Megan Morris

Dr. Morris currently works full-time as a researcher. She is founder and director of the Disability Equity Collaborative where her work focuses on provider and health care organization-level factors that negatively impact the quality of care delivered to patients with disabilities. Her work has been funded by the NIH and other key sources of support. She has published in major medical periodicals, including the New England Journal of Medicine and the journal Health Affairs. Dr. Morris has a Masters of Science degree in Speech-Language Pathology, a Masters of Public Health degree, and a PhD in Rehabilitation Sciences from the University of Washington. She completed post-doctoral fellowships at Northwestern University and the Mayo Clinic in health services research. She has served as a faculty member at the Mayo Clinic, Harvard Medical School, and the University of Colorado Medical School. The following items were discussed in Part 2: how ableism, including structural ableism appear in the healthcare setting; how medicine, including the field of rehabilitation, contributed to ableism in society; the importance of having health care organizations systematically collect and record patients’ disability status within the electronic health record; challenges in achieving effective documentation in the record and how to overcome them; how to determine patients’ needed disability accommodations and implementing them into routine clinical and hospital care; and any ongoing studies in which she is involved and anticipates undertaking in the near term.

Dr. Morris currently works full-time as a researcher. She is founder and director of the Disability Equity Collaborative where her work focuses on provider and health care organization-level factors that negatively impact the quality of care delivered to patients with disabilities. Her work has been funded by the NIH and other key sources of support. She has published in major medical periodicals, including the New England Journal of Medicine and the journal Health Affairs. Dr. Morris has a Masters of Science degree in Speech-Language Pathology, a Masters of Public Health degree, and a PhD in Rehabilitation Sciences from the University of Washington. She completed post-doctoral fellowships at Northwestern University and the Mayo Clinic in health services research. She has served as a faculty member at the Mayo Clinic, Harvard Medical School, and the University of Colorado Medical School. The following items were discussed in Part 2: how ableism, including structural ableism appear in the healthcare setting; how medicine, including the field of rehabilitation, contributed to ableism in society; the importance of having health care organizations systematically collect and record patients’ disability status within the electronic health record; challenges in achieving effective documentation in the record and how to overcome them; how to determine patients’ needed disability accommodations and implementing them into routine clinical and hospital care; and any ongoing studies in which she is involved and anticipates undertaking in the near term.

Dr. Megan Morris: Ableism and Health Care, Part 2

Dr. Morris currently works full-time as a researcher. She is founder and director of the Disability Equity Collaborative where her work focuses on provider and health care organization-level factors that negatively impact the quality of care delivered to patients with disabilities. Her work has been funded by the NIH and other key sources of support. She has published in major medical periodicals, including the New England Journal of Medicine and the journal Health Affairs. Dr. Morris has a Masters of Science degree in Speech-Language Pathology, a Masters of Public Health degree, and a PhD in Rehabilitation Sciences from the University of Washington. She completed post-doctoral fellowships at Northwestern University and the Mayo Clinic in health services research. She has served as a faculty member at the Mayo Clinic, Harvard Medical School, and the University of Colorado Medical School. The following items were discussed in Part 1: her definition of the term ableism; meaning of the term structural ableism and how it is manifested in society; whether there can be a tendency for ableism to occur in conjunction with another kind of ism, such as racism; and how she developed an interest in focusing on the topic of ableism.

Dr. Morris currently works full-time as a researcher. She is founder and director of the Disability Equity Collaborative where her work focuses on provider and health care organization-level factors that negatively impact the quality of care delivered to patients with disabilities. Her work has been funded by the NIH and other key sources of support. She has published in major medical periodicals, including the New England Journal of Medicine and the journal Health Affairs. Dr. Morris has a Masters of Science degree in Speech-Language Pathology, a Masters of Public Health degree, and a PhD in Rehabilitation Sciences from the University of Washington. She completed post-doctoral fellowships at Northwestern University and the Mayo Clinic in health services research. She has served as a faculty member at the Mayo Clinic, Harvard Medical School, and the University of Colorado Medical School. The following items were discussed in Part 1: her definition of the term ableism; meaning of the term structural ableism and how it is manifested in society; whether there can be a tendency for ableism to occur in conjunction with another kind of ism, such as racism; and how she developed an interest in focusing on the topic of ableism.

Dr. Megan Morris: Ableism and Health Care

Akhila Veerubhotla

Akhila Veerubhotla is an Assistant Professor in the Department of Rehabilitation Medicine at NYU-Grossman School of Medicine. She completed her post-doctoral fellowship jointly at the Center for Mobility and Rehabilitation Engineering at the Kessler Foundation and in the Department of Physical Medicine and Rehabilitation at Rutgers – New Jersey Medical School. She has a PhD in Rehabilitation Science from the University of Pittsburgh and a Masters degree in Biomedical Engineering from Carnegie Mellon University. Her research focuses on using technology to help improve mobility, balance, and physical activity in individuals with neurological impairments. Her work primarily is focused toward individuals with stroke, traumatic brain injury and spinal cord injury.  The following items were discussed in Part 2: a Novel Core Strengthening Intervention for Improving Trunk Function, Balance and Mobility after a Stroke; variability in interventions may occur when therapists also provide assistance; risk of falls in individuals with traumatic brain injury; effectiveness of treadmills in conducting research that produces accurate measurements regarding falls; inclusion in studies of patients who have a communication disability as a result of a stroke; funding sources for studies involving technological devices in rehabilitation; role of artificial intelligence in rehabilitation research; and current studies underway or planned for the near future.

Akhila Veerubhotla is an Assistant Professor in the Department of Rehabilitation Medicine at NYU-Grossman School of Medicine. She completed her post-doctoral fellowship jointly at the Center for Mobility and Rehabilitation Engineering at the Kessler Foundation and in the Department of Physical Medicine and Rehabilitation at Rutgers – New Jersey Medical School. She has a PhD in Rehabilitation Science from the University of Pittsburgh and a Masters degree in Biomedical Engineering from Carnegie Mellon University. Her research focuses on using technology to help improve mobility, balance, and physical activity in individuals with neurological impairments. Her work primarily is focused toward individuals with stroke, traumatic brain injury and spinal cord injury.  The following items were discussed in Part 2: a Novel Core Strengthening Intervention for Improving Trunk Function, Balance and Mobility after a Stroke; variability in interventions may occur when therapists also provide assistance; risk of falls in individuals with traumatic brain injury; effectiveness of treadmills in conducting research that produces accurate measurements regarding falls; inclusion in studies of patients who have a communication disability as a result of a stroke; funding sources for studies involving technological devices in rehabilitation; role of artificial intelligence in rehabilitation research; and current studies underway or planned for the near future.

Dr. Akhila Veerubhotla: Application of Technology to Rehabilitation, Part 2

Akhila Veerubhotla is an Assistant Professor in the Department of Rehabilitation Medicine at NYU-Grossman School of Medicine. She completed her post-doctoral fellowship jointly at the Center for Mobility and Rehabilitation Engineering at the Kessler Foundation and in the Department of Physical Medicine and Rehabilitation at Rutgers – New Jersey Medical School. She has a PhD in Rehabilitation Science from the University of Pittsburgh and a Masters degree in Biomedical Engineering from Carnegie Mellon University. Her research focuses on using technology to help improve mobility, balance, and physical activity in individuals with neurological impairments. Her work primarily is focused toward individuals with stroke, traumatic brain injury and spinal cord injury.  The following items were discussed in Part 1: whether devices used in her studies also are available commercially for patients to use at home; a systematic review study involving wearable devices for tracking physical activity in the community after an acquired brain injury; why the transition of wearable devices from the laboratory to the community has gained momentum slowly in recent years; and the value of having a wider representation of participants from different population subgroups in clinical studies.

