came through the doors of the hospital on his own, regardless of severity or complexity, and he said "absolutely" in a confident tone. I was just astounded by what it must feel like to command that kind of knowledge and whether I would also feel the same way in a few years. However, within 1 year (by the end of the second year of residency) I already felt 90% there, and by the time I finished my third year, I felt ready to take on anything that came my way whether it was building my own practice or taking a position as a psychiatrist in any setting. So, I think the immense amount of knowledge gained between the end of year 1 to the end of year 2 was most memorable to me.
What has your career path looked like since you completed your residency?
I started moonlighting in an outpatient clinic (seeing patients unsupervised, under my own LLC which eventually became the Eappen Clinic) immediately after I received my independent medical license in august 2014, early in my 3rd year of residency. This practice grew quickly within months to the point where I was balancing seeing 20-30 hours of outpatients on evenings and weekends on top of my duties as a third-year resident.
By late 2014, a mentor and friend of mine in Chicago (who I shadowed while I was a medical student) offered the opportunity to provide inpatient coverage in Chicago on some weekdays and weekends for an inpatient unit after the loss of a physician there. I kept this offer in mind as I interviewed for child psychiatry positions, and did my child psychiatry fellowship at MUSC in Charleston, SC, not only because it was a strong program with amazing faculty who I still keep in touch with, but because they allowed me to customize my schedule to facilitate flying to Chicago for a three- to four-day weekend nearly every other weekend to pursue this opportunity.
Within weeks of first providing inpatient coverage in Chicago, I was told I did very high-quality work and word of mouth spread. Over time, other doctors and hospitals asked if I could provide coverage for them. Having more work than I could handle allowed me to negotiate very favorable terms. During my second year of fellowship, I started my private outpatient practice in Chicago, and the practice grew from scratch with 1 patient seen in December 2016 to about 30 patients every other week in June 2017. Between graduating child fellowship in June 2017 and early March 2020, I was doing inpatient, outpatient, nursing home, and consult liaison work at so many clinical sites that I hired a driver (who is now my practice manager) who would pick me up at 6am and drop me off by 9pm, 365 days a year (with half days on holidays).
By January 2020, my plan was to keep working at this pace for a few more years and then slowly taper off to build up the Eappen Clinic. For years, the clinic had to be capped at around 50 patients a week between myself and our nurse practitioner, Kristen, because my schedule was packed from my other work. However, by mid-March 2020 when the pandemic was declared, I took that as a sign to focus exclusively on the clinic and gave up all of my hospital work to other psychiatrists. I called every referral source to let them know our waitlist was gone and that I could see anyone they sent me within 24 hours. We went from seeing 50 patients a week in April 2020, growing to over 100 patients per week in December 2020, and then to 160 patients a week in May 2021 which is where we were capped at for some time until we were able to recruit and train additional members to our team.
What is your favorite memory of your time in Ann Arbor?
I loved every minute of my time in Ann Arbor. I would do an injustice to the unchosen memories if I chose a single one!
What are some activities you enjoy in your free time?
I enjoy traveling—I am writing this on a return flight from one week spent with one of my best friends in Tokyo, Japan. I enjoy concerts and summer music festivals. I've enjoyed weightlifting since age 11 and have been working with multiple personal trainers weekly for the past 2 years. As of a few months ago, the weights I've been lifting have exceeded the levels required to qualify for the USAPL national powerlifting competitions, so now I have a new goal of aspiring to become a competitive powerlifter at the national and international level.
I enjoy spending time with friends and family. My parents, sister, brother-in-law, and niece/nephew drive several hours from Carmel, Indiana to stay at my house for a 4-day weekend at least once a month, and I always have a blast with them.
I read voraciously. Anyone who knows me well knows that if I have downtime, I'm filling it with my eyes glued either to the WSJ or a business/finance/sports science/psychiatry/medical journal.
Where are you now and what does your work focus on?
Currently, I work remotely from one of three places: my condo in Chicago, my home in Hinsdale, or my office in Oak Brook. My work focuses on treating any psychiatric concerns regardless of the age, severity, or medical comorbidities of the patient. We currently have three nurse practitioners and one adult psychiatrist, and we see about 250-300 patients per week. I read every new evaluation and progress note for every patient seen in the clinic and provide feedback frequently to ensure that the quality of care stays high. For the nurse practitioners, I create a detailed plan for every single visit on my own, and this plan is shared with the patient at each appointment so that the care their patients receive is no different from the care the patients would receive if they saw me. Since the practice style I've developed—honed from seeing over 20,000 patients in the past decade and built off the foundation given to me by my residency and fellowship—has been proven to be effective (per our patients and referral sources), my latest focus is on creating a set of practice parameters that is evidence-based but also influenced from our patient outcomes in the clinic. That way, if we continue to grow or if I retire, any new patient can expect the same high quality of care with one doctor as they would with another.
What do you find most rewarding about your work?
The answer to this changes over time. Between 2014 and 2019, the honor of being able to practice psychiatry independently and in a variety of settings (inpatient, outpatient, ER) was thrilling and rewarding on its own.
By early 2019, our reputation developed to the point where I was frequently referred "treatment-resistant" cases from other more senior psychiatrists and psychologists in the Chicagoland area. I've had academic institutions in Chicago refer their own physicians who were in crisis, when the psychiatric treatments they were being given were not working, and I was able to overhaul their treatments to get them fully functional and back to work again. I've had patients come to me after being refused from other hospitals, intensive outpatient and partial hospitalization programs, because the severity of their conditions exceeded what these facilities could accept. I find it extremely rewarding to be trusted to help get these individuals functioning not only to a level they peaked at in the past, but to a level far beyond what they or their family dreamed of. These are the patients who, once they get well, they never leave. Seeing these patients every few months with a smile on their face, beaming about the milestones they've reached since I last saw them—under the context of us both knowing how poorly they were once functioning, or how hopeless things felt for them years ago when I was seeing them weekly—is SO rewarding.
Next, having existing patients refer their friends or family members to us is very rewarding. These referrals, plus referrals from trusted healthcare professionals, are the most objective sources of feedback telling us that we are doing something right.
Finally, I count this as the greatest reward of 2024: this month, one of my former attendings agreed to join the clinic. To have one of your former teachers, who you’ve always held in high regard and who helped train you, join your team? That is the greatest honor and professional endorsement that I could ever receive.
