Gia Merlo

Faculty

Gia Merlo Headshot

Gia Merlo

Clinical Professor, Nursing & Psychiatry
Senior Advisor on Wellness

1 212 998 5323

Gia Merlo's additional information

Gia Merlo, MD, is a clinical professor in nursing and psychiatry and senior advisor on wellness at NYU Rory Meyers College of Nursing. She is a triple board-certified physician in psychiatry, child, and adolescent psychiatry and lifestyle medicine. She is active on multiple national professional organizations, including serving as a board member of the Academy of Professionalism in Health Care (APHC). She served as the chair of the 2017 APHC Annual Meeting in Chicago. She currently serves on the Board of Directors for Child Advocates of Houston, a nonprofit dedicated to lifesaving advocacy that helps abused and neglected children, and has served on various boards, including the Children’s Hospital of Philadelphia Alumni Board and the board of directors for Laurel House, a non-profit organization.

She maintains involvement and serves on multiple committees, including with the American College of Lifestyle Medicine, Texas Medical Association, American Academy of Child and Adolescent Psychiatry, American Society for Bioethics and Humanities, National Association of Advisors for the Health Professions, Texas Society of Child and Adolescent Psychiatry, Harris County Medical Society, and Texas Society of Psychiatric Physicians. She is a 2017-2019 Master Teacher Fellow at Baylor College of Medicine, in Houston. She is currently working on her first book on medical professionalism. 

Prior to joining faculty at NYU, Merlo was the associate dean of health professions at Rice University and founding director of the Medical Professionalism Program. At Rice University, she taught premedical students as well as conducted medical education research. She provided clinical supervision of the child and adolescent psychiatry fellows at Texas Children’s Hospital medical home located at Corinthian Pointe in Houston. In addition, she taught medical students, residents, and fellows at Baylor College of Medicine. She was the director for the Transition to Practice course for child psychiatry fellows and for adult psychiatry residents at the Baylor College of Medicine. She was also faculty at the University of Pennsylvania and the Children’s Hospital of Philadelphia before transitioning to full-time private practice and leadership roles in community psychiatry in the Philadelphia area. 

Merlo earned her MD at Nagarjuna University and MBA at Temple University. She also completed a certificate in evidence-based teaching at Johns Hopkins University in 2018 and finished her training in child and adult psychiatry training at the University of Texas Southwestern Medical Center, in Dallas, Texas. She is a fellow in the Master of Education degree program in health professions at Baylor College of Medicine.

MD - Nagarjuna University
MBA - Temple University

American Academy of Child and Adolescent Psychiatry
American College of Lifestyle Medicine
Academy of Professionalism in Health Care
American Society for Bioethics and Humanities
Harris County Medical Society
Houston Academy of Medicine
National Association of Advisors for the Health Professions
Obesity Medicine Association
Southeastern Association of Advisors for the Health Professions
Texas Association of Advisors for the Health Professions
Texas Medical Association
Texas Society of Child and Adolescent Psychiatry
Texas Society of Psychiatric Physicians

Faculty Honors Awards

Master Teacher Fellowship, Baylor College of Medicine (2019)
Houston’s 50 Most Influential Women, Houston Women’s Magazine (2018)
Favorite Professor Award, Rice University Scholar Athletes (2017)
Fellowship, American Psychoanalytic Association (1997)

Publications

The Aging Physician

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0015
Abstract
Abstract
After decades of working in the medical field, physicians have gathered an extensive knowledge of human pathology as well as effective courses of treatment for illnesses. However, aging may also bring about cognitive deterioration, which may compromise the quality of care physicians provide to their patients. In 2015, 23 percent of physicians were above the age of 65. An estimated 25,000 to 50,000 active physicians are expected to suffer from mild cognitive impairment and up to 25,000 from dementia. Currently, physicians are not held to a mandatory retirement age and are not subject to oversight of their cognitive abilities and physical health as they age. However, the current system of self-regulation for cognitive impairment is insufficient for protecting patient safety; on the other hand, mandatory retirement or screening of aging physicians may be ethically or legally problematic. An optimal solution would balance the safety of patients and the dignity of aging physicians. It is likely to be multipronged and multifactorial, involving multiple screening steps and continued development to assess the quality of validation. Adoption of healthy lifestyle practices and financial literacy, as well as providing opportunities for retired physicians to stay involved with the medical profession, may encourage successful aging among physicians and ease the transition to retirement.

