L+M Physician Friday -- Dr. Alexander Miano

Dr. Alexander P. Miano has been so busy taking care of business in his first few weeks at Lawrence + Memorial Hospital that he has yet to hang his various medical diplomas on the walls of his new office in Pond House.

However, as L+M’s new Director of Outpatient Psychiatry Services, Dr. Miano has found time to frame a few opinions on the kinds of people working at L+M.

“Having worked in some big hospitals, it’s really refreshing to come back to a smaller, community sized hospital where you have people that genuinely care,” Dr. Miano says.

“In the cafeteria, people will come up to me and say: ‘Hey, I saw your picture. You’re the new doctor. I just wanted to say hi, and it’s very nice to meet you.’ That’s a breath of fresh air.”

Before his arrival about a month ago, Dr. Miano spent three years as an assistant professor and the medical director of the psychiatric emergency room at the University of Connecticut Health Center in Farmington. He also ran a private psychiatric practice in West Hartford.

But juggling two “part-time” jobs that added to more than 60 hours per week was not the best fit for Dr. Miano. He believed a single position elsewhere could provide him more satisfaction and time with family.

When he first heard about an opening at L+M, it was one of several possible jobs he was considering, but after numerous interviews and trips to the area, he realized L+M was the best choice.

“Ultimately, I realized this would be the ideal place to work,” he says. “My wife and I loved the area from the start. We wanted to be near the water, and we’re still only an hour away from Hartford and Providence. We’re close to New York and Boston but love those turkeys, foxes and deer in our backyard. This area is a hidden gem.”

Dr. Miano was born in Italy. He came with his family to the United States when he was 10 years old and only then began learning English. He grew up in New Britain, CT, and later attended the University of Connecticut, where he pursued both language arts and science, with a focus on biology.

Dr. Miano traveled back to Italy after college and began medical school in the city of Bologna, but returned again to the States to earn his medical degree from Mount Sinai Medical School in New York City. Both his residency in Psychiatry and fellowship in Neuropsychiatry/Psychopharmacology were at Yale, where he also directed the Clozapine Medication Clinic after finishing his fellowship (Clozapine is a medication used to treat patients with intractable schizophrenia).

Dr. Miano also worked for the Connecticut State Department of Mental Health and Addiction Services in Waterbury before beginning his years of psychiatric emergency work at the UConn Health Center. He says his time at Health Center ED was “intense and never boring,” but clinical outpatient work has always been his preference.

“Ever since finishing my fellowship, I knew I wanted to go into the outpatient clinical services,” he states. “It really requires some quick thinking on your feet. The issues we see range from those as common as depression to those as complicated as schizophrenia.”

A key to quality outpatient therapy, Dr. Miano believes, is helping patients find the ability to live normal lives despite their illness.

“I take great pride in seeing psychiatrically afflicted patients who are able to enjoy life to their full natural capacity because of the medications and the counseling skills we offer in our clinics,” he says.

A common thread affecting most people with mental illness is something everyone has to deal with: stress.

“Stress is the generator of psychiatric illnesses more often than not,” Dr. Miano explains. “If we have a genetic or psychological disposition toward psychiatric decompensation, in the absence of stress we might be able to keep our mental processes in balance and carry on a capacity life. But with uncontrolled stress, the physiological changes it creates may easily turn into overwhelming sensations, thoughts and emotions not easily contained, while our coping skills also may begin to drift and fail us. That is the time when it (stress) becomes quite dangerous, specially so for the predisposed individuals.”

Medications and counseling are keys to treating patients, Miano says. “Medication provides acute treatment for the suffering brain, and once maintenance regimens are reached, the patient can maximize his/her ability to work on improving coping skills, insight and judgment that ultimately help manage stressful situations,” he says.

Dr. Miano says he looks forward to the challenges ahead as he works to enhance L+M’s outpatient services.

“It’s easy to see that there are top-notch physicians and top-notch services at L&M,” he says, “but there’s also a genuine sense of caring that goes on in and between the departments and the staff members. The staff does not seem to be walking the halls in a linear fashion. They take the time smile, to greet each other as they go about their daily tasks. I think it’s a great atmosphere to carry on the healing.”

To learn more about Dr. Miano, click here.