Dr. Larry Krupa: From Primary Care to Behavioral Pediatrics
Lawrence (Larry) Krupa, MD, FAAP, grew up in Oregon and graduated from the OHSU School of Medicine. After completing his residency at Letterman General Hospital in San Francisco, he joined the U.S. Army and moved with his wife to Stuttgart, Germany. He spent the next three years there developing a lifelong love of pediatrics and travel. Larry said he was drawn to pediatrics because of the possibility to make impactful, upstream change in people’s lives.
After completing his military commitment, Dr. Krupa returned to Oregon where he was a founder at Hillsboro Pediatric Clinic. Over the course of 30 years as his family and his primary practice grew, he found himself drawn to child behavioral health. His original training had included a focus on this specialty, and he realized he wanted to spend more time in this critical area. Larry enrolled in a fellowship training program in Developmental-Behavioral Pediatrics and transitioned out of primary care.
Today Dr. Krupa practices at Mind Matters, PC, in Hillsboro, or remotely via telehealth. Dr. Krupa says that the biggest transition in the past decade is the acceptance of the brain’s ability to change – neuroplasticity – a driving force behind his work. He values Positive Childhood Experiences, and how experiences of connection and belonging can stimulate particular neurons to grow and multiply, and to create positive change in a child’s life. Children are less likely to be labeled as problematic, or just “born that way,” and overwhelmed families are grateful for the education and behavioral interventions.
Dr. Krupa had a chance to pilot the concept of virtual visits long before the pandemic made them commonplace. Early in his DBP practice, he and a colleague would fly from Portland to Pendleton to treat patients. Over time the air service became unreliable, and since it wasn’t feasible for families to travel to Portland, the physicians started using video visits. While he admits that the best model would include initial in-person sessions to build a relationship with the patient, in the absence of that option, the virtual visits met – and continue to meet – a critical need.
When reflecting on our current behavioral healthcare system, Dr. Krupa highlighted the strength of medical homes that include embedded behavioral health specialists who can facilitate warm handoffs when an issue is identified. He sees a need for more behavioral health training for pediatricians and increased primary care staffing of psychologically skilled providers, such as PNPs, LCSWs, and PAs. He also points to necessary legislative changes that would require insurance companies to increase payment for behavioral health services within primary care facilities. As an active member of the OPS Advocacy Committee and delegate to the Oregon Medical Association board of trustees, Larry works to help make these changes a reality.
Because the need is so great, Dr. Krupa said he aims to influence other physicians to have a similar understanding and belief in the importance of behavioral health. “It is a very gratifying kind of work,” he says. “The message that I hear from my patient families is, ‘There is a ray of hope and things can get better.’”