Akhila Veerubhotla is an Assistant Professor in the Department of Rehabilitation Medicine at NYU-Grossman School of Medicine. She completed her post-doctoral fellowship jointly at the Center for Mobility and Rehabilitation Engineering at the Kessler Foundation and in the Department of Physical Medicine and Rehabilitation at Rutgers – New Jersey Medical School. She has a PhD in Rehabilitation Science from the University of Pittsburgh and a Masters degree in Biomedical Engineering from Carnegie Mellon University. Her research focuses on using technology to help improve mobility, balance, and physical activity in individuals with neurological impairments. Her work primarily is focused toward individuals with stroke, traumatic brain injury and spinal cord injury.  The following items were discussed in Part 1: whether devices used in her studies also are available commercially for patients to use at home; a systematic review study involving wearable devices for tracking physical activity in the community after an acquired brain injury; why the transition of wearable devices from the laboratory to the community has gained momentum slowly in recent years; and the value of having a wider representation of participants from different population subgroups in clinical studies.

Dr. Akhila Veerubhotla: Application of Technology to Rehabilitation, Part 1

Kathleen Isaac

Dr. Kathleen Isaac is a licensed Clinical Psychologist and Clinical Assistant Professor at NYU Langone Health. As a Haitian-American, cis-gender female, she directs the Medical Student and House Staff Mental Health program, which provides individual, couples, and group psychotherapy to medical students, residents, and fellows. She also has a part-time private practice focused on serving BIPOC and LGBTQ+ clients with integrative treatment approaches, where she specializes in trauma, health psychology, and cultural issues. Dr. Isaac also is an adjunct lecturer in the City College of New York’s doctoral program in clinical psychology where she teaches an advanced practicum on intersectional therapy and a Group Psychotherapy course. She has been featured on multiple media platforms, including NBC and the New York Times. Recently, she has published in the journal Psychiatry Annals and in a book chapter dealing with Her Clients’ Racial Identity Development During the Pandemic and the Black Lives Matter Movement. The following items were discussed in Part 2: whether NYU offers any standardized screening to identify residents who may be struggling with mental health and burnout concerns; if NYU has a mentorship program for residents; kinds of differences that may occur in the types of pressures and challenges that may arise depending on the medical specialty; cultivating resilience to increase an ability to cope with various everyday pressures; and enhancing self-management skills in self-monitoring, recognizing, and reporting symptoms of any mental health problems.

Dr. Kathleen Isaac is a licensed Clinical Psychologist and Clinical Assistant Professor at NYU Langone Health. As a Haitian-American, cis-gender female, she directs the Medical Student and House Staff Mental Health program, which provides individual, couples, and group psychotherapy to medical students, residents, and fellows. She also has a part-time private practice focused on serving BIPOC and LGBTQ+ clients with integrative treatment approaches, where she specializes in trauma, health psychology, and cultural issues. Dr. Isaac also is an adjunct lecturer in the City College of New York’s doctoral program in clinical psychology where she teaches an advanced practicum on intersectional therapy and a Group Psychotherapy course. She has been featured on multiple media platforms, including NBC and the New York Times. Recently, she has published in the journal Psychiatry Annals and in a book chapter dealing with Her Clients’ Racial Identity Development During the Pandemic and the Black Lives Matter Movement. The following items were discussed in Part 2: whether NYU offers any standardized screening to identify residents who may be struggling with mental health and burnout concerns; if NYU has a mentorship program for residents; kinds of differences that may occur in the types of pressures and challenges that may arise depending on the medical specialty; cultivating resilience to increase an ability to cope with various everyday pressures; and enhancing self-management skills in self-monitoring, recognizing, and reporting symptoms of any mental health problems.

Dr. Kathleen Isaac: Mental Health and Medical Residents, Part 2

Dr. Kathleen Isaac is a licensed Clinical Psychologist and Clinical Assistant Professor at NYU Langone Health. As a Haitian-American, cis-gender female, she directs the Medical Student and House Staff Mental Health program, which provides individual, couples, and group psychotherapy to medical students, residents, and fellows. She also has a part-time private practice focused on serving BIPOC and LGBTQ+ clients with integrative treatment approaches, where she specializes in trauma, health psychology, and cultural issues. Dr. Isaac also is an adjunct lecturer in the City College of New York’s doctoral program in clinical psychology where she teaches an advanced practicum on intersectional therapy and a Group Psychotherapy course. She has been featured on multiple media platforms, including NBC and the New York Times. Recently, she has published in the journal Psychiatry Annals and in a book chapter dealing with Her Clients’ Racial Identity Development During the Pandemic and the Black Lives Matter Movement.   The following items were discussed in Part 1: regarding how she developed an interest in working with medical residents; how diversity is defined at NYU; why it is essential for the health workforce to be diverse from the perspective of both the clinicians and the patients whom they treat; kinds of structural barriers of an institutional nature within the learning environment that have the capability to hinder workforce diversity; and preparing residents at the beginning of their residency to deal with the kinds of hardship that are likely to develop during the early months of training.

Dr. Kathleen Isaac is a licensed Clinical Psychologist and Clinical Assistant Professor at NYU Langone Health. As a Haitian-American, cis-gender female, she directs the Medical Student and House Staff Mental Health program, which provides individual, couples, and group psychotherapy to medical students, residents, and fellows. She also has a part-time private practice focused on serving BIPOC and LGBTQ+ clients with integrative treatment approaches, where she specializes in trauma, health psychology, and cultural issues. Dr. Isaac also is an adjunct lecturer in the City College of New York’s doctoral program in clinical psychology where she teaches an advanced practicum on intersectional therapy and a Group Psychotherapy course. She has been featured on multiple media platforms, including NBC and the New York Times. Recently, she has published in the journal Psychiatry Annals and in a book chapter dealing with Her Clients’ Racial Identity Development During the Pandemic and the Black Lives Matter Movement. The following items were discussed in Part 1: regarding how she developed an interest in working with medical residents; how diversity is defined at NYU; why it is essential for the health workforce to be diverse from the perspective of both the clinicians and the patients whom they treat; kinds of structural barriers of an institutional nature within the learning environment that have the capability to hinder workforce diversity; and preparing residents at the beginning of their residency to deal with the kinds of hardship that are likely to develop during the early months of training.

Dr. Kathleen Isaac: Mental Health and Medical Residents, Part 1

Salvador Portugal

Dr. Salvador Portugal is an Assistant Professor in the Dapartment of Rehabilitation Medicine at NYU Grossman School of Medicine. He is also Director of the Sports Fellowship program and Medical Director, Sports Medicine Rehabilitation. Dr. Portugal completed his residency at NYU Grossman and his fellowship at UMDNJ. He also received an MBA from Brandies in 2020.  In this segment, Dr. Portugal indicated that in 2014, a systematic review was done, which found that a combination of PT and mobilization was strongly recommended, especially in patients in stages two and three. Cortisone injections were found to be most effective early, and acupuncture plus therapeutic exercises improved pain, range of motion and function. Therapeutic sonograph treatment was not recommended. PT is recommended after phase one or after the painful phase. A Cochrane study concluded that PT should be provided in combination with other treatments. Patients that were compliant with home exercises are shown to be equally effective compared to supervised stretching exercises. He also discussed cortical steroid injections compared to other interventions. Similarly, platelet-rich plasma (PRP) was described in comparison to other forms of treatment, such as physical therapy. A related area of interest is the use of shock wave therapy in comparison to oral steroids. Many patients do well with non-surgical forms of treatment, but surgery may be an option for those who do not do so well with non-surgical treatment.

