Dr. Coker is an Associate Professor in the Departments of Psychiatry and OB/GYN at UAMS. She has been awarded multiple grants focusing on substance use disorders during the perinatal period and became the medical director of the psychiatry inpatient units in 2023.  Dr. Coker was recently chosen by her colleagues to serve as medical Chief of Staff-elect. 

Interview and article by Brittany Tian and Claire Gist

Guest Editor: Arthur Jefferson

What brought you to medicine?

A memorable career day in sixth grade initially sparked my interest in medicine. A neonatologist gave a compelling presentation, and I decided then that I wanted to be a neonatologist or doctor. It took a lot of perseverance to make it through all the required schooling. I entered medical school with an interest in neonatology or pediatric medicine, but eventually found a home in psychiatry with a focus on women’s mental health.  

Were you drawn to psychiatry immediately? 

Not at all. I tell current med students that mental health was not talked about when I was in high school or college. Back then, mental health still carried a lot of stigma. At the start of med school, I wasn’t even sure what a psychiatry practice looked like. Med school required students to take “Brain and Behavior,” but mental health was not a central focus of that course.  

My love of children is what I think initially sparked my interest in psychiatry, and specifically women’s mental health. A frustrating part of pediatrics is that you often encounter children who don’t have safe families and family structures. I realized that parents need a lot of help, too. We know that parents’ mental health issues impact the way they raise their children. I found that the best way that I can help children in Arkansas is to help their moms be as happy, stable, and functional as they can be. Helping these women gives me joy and satisfaction with my work. 

What are your favorite parts of psychiatry?

Psychotherapy. I appreciate women’s openness to therapy and willingness to address uncomfortable or sensitive issues in treatment. As a mom, I also naturally connect with other moms and pregnant and post-partum women.  Many doctors hesitate to see these women, so I like helping a patient population that at times is avoided or overlooked. I enjoy helping moms figure out which treatment options effectively balance their mental health needs with the safety of their pregnancy and breastfeeding.  

Tell us about your research in psychiatry and postpartum patients. 

A lot of my research has focused on how substance use impacts maternal mortality, as this is a big issue in our country. Drug overdoses are the number one cause of why women die during the first year postpartum and suicide is the second.  If you look at why this is happening, it is mostly for psychiatric reasons. We are looking at how we can do a better job for these women so we can help prevent maternal deaths. In Arkansas, we don’t track the data of how many postpartum women in Arkansas have died from drug overdose or suicide. My resident, Dr. Wesley White, and I are working to get that data so we can see how many postpartum deaths are from drug overdose or suicide because they are not currently reported anywhere or provided in the legislative report. 

Do you think there’s a misconception that maternal mortality is only an obstetrics complication as opposed to a psychiatric one as well? 

I think there has always been a lot of heat on OB/GYNs for the maternal mortality issue for a variety of reasons. In my view, a root cause is a general lack of ownership among physicians for new moms. What I mean is, when a mom is pregnant, her obstetrician follows her. When baby is born, the pediatricians care for the baby, but nobody is focusing on the mom’s care after the birth. Moms naturally focus on their newborn in the first year postpartum while their own health needs take a backseat. A gap exists in our healthcare system between the moment of delivery and the connection to providers such as psychiatrists afterward. It’s a huge challenge because we want to connect with these women and encourage them to seek help, but it takes ground-level providers to identify and refer them to us.  

Are any systems in place between psychiatry and OB/GYN that help with referrals? 

Right now, we mostly see referrals from UAMS and UAMS-trained providers because they know about us, and they keep us busy without a need to advertise. Because we have a limited number of providers, our clinic is almost always full. We recently started a new fellowship to help us grow.

Are there any specific moments in your career that you carry with you or have shaped your career? 

Countless, but for me and many other doctors, one patient encounter can spark your passion. I reached a point as a medical student here at UAMS where I narrowed my likely career path to either pediatrics, internal medicine or psychiatry. During my psychiatry rotation, I helped treat a pregnant patient with substance use issues. We struggled to form an appropriate treatment program for her and considered reporting her to DHS, but ultimately discharged her. About nine months later during a family medicine rotation, I encountered this patient for the second time. She had overdosed and was intubated in the ICU. When I walked into her room, she recognized me from her stay at UAMS and I comforted her. After seeing her again, I knew psychiatry was the right fit for me and that I wanted to help pregnant women, including those with substance use disorders. I still get goosebumps when I think of this patient. It was a profoundly impactful moment. 

Do you have any words of wisdom for students when choosing a specialty?

I think one of the big mistakes people make is externalizing rather than internalizing their decision. Externalizing their decision is often deciding based on factors such as the patient population, the people they get to work with, and/or “liking” a certain pathophysiology. And while this is helpful, internalizing what about themselves would make them a good fit in their chosen field or what skills make them work well with a certain patient population can lead to more satisfaction in the long run. 

If someone is interested in psychiatry, I think they need to be very curious, empathetic and have emotional intelligence about how people are feeling. The ability to read people is critical in psychiatry. Other considerations are whether you enjoy listening to people and their stories, your willingness to spend a lot of time with patients, and whether you can treat patients in distress without feeling like you must fix it.

What general career advice do you have for students?

Being a physician has its ups and downs and with the incredible privilege of caring for patients, there is also the burden of responsibility and stress. My advice is that if you are not happy in your career, you have the power to change this to be happy with whatever work you’re doing. Often people will expect things around them to change, but I have found it easier and more fulfilling to make my own changes (even minor ones). The resources that come with being a physician can provide less burden on other parts of your life and there are many different types of jobs in various locations to explore. The extensive education you have received as a doctor can even help if you no longer want to see patients.  If I’m ever not happy with my work, I will change what I’m doing, and I hope that encourages others to as well. 

As the recent Chief of Staff Elect for UAMS, what does your role mean to you? 

I like to think of the position as being the voice of all providers who see patients at UAMS to the senior leadership. I would describe it more as an influencer role than a management role. I’ll also be part of the Hospital Medical Board, the Credentialing Committee, and other committees that govern how providers practice medicine. I’ll be working on things like hospital policies and procedures in collaboration with providers who are working hard to care for our patients.

What goals do you have in the near future? 

Some of my goals include continuing personal growth and a bigger focus on mentoring, which is one of my big passions. I like helping people grow and figure out what they love to do. 

With the PRI, our goals are to be more present in the community and find ways to better connect with people from across the state by continuing to expand our faculty and services provided.

One last question: What’s bringing you joy right now in your life?

Lots of things bring me joy, but my family and work bring me the most joy.  My eight-year-old, Evelyn, is the light of the life.  Work brings me joy because I genuinely love what I do.  Being a doctor becomes part of your identity, and I love being at UAMS.  Outside of work, I also love reading, exercising, long walks with my dog, and traveling.