Applying Psychiatry and Psychology Principles to Lifestyle Approaches for Mental and Behavioral Health

Merlo, G., & Vela, A. (2021). American Journal of Lifestyle Medicine. 10.1177/15598276211023415
Abstract
Abstract
Research suggests that mental health symptoms and disorders are historically underdiagnosed and undertreated, in part due to the siloed nature of medicine. Yet, approximately 50 million American adults experience a mental health disorder. As the field of lifestyle medicine continues to emerge and grow, there is an important opportunity to address mental health from a lifestyle medicine perspective, as well as to ensure that lifestyle medicine can be utilized for all patients, including those with mental health conditions. To effectively address mental health, the field of lifestyle medicine would benefit from understanding and leveraging the decades of science and practice from the fields of psychiatry and psychology, as well as the expertise of psychiatrists and psychologists who are familiar with the science and trained in lifestyle medicine. Incorporating empirical literature from other areas, utilizing well-established conceptual frameworks, and addressing the overlap between lifestyle medicine and mental health early in, and throughout, training and education, are important steps to move toward addressing mental and behavioral health with a lifestyle medicine approach.

Artificial Intelligence in Medicine

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0004
Abstract
Abstract
Disruptive forces are challenging the future of medicine. One of the key forces bringing change is the development of artificial intelligence (AI). AI is a technological system designed to perform tasks that are commonly associated with human intelligence and ability. Machine learning is a subset of AI, and deep learning is an aspect of machine learning. AI can be categorized as either applied or generalized. Machine learning is key to applied AI; it is dynamic and can become more accurate through processing different results. Other new technologies include blockchain, which allows for the storage of all of patients’ records to create a connected health ecosystem. Medical professionals ought to be willing to accept new technology, while also developing the skills that technology will not be able to replicate.

Communication, Empathy, and Compassion

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0006
Abstract
Abstract
The state of modern healthcare is often not conducive to empathy or effective communication because physicians are pressured to see as many patients as they possibly can, sometimes forcing them to forsake emotional connection. However, empathy and communication are among the most vital skills for providing excellent care to patients. Incorporation of empathy and communication have been found to result in fewer malpractice suits, better adherence to treatment plans, fewer errors, and improved outcomes. The components of effective communication include active listening, offering feedback, and being able to apologize for past errors or miscommunication. The challenges associated with patients that are labelled “difficult” are discussed. The neurological processes of empathy are highlighted including the regions of the brain that are implicated. The chapter also frames empathy as a broad concept with emotive, moral, cognitive, and behavioral components, and that compassion is an empathic response that may facilitate feelings of engagement and protect against burnout. Increasingly, medical schools are incorporating training in building empathy and compassion into their curricula.

Depression, Anxiety, and Physician Suicide

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0011
Abstract
Abstract
Physicians suffer from mental health issues, particularly depression, at higher rates than the general population, due to many of the same factors that contribute to burnout. However, there is a stigma within the profession that prevents them from getting help. This stigma can be based on feedback from self, colleagues, hospitals/medical systems, and licensing boards. Self-criticism by physicians may lead to self-stigmatization. Colleagues may be afraid to broach the topic of mental health and fail to refer their peers to professional help. Hospitals/medical systems often label physicians suffering from mental health issues as ”unprofessional.” Lastly, licensing boards may discriminate against physicians who disclose prior psychiatric history. Major depressive disorder is the most common diagnosis among physicians. Anxiety disorders have been less well-studied but are likely also to be a major problem. Approximately 300 to 400 physicians are estimated to die from suicide each year, and untreated mental health conditions are a significant risk factor. Action at individual, institutional, and organizational levels is necessary to combat the stigma of mental illness.