Dr. Salvador Portugal is an Assistant Professor in the Dapartment of Rehabilitation Medicine at NYU Grossman School of Medicine. He is also Director of the Sports Fellowship program and Medical Director, Sports Medicine Rehabilitation. Dr. Portugal completed his residency at NYU Grossman and his fellowship at UMDNJ. He also received an MBA from Brandies in 2020.  In this segment, Dr. Portugal indicated that in 2014, a systematic review was done, which found that a combination of PT and mobilization was strongly recommended, especially in patients in stages two and three. Cortisone injections were found to be most effective early, and acupuncture plus therapeutic exercises improved pain, range of motion and function. Therapeutic sonograph treatment was not recommended. PT is recommended after phase one or after the painful phase. A Cochrane study concluded that PT should be provided in combination with other treatments. Patients that were compliant with home exercises are shown to be equally effective compared to supervised stretching exercises. He also discussed cortical steroid injections compared to other interventions. Similarly, platelet-rich plasma (PRP) was described in comparison to other forms of treatment, such as physical therapy. A related area of interest is the use of shock wave therapy in comparison to oral steroids. Many patients do well with non-surgical forms of treatment, but surgery may be an option for those who do not do so well with non-surgical treatment.

Dr. Salvador Portugal: Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment, Part 2

Dr. Salvador Portugal is an Assistant Professor in the Dapartment of Rehabilitation Medicine at NYU Grossman School of Medicine. He is also Director of the Sports Fellowship program and Medical Director, Sports Medicine Rehabilitation. Dr. Portugal completed his residency at NYU Grossman and his fellowship at UMDNJ. He also received an MBA from Brandies in 2020.  For this portion, he discussed several topics, such as clinical presentation, risk factors, pathophysiology, diagnostic testing, and non-surgical treatment options. He provided a review from the standpoint of what we should be doing in current practice. Shoulder injury usually is characterized as a marked decrease in range of motion. Patients often have difficulty reaching overhead or behind the back that causes a sensation of pain and stiffness. Prevalence in the general population is 2-5% and women are more affected than men. Pathophysiology is not often understood. Adhesive Capsulitis of the Shoulder after surgery potentially may be a risk. Prevalence is around 11% and women are affected more than men. He addressed the issue of which kind of imaging is important, such as X-rays and MRIs. He then moved on to additional diagnostic testing. Patients with a thyroid condition or diabetes are at increased risk of developing adhesive capsulitis. So, when should we begin considering testing or evaluating these conditions? Approximately one-third of patients with adhesive capsulitis are likely to have diabetes. Next, he focused on non-surgical forms of treatment and management.  

Dr. Salvador Portugal is an Assistant Professor in the Dapartment of Rehabilitation Medicine at NYU Grossman School of Medicine. He is also Director of the Sports Fellowship program and Medical Director, Sports Medicine Rehabilitation. Dr. Portugal completed his residency at NYU Grossman and his fellowship at UMDNJ. He also received an MBA from Brandies in 2020.  For this portion, he discussed several topics, such as clinical presentation, risk factors, pathophysiology, diagnostic testing, and non-surgical treatment options. He provided a review from the standpoint of what we should be doing in current practice. Shoulder injury usually is characterized as a marked decrease in range of motion. Patients often have difficulty reaching overhead or behind the back that causes a sensation of pain and stiffness. Prevalence in the general population is 2-5% and women are more affected than men. Pathophysiology is not often understood. Adhesive Capsulitis of the Shoulder after surgery potentially may be a risk. Prevalence is around 11% and women are affected more than men. He addressed the issue of which kind of imaging is important, such as X-rays and MRIs. He then moved on to additional diagnostic testing. Patients with a thyroid condition or diabetes are at increased risk of developing adhesive capsulitis. So, when should we begin considering testing or evaluating these conditions? Approximately one-third of patients with adhesive capsulitis are likely to have diabetes. Next, he focused on non-surgical forms of treatment and management.

Dr. Salvador Portugal: Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment, Part 1

Alex Moroz

Brian Sunwoo

Dr. Moroz attended the NYU School of Medicine and remained at NYU-Rusk Rehabilitation for residency training, and subsequently, his first and only job. He rose through the faculty ranks and currently is Director of Residency Training and Vice Chair for Education. Dr. Moroz sought out additional training and became a New York State certified acupuncturist, and is directing the Integrative Sports Medicine program, which includes an 18-month track for PM&amp;R residents leading them to becoming certified physician acupuncturists. Dr. Brian Sunwoo is a current administrative chief resident in the Physical Medicine and Rehabilitation residency program at NYU Langone Health. He attended Rowan School of Osteopathic Medicine, where he received the Dean's Recognition Award and will begin a fellowship in Interventional Spine after completing residency. As an NYU resident, he has served on the Rusk Health Equity, GME Diversity and Inclusion, and House Staff Leadership Committees. Dr. Sunwoo currently is completing his clinical acupuncture certification through the NYU PM&amp;R residency program with plans to incorporate its use in his future practice.   The following items were discussed in Part 2: effectiveness of acupuncture treatment either pre- or post-operative in dealing with nausea and vomiting in the post-surgical period; use of acupuncture in treating mental health conditions; extent to which sham acupuncture is being used in research; whether expectancy data are collected beforehand to measure how strongly patients anticipate a positive acupuncture treatment outcome; health problems where research indicates a high-certainty level of evidence for acupuncture; use of artificial intelligence in acupuncture research and treatment; and current or planned research endeavors at NYU that involve acupuncture.

Dr. Moroz attended the NYU School of Medicine and remained at NYU-Rusk Rehabilitation for residency training, and subsequently, his first and only job. He rose through the faculty ranks and currently is Director of Residency Training and Vice Chair for Education. Dr. Moroz sought out additional training and became a New York State certified acupuncturist, and is directing the Integrative Sports Medicine program, which includes an 18-month track for PM&amp;R residents leading them to becoming certified physician acupuncturists. Dr. Brian Sunwoo is a current administrative chief resident in the Physical Medicine and Rehabilitation residency program at NYU Langone Health. He attended Rowan School of Osteopathic Medicine, where he received the Dean's Recognition Award and will begin a fellowship in Interventional Spine after completing residency. As an NYU resident, he has served on the Rusk Health Equity, GME Diversity and Inclusion, and House Staff Leadership Committees. Dr. Sunwoo currently is completing his clinical acupuncture certification through the NYU PM&amp;R residency program with plans to incorporate its use in his future practice.   The following items were discussed in Part 2: effectiveness of acupuncture treatment either pre- or post-operative in dealing with nausea and vomiting in the post-surgical period; use of acupuncture in treating mental health conditions; extent to which sham acupuncture is being used in research; whether expectancy data are collected beforehand to measure how strongly patients anticipate a positive acupuncture treatment outcome; health problems where research indicates a high-certainty level of evidence for acupuncture; use of artificial intelligence in acupuncture research and treatment; and current or planned research endeavors at NYU that involve acupuncture.

