found himself paying attention to something different.
“ I found myself in the ICU focusing more on the kids and the family than their sodium levels.”
That realization ultimately led him toward a highly specialized training path. After graduating from the UofL School of Medicine, he entered a prestigious Triple Board Residency program in Honolulu. The five-year program combines pediatrics, adult psychiatry, and child and adolescent psychiatry training, compressing nine years of education into one integrated experience.
“ There were only 18 sites with the triple board at the time,” he said.“ They minted about 20 of us each year.”
The program proved to be a perfect fit. Rather than viewing patients through a single lens, he learned to understand them as whole people shaped by family, culture, community and life experience. His undergraduate studies in religion and culture unexpectedly became practical tools. In one memorable example, a patient listed 18 different ethnic backgrounds on an intake form.
“ That family had a unique culture,” he said.“ But it taught me that if you understood the contributions of each culture, you had a better chance of communicating with the family.”
He originally planned to spend only a few years in Hawaii after a cruise at 18 years old had convinced him that he wanted to live somewhere with palm trees. Honolulu seemed like a temporary adventure before moving on to the next chapter. Instead, Hawaii became his home for 25 years. Most of his work focused on underserved communities spread across the islands. He treated patients in rural regions, immigrant
communities and schools struggling with significant mental health challenges.“ I got to work with homeless folks living on the beach, people who were immigrants, people who were illiterate,” he said.
Over time, he became deeply involved in efforts to improve access to psychiatric care across Hawaii. Then another opportunity emerged, one that would place him at the forefront of a movement that eventually transformed healthcare. Long before virtual visits became commonplace, Dr. Roth saw telemedicine’ s potential. In 2010, Hawaii’ s geography presented a challenge. Flying physicians between islands was expensive and inefficient and patients, including many children, often waited weeks for appointments.
“ Originally, they had what they would call‘ doctor day’ each month where a specialist doctor would fly in, see all the kids that day, fly back, and come back the next month. If the child missed it that day, they missed it for a month,” he said.
Working with state partners, he helped create what he describes as the first telemedicine-based school evaluation and treatment program in the country. The model transformed access to care. Rather than forcing patients to adapt to a provider’ s travel schedule, follow-up visits could occur when families needed them. What began as a small operation serving 22 schools on Maui, Molokai and Lanai eventually expanded to more than 100 across the Hawaiian Islands. The work earned national recognition.
“ It was the best of times,” he said.“ We presented at national child psychiatry meetings because we were the first execution of a large-scale hybrid telepsychiatry model in the country.” The success of the program
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