Developing Cultural Praxis

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0007
Abstract
Abstract
The ever-evolving composition of the U.S. population prompts healthcare systems to adapt in order to provide care to diverse populations. Health disparities exist, and it is part of our responsibility as medical professionals to reflect on how the sociocultural determinants of health affect outcomes and uncover our unconscious or implicit biases to work towards health equity. The author defines this process as cultural praxis, drawing from Freire’s theory on developing a critical consciousness and understanding cultural humility. Physicians must also understand the systematic problems that lead to inequities in healthcare; the author defines this as structural competence. As in professional identity formation, development of a critical consciousness is an ongoing process that requires reflection, and cultural praxis is more than a set of competencies to be satisfied. This discusses strategies for developing cultural praxis, and provide reflective opportunities in scenarios in which cultural praxis is particularly important, such as in end-of-life care.

Happiness and Self-Care

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0003
Abstract
Abstract
Happiness is more than a feeling: it refers to human flourishing and fulfilment and includes finding meaning in what we do. This chapter encourages the reader to consider what personal happiness is to them. The definition of happiness is individual for each person but can be thought of as consisting of five main factors: positive emotions, engagement, relationships, meaning, and accomplishments. Happiness has genetic and environmental determinants. A survey of the history of concepts of happiness is offered, including the work of the Greek philosophers, Aristotle and Epicurus. Martin Seligman’s PERMATM model, common measures of happiness, recent studies of the biological bases of happiness, the concept of the hedonic treadmill, and the value of expectation management are introduced. Finally, self-care is emphasized to manage stress and enhance overall happiness.

Lifestyle Medicine

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0009
Abstract
Abstract
This chapter addresses the rise of lifestyle medicine. The impact of chronic diseases on health and quality of life are well-known within the medical community. Preventive medicine has only been partially successful in addressing these problems. For physicians to advocate healthy lifestyle choices for their patients, they must first understand what a healthy lifestyle entails. The Six Pillars of Lifestyle Medicine outline the six main lifestyle changes—healthful eating, increasing physical activity, improving sleep, managing stress, avoiding risky substances, forming and maintaining relationships—that physicians should promote to their patients. The global public health burden of diabetes, obesity, and other lifestyle diseases is increasing at an astounding rate. However, very few training programs have robust educational offerings for physicians on nonpharmacological treatment of obesity and diabetes.

Looking to the Future

Merlo, G. (2021). In Principles of Medical Professionalism. Oxford University Press. 10.1093/med/9780197506226.003.0016
Abstract
Abstract
The physician’s role is continually changing and is sure to undergo significant changes in the near future. Among many other disruptive forces, healthcare continues to become more team- and technology-based. The COVID-19 pandemic is likely to be an important turning point for the medical profession. One current issue in healthcare is physicians experiencing moral distress due to conflicts between their duty as employees and their ultimate duty to patients. Other imminent changes are coming due to incorporation of technology, in particular, artificial intelligence and telehealth. These changes can be met through the process of lifelong learning, which entails a commitment to continually improve our knowledge and skills to deliver a high standard of care.

Mental Health in Lifestyle Medicine: A Call to Action

Merlo, G., & Vela, A. (2021). American Journal of Lifestyle Medicine. 10.1177/15598276211013313
Abstract
Abstract
Mental health symptoms are pervasive, with 1 in 5 American adults experiencing a mental disorder. Poor mental health is associated with a significant global cost burden, from disability to economic impacts. The field of lifestyle medicine, which emphasizes the role of lifestyle factors in the onset and treatment of disease and well-being, is well suited to address mental health. More recently, there has been attention to the need to incorporate mental health into the field of lifestyle medicine and to attend to the bidirectional role of mental health and lifestyle. Thus, there is a critical opportunity for the field of lifestyle medicine to incorporate mental health into each of the foundational pillars (diet, exercise, substance use, psychological well-being/stress, relationships, sleep) while also specifically targeting lifestyle interventions for populations with mental disorders. The current article provides a framework for the role of mental health within lifestyle medicine by addressing the scope of the problem, clarification regarding mental health, and areas of practice (ie, psychiatry), and providing an overview of the relevant mental health literature for each pillar. This article serves as a call to action to explicitly address and include mental health within all aspects of lifestyle medicine research and practice.