Dr. Alex Moroz & Dr. Brian Sunwoo: Acupuncture Panel Interview, Part 2

Dr. Moroz attended the NYU School of Medicine and remained at NYU-Rusk Rehabilitation for residency training, and subsequently, his first and only job. He rose through the faculty ranks and currently is Director of Residency Training and Vice Chair for Education. Dr. Moroz sought out additional training and became a New York State certified acupuncturist, and is directing the Integrative Sports Medicine program, which includes an 18-month track for PM&amp;R residents leading them to becoming certified physician acupuncturists. Dr. Brian Sunwoo is a current administrative chief resident in the Physical Medicine and Rehabilitation residency program at NYU Langone Health. He attended Rowan School of Osteopathic Medicine, where he received the Dean's Recognition Award and will begin a fellowship in Interventional Spine after completing residency. As an NYU resident, he has served on the Rusk Health Equity, GME Diversity and Inclusion, and House Staff Leadership Committees. Dr. Sunwoo currently is completing his clinical acupuncture certification through the NYU PM&amp;R residency program with plans to incorporate its use in his future practice.   The following items were discussed in Part 1: number of participants in the residency program at NYU using acupuncture with patients; professional qualifications deemed necessary to use acupuncture in treating patients; insurance company coverage of acupuncture treatment; role of patients’ age in achieving desired clinical outcomes involving acupuncture; different kinds of instruments used by acupuncture practitioners; acupuncture as a lone intervention and also as an adjunct to western medicine; contributions that acupuncture can make in dealing with problems, such as stroke; and possible differences among clinicians in different health professions regarding the effectiveness of acupuncture treatments?

Dr. Moroz attended the NYU School of Medicine and remained at NYU-Rusk Rehabilitation for residency training, and subsequently, his first and only job. He rose through the faculty ranks and currently is Director of Residency Training and Vice Chair for Education. Dr. Moroz sought out additional training and became a New York State certified acupuncturist, and is directing the Integrative Sports Medicine program, which includes an 18-month track for PM&amp;R residents leading them to becoming certified physician acupuncturists. Dr. Brian Sunwoo is a current administrative chief resident in the Physical Medicine and Rehabilitation residency program at NYU Langone Health. He attended Rowan School of Osteopathic Medicine, where he received the Dean's Recognition Award and will begin a fellowship in Interventional Spine after completing residency. As an NYU resident, he has served on the Rusk Health Equity, GME Diversity and Inclusion, and House Staff Leadership Committees. Dr. Sunwoo currently is completing his clinical acupuncture certification through the NYU PM&amp;R residency program with plans to incorporate its use in his future practice.   The following items were discussed in Part 1: number of participants in the residency program at NYU using acupuncture with patients; professional qualifications deemed necessary to use acupuncture in treating patients; insurance company coverage of acupuncture treatment; role of patients’ age in achieving desired clinical outcomes involving acupuncture; different kinds of instruments used by acupuncture practitioners; acupuncture as a lone intervention and also as an adjunct to western medicine; contributions that acupuncture can make in dealing with problems, such as stroke; and possible differences among clinicians in different health professions regarding the effectiveness of acupuncture treatments?

Dr. Alex Moroz & Dr. Brian Sunwoo: Acupuncture Panel Interview, Part 1

RUSK Insights on Rehabilitation Medicine is a top podcast featuring interviews with faculty and staff of RUSK Rehabilitation at NYU Langone Medical Center. These podcasts are being offered by RUSK, one of the top rehabilitation centers in the world. Your host for these interviews is Dr. Tom Elwood. He will take you behind the scenes to look at what is transpiring in the exciting world of rehabilitation research and clinical services through the eyes of those involved in making dynamic breakthroughs in health care.

Byron Schneider

Dr. Byron Schneider is currently an associate professor with the Department of Physical Medicine and Rehabilitation at Vanderbilt University Medical Center and serves as the Director of the Interventional Spine and Musculoskeletal Medicine Fellowship. Previously, he completed his residency and interventional spine fellowship at Stanford University. He has nearly 100 publications, with a research focus on the safety and outcomes of interventional spine procedures. He has given over 100 lectures at national and international meetings. He currently is on the Spine Intervention Society Board of Directors as the Chair of Research, and within the North American Spine Society is Chair of the Interventional Spine and Musculoskeletal Section as well as Co-Chair for the Coverage Committee. In Part 2 of his presentation, he indicated that the study by Wolf and his group was observational and retrospective, so there are some missing data. They enrolled patients based on provocation discography, which you hope would result in better outcomes. He stated that this number, 50 percent of people saying that they are 50 percent better is very common in pain literature. He wouldn’t say it is favorable. Over and over, these are the numbers we see that turn out to be dead ends. These are non-compelling data unless we are able to show they are non-placebo. You need RCTs to do that. He is a huge proponent of observational studies. They can give you very meaningful clinical information, but unfortunately for a new technology like this, we need at least some evidence that these things are doing something beyond placebo. Next, he indicated the discussion in his presentation would shift to discussing some RCTs that have been published more recently. As of right now, however, the totality of evidence because of the negative RCTs in the research done today, stem cells do not work as a treatment for disc-related low back pain. He then described four new RCTs that came out in the last two years that will shed some new light. The first study involved a comparison with saline treatment. Unwanted side effects, such as infections and other complications have occurred as a result of the treatments in the four studies. Safety continues to be a concern in developing effective treatments using stem cell and PRP approaches.

Dr. Byron Schneider is currently an associate professor with the Department of Physical Medicine and Rehabilitation at Vanderbilt University Medical Center and serves as the Director of the Interventional Spine and Musculoskeletal Medicine Fellowship. Previously, he completed his residency and interventional spine fellowship at Stanford University. He has nearly 100 publications, with a research focus on the safety and outcomes of interventional spine procedures. He has given over 100 lectures at national and international meetings. He currently is on the Spine Intervention Society Board of Directors as the Chair of Research, and within the North American Spine Society is Chair of the Interventional Spine and Musculoskeletal Section as well as Co-Chair for the Coverage Committee. In Part 2 of his presentation, he indicated that the study by Wolf and his group was observational and retrospective, so there are some missing data. They enrolled patients based on provocation discography, which you hope would result in better outcomes. He stated that this number, 50 percent of people saying that they are 50 percent better is very common in pain literature. He wouldn’t say it is favorable. Over and over, these are the numbers we see that turn out to be dead ends. These are non-compelling data unless we are able to show they are non-placebo. You need RCTs to do that. He is a huge proponent of observational studies. They can give you very meaningful clinical information, but unfortunately for a new technology like this, we need at least some evidence that these things are doing something beyond placebo. Next, he indicated the discussion in his presentation would shift to discussing some RCTs that have been published more recently. As of right now, however, the totality of evidence because of the negative RCTs in the research done today, stem cells do not work as a treatment for disc-related low back pain. He then described four new RCTs that came out in the last two years that will shed some new light. The first study involved a comparison with saline treatment. Unwanted side effects, such as infections and other complications have occurred as a result of the treatments in the four studies. Safety continues to be a concern in developing effective treatments using stem cell and PRP approaches.

Dr. Byron Schneider: Grand Rounds Part 2

Dr. Byron Schneider is currently an associate professor with the Department of Physical Medicine and Rehabilitation at Vanderbilt University Medical Center and serves as the Director of the Interventional Spine and Musculoskeletal Medicine Fellowship. Previously, he completed his residency and interventional spine fellowship at Stanford University. He has nearly 100 publications, with a research focus on the safety and outcomes of interventional spine procedures. He has given over 100 lectures at national and international meetings. He currently is on the Spine Intervention Society Board of Directors as the Chair of Research, and within the North American Spine Society is Chair of the Interventional Spine and Musculoskeletal Section as well as Co-Chair for the Coverage Committee. In Part 1 of his presentation, the focus was on a systematic review that was done of how stem cells and PRP pertain to back pain. He began by going over the history and regulations. Traditionally as it pertains to all biologics, they were largely exempt from the pathway of the FDA. Because they did not go through that process, these medicines were allowed to be done, but really did not have any insurance coverage. They became a cash cow for those offering fee-for-service treatment for things that did not have a lot of evidence behind them yet. It led to much public confusion, but that gap has shrunk in recent years. The FDA began issuing more restrictive language in 2020 regarding treatments that were not approved by that agency. The primary purpose of the aforementioned review was to look at 50 or more percent relief of low back pain at a six-month outcome. Based on those criteria, the number of citations was whittled down from 3,000 citations reviewed to 37, then finally down to only 12 that actually met the criteria. Those results should be alarming given that hundreds of clinics in the U.S. were providing treatments for cash payments that were based on only 12 research papers. Only one paper was on PRPs and one on stem cell treatment. He then described a study on PRP in 2015. He also provided summaries of other investigations that entailed PRP and stem cell treatments.

Dr. Byron Schneider is currently an associate professor with the Department of Physical Medicine and Rehabilitation at Vanderbilt University Medical Center and serves as the Director of the Interventional Spine and Musculoskeletal Medicine Fellowship. Previously, he completed his residency and interventional spine fellowship at Stanford University. He has nearly 100 publications, with a research focus on the safety and outcomes of interventional spine procedures. He has given over 100 lectures at national and international meetings. He currently is on the Spine Intervention Society Board of Directors as the Chair of Research, and within the North American Spine Society is Chair of the Interventional Spine and Musculoskeletal Section as well as Co-Chair for the Coverage Committee. In Part 1 of his presentation, the focus was on a systematic review that was done of how stem cells and PRP pertain to back pain. He began by going over the history and regulations. Traditionally as it pertains to all biologics, they were largely exempt from the pathway of the FDA. Because they did not go through that process, these medicines were allowed to be done, but really did not have any insurance coverage. They became a cash cow for those offering fee-for-service treatment for things that did not have a lot of evidence behind them yet. It led to much public confusion, but that gap has shrunk in recent years. The FDA began issuing more restrictive language in 2020 regarding treatments that were not approved by that agency. The primary purpose of the aforementioned review was to look at 50 or more percent relief of low back pain at a six-month outcome. Based on those criteria, the number of citations was whittled down from 3,000 citations reviewed to 37, then finally down to only 12 that actually met the criteria. Those results should be alarming given that hundreds of clinics in the U.S. were providing treatments for cash payments that were based on only 12 research papers. Only one paper was on PRPs and one on stem cell treatment. He then described a study on PRP in 2015. He also provided summaries of other investigations that entailed PRP and stem cell treatments.

Dr. Byron Schneider: Grand Rounds Part 1

Judy Baumhauer

Dr. Baumhauer is a tenured Professor and serves as the Senior Associate Dean of Academic Affairs for the University of Rochester School of Medicine and Dentistry. She also is the Associate Chair of Academic Affairs within the Department of Orthopaedics at the University of Rochester. In addition to providing clinical care and performing surgery, she holds the position as the Director of the Clinical Health Informatics Core for the UR Healthcare System and is a board of director of Accountable Health Partners, ACO for the Rochester Region. She received her Doctorate of Medicine from the University of Vermont College of Medicine. She completed orthopaedic residency at the Medical Center Hospital of Vermont and a Fellowship in Foot and Ankle Surgery at the Medical College of Wisconsin. She also completed a Masters in Public Health degree from the University of Rochester. Dr. Baumhauer is the past president of the American Board of Orthopaedic Surgery, American Orthopaedic Foot and Ankle Society (AOFAS), and Eastern Orthopaedic Association. She currently is the President of the Patient-Reported Outcomes Measurement Information System (PROMIS) Health Organization and has published over two hundred peer reviewed papers and book chapters. In Part 2, Dr. Baumhauer described research showing that patients who were able to report at times that were important to the patient ended up visiting the emergency room less and were experiencing more favorable outcomes. She discussed how data are used. The first time seeing a patient, it is important to know what their baseline values are, e.g., mild depression and moderate symptoms for physical function and pain. Trends can be noted that make it possible before meeting with a patient to look at the PROMIS scores and be able to anticipate how much time to spend with this individual. It enables the physician to triage, which patients appreciate. Patients also are asked anchoring questions, such as general health status questions that make it possible to link the medical visit. An example is are you worse, better, or the same since your last visit? Another question is can you live with your symptoms? She also discussed how patients can ask questions, such as whether there will be substantial improvement as a result of surgery. If such an outcome is unlikely, surgery should not occur. Another question patients ask is which of various treatment options should be selected? It is important to know what the patient wants to measure.

Dr. Baumhauer is a tenured Professor and serves as the Senior Associate Dean of Academic Affairs for the University of Rochester School of Medicine and Dentistry. She also is the Associate Chair of Academic Affairs within the Department of Orthopaedics at the University of Rochester. In addition to providing clinical care and performing surgery, she holds the position as the Director of the Clinical Health Informatics Core for the UR Healthcare System and is a board of director of Accountable Health Partners, ACO for the Rochester Region. She received her Doctorate of Medicine from the University of Vermont College of Medicine. She completed orthopaedic residency at the Medical Center Hospital of Vermont and a Fellowship in Foot and Ankle Surgery at the Medical College of Wisconsin. She also completed a Masters in Public Health degree from the University of Rochester. Dr. Baumhauer is the past president of the American Board of Orthopaedic Surgery, American Orthopaedic Foot and Ankle Society (AOFAS), and Eastern Orthopaedic Association. She currently is the President of the Patient-Reported Outcomes Measurement Information System (PROMIS) Health Organization and has published over two hundred peer reviewed papers and book chapters. In Part 2, Dr. Baumhauer described research showing that patients who were able to report at times that were important to the patient ended up visiting the emergency room less and were experiencing more favorable outcomes. She discussed how data are used. The first time seeing a patient, it is important to know what their baseline values are, e.g., mild depression and moderate symptoms for physical function and pain. Trends can be noted that make it possible before meeting with a patient to look at the PROMIS scores and be able to anticipate how much time to spend with this individual. It enables the physician to triage, which patients appreciate. Patients also are asked anchoring questions, such as general health status questions that make it possible to link the medical visit. An example is are you worse, better, or the same since your last visit? Another question is can you live with your symptoms? She also discussed how patients can ask questions, such as whether there will be substantial improvement as a result of surgery. If such an outcome is unlikely, surgery should not occur. Another question patients ask is which of various treatment options should be selected? It is important to know what the patient wants to measure.

Dr. Judy Baumhauer: Implementing and Interpreting Patient Reported Outcomes, Part 2

Dr. Baumhauer is a tenured Professor and serves as the Senior Associate Dean of Academic Affairs for the University of Rochester School of Medicine and Dentistry. She also is the Associate Chair of Academic Affairs within the Department of Orthopaedics at the University of Rochester. In addition to providing clinical care and performing surgery, she holds the position as the Director of the Clinical Health Informatics Core for the UR Healthcare System and is a board of director of Accountable Health Partners, ACO for the Rochester Region. She received her Doctorate of Medicine from the University of Vermont College of Medicine. She completed orthopaedic residency at the Medical Center Hospital of Vermont and a Fellowship in Foot and Ankle Surgery at the Medical College of Wisconsin. She also completed a Masters in Public Health degree from the University of Rochester. Dr. Baumhauer is the past president of the American Board of Orthopaedic Surgery, American Orthopaedic Foot and Ankle Society (AOFAS), and Eastern Orthopaedic Association. She currently is the President of the Patient-Reported Outcomes Measurement Information System (PROMIS) Health Organization and has published over two hundred peer reviewed papers and book chapters. Part 1:  Data are needed to help understand how a patient is feeling and functioning to implement preventive health strategies, maximize healthy behaviors, assess their treatment response, and understand how health care resources are being allocated. Dr. Baumhauer defined a patient reported outcome as information directly reported by the patient who experiences it and is not interpreted as when we usually obtain some health history and tell it in our terms and report it into the patient’s note. She provided examples of the disconnect between what is important to the patient and what the clinician believes is important for the patient. A validated number can be placed on how the patient is feeling and functioning. It is important that a validated instrument be used that is quick and does not hold up the clinician. At the University of Rochester, they landed on the use of PROMIS (Patient-Reported Outcomes Measurement Information System) on a custom platform called UR VOICE (Validated Outcomes in Clinical Experience). They collect the same information for each patient. They try to ask the right questions when the information is needed most. The aim is to be domain specific, such as symptom-based, using the core package of pain, physical function, and depression rather than focusing on various diseases. Depending on the medical specialty, the symptoms emphasized can be different. Compared to SF-36, PROMIS is a better measure since it is more responsive to change.

Dr. Baumhauer is a tenured Professor and serves as the Senior Associate Dean of Academic Affairs for the University of Rochester School of Medicine and Dentistry. She also is the Associate Chair of Academic Affairs within the Department of Orthopaedics at the University of Rochester. In addition to providing clinical care and performing surgery, she holds the position as the Director of the Clinical Health Informatics Core for the UR Healthcare System and is a board of director of Accountable Health Partners, ACO for the Rochester Region. She received her Doctorate of Medicine from the University of Vermont College of Medicine. She completed orthopaedic residency at the Medical Center Hospital of Vermont and a Fellowship in Foot and Ankle Surgery at the Medical College of Wisconsin. She also completed a Masters in Public Health degree from the University of Rochester. Dr. Baumhauer is the past president of the American Board of Orthopaedic Surgery, American Orthopaedic Foot and Ankle Society (AOFAS), and Eastern Orthopaedic Association. She currently is the President of the Patient-Reported Outcomes Measurement Information System (PROMIS) Health Organization and has published over two hundred peer reviewed papers and book chapters. Part 1:  Data are needed to help understand how a patient is feeling and functioning to implement preventive health strategies, maximize healthy behaviors, assess their treatment response, and understand how health care resources are being allocated. Dr. Baumhauer defined a patient reported outcome as information directly reported by the patient who experiences it and is not interpreted as when we usually obtain some health history and tell it in our terms and report it into the patient’s note. She provided examples of the disconnect between what is important to the patient and what the clinician believes is important for the patient. A validated number can be placed on how the patient is feeling and functioning. It is important that a validated instrument be used that is quick and does not hold up the clinician. At the University of Rochester, they landed on the use of PROMIS (Patient-Reported Outcomes Measurement Information System) on a custom platform called UR VOICE (Validated Outcomes in Clinical Experience). They collect the same information for each patient. They try to ask the right questions when the information is needed most. The aim is to be domain specific, such as symptom-based, using the core package of pain, physical function, and depression rather than focusing on various diseases. Depending on the medical specialty, the symptoms emphasized can be different. Compared to SF-36, PROMIS is a better measure since it is more responsive to change.

Dr. Judy Baumhauer: Implementing and Interpreting Patient Reported Outcomes

Lucy Kendall

Dr. Kendall is a second-year resident physician at Rusk. She completed her undergraduate education in Nutrition Science with honors from Purdue University. Subsequently, she was awarded Master’s Student of the Year in 2017 by the Purdue University College of Health and Human Sciences for her graduate work in Cancer Epigenetics and Nutriepigenomics. Since discovering the field of physiatry as a medical student, she has adamantly pursued neurorehabilitation, spinal cord injury, and pain medicine research. She serves on the American Osteopathic College of Physical Medicine and Rehabilitation (AOCPMR) Resident Council, regularly provides mentorship to aspiring physiatrists, and serves on the Rusk Rehabilitation residency wellness committee. Her current rehabilitation interests include interventional spine medicine and movement disorders.   The following items were discussed in this one-part interview: incidence and prevalence data for amyotrophic lateral sclerosis (ALS) in the U.S.; the role of heredity; demographic groups more likely to experience the onset of this disease; preventability of ALS;, tools for making a clear diagnosis; ability to acquire wheelchairs in a timely fashion; when to initiate a custom power wheelchair order; training patients to use power wheelchairs; prevention of decubitus ulcers from sitting in an unchanged posture; and seeking to have an impact on legislation regarding this disease.

Dr. Lucy Kendall: Pursuing a Career in PM&R

Benjamin Klyachman

Originally from Brooklyn, Dr. Klyachman is the son of two Russian speaking immigrants and among the first in his family to pursue a career in medicine. He attended the University at Buffalo for his undergraduate education and continued his medical education at Touro College of Osteopathic Medicine in Harlem. After graduating, he went to Florida to complete an internship and currently is in the fourth year of a rehabilitation residency at NYU Rusk. He recently matched into a fellowship at NYU where he plans to continue specialty training that starts in July 2023.  The following items were discussed in this one-part interview: a typical day in the life of a medical resident at Rusk; involvement in research at Rusk; area of specialization upon completion of the residency; types of components that should be included for residents in a skilled nursing facility level rehabilitation program, such as prediction tools for identifying and stratifying patients being discharged to a skilled nursing facility; social media developed for residents at Rusk; ways in which social media have played a constructive role in contributing to the mental and physical wellbeing of these clinicians; how social media can serve as a key adjunct to traditional residency learning in classrooms and on the wards; use of social media from the perspective of interacting with residency peers, instructors, and patients;  role for physiatrists to play in enhancing social media skill development in patients; and empowering patients by providing them with the necessary knowledge and skills to promote constructive behavior change.    Many patients have as a rehabilitation goal a successful reintegration into the society by returning to previous employment and renewing their social networks. Self-management programs may contribute to realizing the attainment of this goal. What role do you see being played by physiatrists, if any, in empowering patients by providing them with the necessary knowledge and skills to promote constructive behavior changes through self-management.

Originally from Brooklyn, Dr. Klyachman is the son of two Russian speaking immigrants and among the first in his family to pursue a career in medicine. He attended the University at Buffalo for his undergraduate education and continued his medical education at Touro College of Osteopathic Medicine in Harlem. After graduating, he went to Florida to complete an internship and currently is in the fourth year of a rehabilitation residency at NYU Rusk. He recently matched into a fellowship at NYU where he plans to continue specialty training that starts in July 2023.  The following items were discussed in this one-part interview: a typical day in the life of a medical resident at Rusk; involvement in research at Rusk; area of specialization upon completion of the residency; types of components that should be included for residents in a skilled nursing facility level rehabilitation program, such as <a></a>prediction tools for identifying and stratifying patients being discharged to a skilled nursing facility; social media developed for residents at Rusk; ways in which social media have played a constructive role in contributing to the mental and physical wellbeing of these clinicians; how social media can serve as a key adjunct to traditional residency learning in classrooms and on the wards; use of social media from the perspective of interacting with residency peers, instructors, and patients;  role for physiatrists to play in enhancing social media skill development in patients; and empowering patients by providing them with the necessary knowledge and skills to promote constructive behavior change.    Many patients have as a rehabilitation goal a successful reintegration into the society by returning to previous employment and renewing their social networks. Self-management programs may contribute to realizing the attainment of this goal. What role do you see being played by physiatrists, if any, in empowering patients by providing them with the necessary knowledge and skills to promote constructive behavior changes through self-management.

Dr. Benjamin Klyachman: Rusk Medical Education: Empowering our Learners to Transform Patient Care.

Brian Im

Lindsey Gurin

Dr. Lindsey Gurin is a clinical assistant professor of neurology, psychiatry, and rehabilitation medicine at NYU Langone Health. She is dual board-certified in neurology and psychiatry and currently serves as Director of Behavioral Neurology at NYU Langone Orthopedics Hospital, where she provides neuropsychiatric consultation to the Rusk acute inpatient brain injury rehabilitation service. She also is Director of the NYU Combined Psychiatry/Neurology Residency Training Program. Dr. Gurin has published on neuropsychiatric manifestations of brain injury and her current research interests include psychosis after brain injury; disorders of consciousness; and catatonia in patients with neurologic disorders. Dr. Brian Im is heavily involved in program development and academic medicine. He has an active role in brain injury rehabilitation research at NYU. After completing medical school at SUNY Upstate Medical University, a rehabilitation residency at NYU School of Medicine/Rusk Rehabilitation, and a fellowship in brain injury medicine at UMDNJ/Johnson Rehabilitation Institute, his subsequent tenure at Bellevue Hospital focused upon an interest in improving brain injury rehabilitation for underserved populations.  He remains involved in this research at Bellevue Hospital while at his current role as the director for brain injury rehabilitation medicine at NYU/Rusk Rehabilitation.  In Part One, the discussion included the following: a description of the care provided at NYU for patients who experience a brain injury from the perspective of the overall number and kinds of personnel involved and the clinical facilities in which they work; early neurorehabilitation and recovery from disorders of consciousness after severe COVID-19; and the kinds of challenges involved, such as arriving at a correct diagnosis of disorders of consciousness that could prove difficult because of a combination of patient and health system factors. In Part Two, the discussion included the following: long COVID with brain fog and treatments that are being tried; a definition of the terms catatonia and hypoxia-ischemia and a description of their causes; challenges involved in diagnosing and treating catatonia effectively in a timely manner; possible outcome of ineffective treatment occurring if catatonia is under-recognized diagnostically, and current and future research endeavors at NYU pertaining to brain injury.

Dr. Lindsey Gurin is a clinical assistant professor of neurology, psychiatry, and rehabilitation medicine at NYU Langone Health. She is dual board-certified in neurology and psychiatry and currently serves as Director of Behavioral Neurology at NYU Langone Orthopedics Hospital, where she provides neuropsychiatric consultation to the Rusk acute inpatient brain injury rehabilitation service. She also is Director of the NYU Combined Psychiatry/Neurology Residency Training Program. Dr. Gurin has published on neuropsychiatric manifestations of brain injury and her current research interests include psychosis after brain injury; disorders of consciousness; and catatonia in patients with neurologic disorders. Dr. Brian Im is heavily involved in program development and academic medicine. He has an active role in brain injury rehabilitation research at NYU. After completing medical school at SUNY Upstate Medical University, a rehabilitation residency at NYU School of Medicine/Rusk Rehabilitation, and a fellowship in brain injury medicine at UMDNJ/Johnson Rehabilitation Institute, his subsequent tenure at Bellevue Hospital focused upon an interest in improving brain injury rehabilitation for underserved populations.  He remains involved in this research at Bellevue Hospital while at his current role as the director for brain injury rehabilitation medicine at NYU/Rusk Rehabilitation.  In Part One, the discussion included the following: a description of the care provided at NYU for patients who experience a brain injury from the perspective of the overall number and kinds of personnel involved and the clinical facilities in which they work; early neurorehabilitation and recovery from disorders of consciousness after severe COVID-19; and the kinds of challenges involved, such as arriving at a correct diagnosis of disorders of consciousness that could prove difficult because of a combination of patient and health system factors. In Part Two, the discussion included the following: long COVID with brain fog and treatments that are being tried; a definition of the terms catatonia and hypoxia-ischemia and a description of their causes; challenges involved in diagnosing and treating catatonia effectively in a timely manner; possible outcome of ineffective treatment occurring if catatonia is under-recognized diagnostically, and current and future research endeavors at NYU pertaining to brain injury.

Dr. Brian Im and Dr. Lindsey Gurin: Exploring Brain Injury Part 2

Dr Brian Im and Dr. Lindsey Gurin: Exploring Brain Injury Part 1

Francis Lopez

Sam Wu

JR Rizzo

Part Two included a discussion of the barriers that students still face despite the ADA. They did not seek supportive accommodations because of stigma or fear. Dr. Rizzo wanted to draw attention to definitions of disability. He also emphasized that people with disabilities can help with accessibility and for coming up with empathetic dialogue that is critical in moving forward as a medical community. These agendas must be pushed here at NYU to ensure that we are doing enough to increase disability inclusion and also to ensure that patients are receiving the preventive medicine that they actually need. Dr. Wu indicated that in his research conducted 30 years ago, deans not only were asked how many medical school students have disabilities, but also “how did they do?” Did you do the right thing for society by producing good physicians at the end or did you pass along somebody who shouldn’t be there? The result was those students did as well and better than their able-bodied counterparts.

Part Two included a discussion of the barriers that students still face despite the ADA. They did not seek supportive accommodations because of stigma or fear. Dr. Rizzo wanted to draw attention to definitions of disability. He also emphasized that people with disabilities can help with accessibility and for coming up with empathetic dialogue that is critical in moving forward as a medical community. These agendas must be pushed here at NYU to ensure that we are doing enough to increase disability inclusion and also to ensure that patients are receiving the preventive medicine that they actually need. Dr. Wu indicated that in his research conducted 30 years ago, deans not only were asked how many medical school students have disabilities, but also “how did they do?” Did you do the right thing for society by producing good physicians at the end or did you pass along somebody who shouldn’t be there? The result was those students did as well and better than their able-bodied counterparts.

Drs. Francis Lopez, JR Rizzo, Sam Wu - Diversity, Equity and Inclusion, The Case to Include Disability in the Diversity Space, Part 2

Part One of this grand round presentation delves into the struggle faced by individuals with disabilities and future directions to take to include them in the rehabilitation field. Both Drs. Rizzo and Wu have important stories to tell about living with a disability. An aim in this session is to understand the epidemiology of disability, the American with Disabilities Act (ADA), and be familiar with the barriers that individuals with disabilities face. According to new CDC data, the prevalence of disability in the non-institutionalized portion of the U.S. population is 26%. The data may understate the true prevalence. Data also were provided on the prevalence of disability among medical students, residents, and practicing physicians. These numbers also may under represent the true extent of disability among members of the medical community. A definition of disability in the American with Disabilities Act Amendments and its implications were discussed.

Part One of this grand round presentation delves into the struggle faced by individuals with disabilities and future directions to take to include them in the rehabilitation field. Both Drs. Rizzo and Wu have important stories to tell about living with a disability. An aim in this session is to understand the epidemiology of disability, the American with Disabilities Act (ADA), and be familiar with the barriers that individuals with disabilities face. According to new CDC data, the prevalence of disability in the non-institutionalized portion of the U.S. population is 26%. The data may understate the true prevalence. Data also were provided on the prevalence of disability among medical students, residents, and practicing physicians. These numbers also may under represent the true extent of disability among members of the medical community. A definition of disability in the American with Disabilities Act Amendments and its implications were discussed.

Drs. Francis Lopez, JR Rizzo, Sam Wu - Diversity, Equity and Inclusion, The Case to Include Disability in the Diversity Space, Part 1

pat11215

Mara Sproul

RUSK Insights on Rehabilitation Medicine

Naomi Gerber

Dr. Naomi Gerber serves as the Director of Research for the Department of Medicine at Inova Fairfax Hospital in Virginia and the Outcomes Program at the Beatty Center for Integrated Research. After graduating from Tufts University School of Medicine, Dr. Gerber completed two residencies in internal medicine and rehabilitation medicine and a fellowship in rheumatology. She served as the Chief of the Rehabilitation Medicine Department at the Clinical Center, National Institutes of Health in Bethesda, Maryland and was instrumental in helping to develop the sub-specialty of rehabilitative rheumatology. In 2006, Dr. Gerber joined the faculty of George Mason University in the Health Administration and Policy Department and is co-director of the Laboratory for the Study and Simulation of Human Movement.  In Part 1 of her presentation, Dr. Gerber’s aim is to decipher fatigue in the context of proteomics, performance, and perception. She wants to describe the construct that is beginning to be shaped to enable us to understand fatigue better and indicate how it is effectively measured both objectively and subjectively. She mentioned that the term biosignature is a more robust term than biomarker because it represents multiple domain measures to help us understand complex ideas, such as fatigue. When talking about fatigue, it is necessary for individuals to report what they are experiencing. Expectation plays a role in what a person is trying to accomplish. In order to treat fatigue effectively, it is necessary to know the parameters. Her presentation included the topics of cancer fatigue and liver fatigue, noting that if we do not study the liver better, an important concept in the rehabilitation world, we are not going to conquer this problem. She made a distinction between pathological and non-pathological (normal) fatigue and how to treat these conditions. She also discussed peripheral and central fatigue. There is confusion in the domain culture about these kinds of fatigue and an effort is underway to identify a biosignature that gives a mix of objective measures linked to perception. A portion of the tryptophan pathway is critical for understanding fatigue, both peripheral and central.

Dr. Naomi Gerber serves as the Director of Research for the Department of Medicine at Inova Fairfax Hospital in Virginia and the Outcomes Program at the Beatty Center for Integrated Research. After graduating from Tufts University School of Medicine, Dr. Gerber completed two residencies in internal medicine and rehabilitation medicine and a fellowship in rheumatology. She served as the Chief of the Rehabilitation Medicine Department at the Clinical Center, National Institutes of Health in Bethesda, Maryland and was instrumental in helping to develop the sub-specialty of rehabilitative rheumatology. In 2006, Dr. Gerber joined the faculty of George Mason University in the Health Administration and Policy Department and is co-director of the Laboratory for the Study and Simulation of Human Movement.  In Part 1 of her presentation, Dr. Gerber’s aim is to decipher fatigue in the context of proteomics, performance, and perception. She wants to describe the construct that is beginning to be shaped to enable us to understand fatigue better and indicate how it is effectively measured both objectively and subjectively. She mentioned that the term biosignature is a more robust term than biomarker because it represents multiple domain measures to help us understand complex ideas, such as fatigue. When talking about fatigue, it is necessary for individuals to report what they are experiencing. Expectation plays a role in what a person is trying to accomplish. In order to treat fatigue effectively, it is necessary to know the parameters. Her presentation included the topics of cancer fatigue and liver fatigue, noting that if we do not study the liver better, an important concept in the rehabilitation world, we are not going to conquer this problem. She made a distinction between pathological and non-pathological (normal) fatigue and how to treat these conditions. She also discussed peripheral and central fatigue. There is confusion in the domain culture about these kinds of fatigue and an effort is underway to identify a biosignature that gives a mix of objective measures linked to perception. A portion of the tryptophan pathway is critical for understanding fatigue, both peripheral and central.

Dr. Naomi Gerber, Part 1

Charla Fischer

Dr. Charla Fischer one of New York City’s top minimally invasive spine surgeons. She specializes in lumbar disc herniations, lumbar spinal stenosis, lumbar degenerative disc disease, instability, and cervical spine degeneration. She is also an expert in advanced minimally invasive spine surgery techniques such as minimally invasive microdiscetomy, MIS lumbar fusions, robotic-assisted spine surgery, and advanced MIS techniques. Dr. Fischer completed her residency at Columbia after completing both medical school and undergraduate school on a full academic scholarship at University of Southern California. She spent a year specializing in spine surgery at NYU-Hospital for Joint Diseases. As an associate professor of spine surgery at NYU Langone Medical Center, Dr. Fischer regularly teaches residents and medical students in the areas of compassionate patient care and minimally invasive spine surgery. She has received grants from the National Institutes of Health (NIH) and the Orthopedic Research and Education Foundation (OREF). The funding helps her pursuits in the advancement of minimally invasive surgical techniques, and quality of life improvements after spine surgery. She routinely publishes in the top peer-reviewed journals and presents her findings at internationally attended academic meetings. She serves on the SRS Research Committee and is an Associate Editor for the prestigious Journal of Bone and Joint Surgery.

Dr. Charla Fischer one of New York City’s top minimally invasive spine surgeons. She specializes in lumbar disc herniations, lumbar spinal stenosis, lumbar degenerative disc disease, instability, and cervical spine degeneration. She is also an expert in advanced minimally invasive spine surgery techniques such as minimally invasive microdiscetomy, MIS lumbar fusions, robotic-assisted spine surgery, and advanced MIS techniques. Dr. Fischer completed her residency at Columbia after completing both medical school and undergraduate school on a full academic scholarship at University of Southern California. She spent a year specializing in spine surgery at NYU-Hospital for Joint Diseases. As an associate professor of spine surgery at NYU Langone Medical Center, Dr. Fischer regularly teaches residents and medical students in the areas of compassionate patient care and minimally invasive spine surgery. She has received grants from the National Institutes of Health (NIH) and the Orthopedic Research and Education Foundation (OREF). The funding helps her pursuits in the advancement of minimally invasive surgical techniques, and quality of life improvements after spine surgery. She routinely publishes in the top peer-reviewed journals and presents her findings at internationally attended academic meetings. She serves on the SRS Research Committee and is an Associate Editor for the prestigious Journal of Bone and Joint Surgery.

Dr. Charla Fischer: Orthopedic Leader, Part 1

The best podcast episodes about true crime. For any thrill seeking podcast listeners who just can't get enough of the captivating stories of murderers and criminals. This topic has all the best episodes from many different true crime podcasts.  Add episodes you're interested into your queue below!

Best True Crime Podcasts

The best podcast episodes of anyone with an interesting story. With famous guests like Obama, LeBron James, Drake, Oprah Winfrey, Richard Branson, Michelle Obama, Serena Williams, to anyone who has a unique and interesting story to tell. Add episodes you're interested into your queue below!