Podcasts about rusk rehabilitation

Avery Menaker is a senior occupational therapist at NYU Rusk Rehabilitation. She is certified as both a stroke rehabilitation specialist and a brain injury specialist. She co-leads an initiative at NYU to bring high intensity practice to patients participating in occupational therapy. Faye Bronstein is the inpatient rehabilitation clinical specialist at Rusk Rehabilitation. She is board certified in neurology, geriatrics, and physical therapy, and has led initiatives to bring high intensity training practice into the NYU inpatient setting over the past three years. The following topics were among those discussed in the interview: how high intensity training differs from traditional therapy approaches and what its benefits are; kinds of patients for whom high intensity training is appropriate; research to support high intensity training; equipment needed for this intervention; what a typical high intensity treatment session looks like in physical therapy and occupational therapy; implementation challenges; whether high intensity training is done in every therapy clinic and if all therapists know about it; and contents of an NYU continuing education course on high intensity training that will be offered on May 17-18, 2025.      

Catherine Parkin serves as Clinical Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman School of Medicine, She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years.  Her Master's Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York.  Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health.  Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists.  She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases.  She has been a licensed occupational therapist for over 30 years receiving her Bachelor's degree from the University of Rosario in Bogata Colombia, and her Advance Master's degree from NYU University.  Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field.  The discussion covered the following topics: influence of artificial intelligence, and research endeavors pertaining to occupational therapy, physical therapy, and speech-language pathology.

Catherine Parkin serves as Clinical Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman School of Medicine, She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years.  Her Master's Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York.  Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health.  Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists.  She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases.  She has been a licensed occupational therapist for over 30 years receiving her Bachelor's degree from the University of Rosario in Bogata Colombia, and her Advance Master's degree from NYU University.  Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion covered the following topics: involvement of informal caregivers in treatment, staying on top of new developments, use of assistive technology, provision of care via telehealth, and impact of Long Covid on patient care.

Catherine Parkin serves as Clinical Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman School of Medicine, She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years.  Her Master's Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York.  Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health.  Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists.  She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases.  She has been a licensed occupational therapist for over 30 years receiving her Bachelor's degree from the University of Rosario in Bogata Colombia, and her Advance Master's degree from NYU University.  Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion in Part Two covered the following topics: types of patients treated, impact of health care disparities, and patient cooperation in health care interventions by providers.

Catherine Parkin serves as Clinical Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman School of Medicine, She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years.  Her Master's Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York.  Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health.  Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists.  She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases.  She has been a licensed occupational therapist for over 30 years receiving her Bachelor's degree from the University of Rosario in Bogata Colombia, and her Advance Master's degree from NYU University.  Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion covered the following topics in Part One: a description of each of the three professions, educational requirements to become practitioners, and recruitment and retention of clinicians. 

Dr. Heidi Fusco is an assistant professor of Rehabilitation Medicine at NYU LANGONE Health and the Rusk Rehabilitation hospital. She is the Assistant Director of the Traumatic Brain Injury Program at Rusk and the Medical Director of the Brain Injury Unit at Queens Nassau Nursing and Rehabilitation. She completed a fellowship in Brain injury Rehab in 2013 at the Rusk Institute and is board certified in Brain Injury medicine and Physical Medicine and Rehabilitation. Alaina B. Hammond is a board certified rehabilitation psychologist and currently serves as Clinical Assistant Professor and Staff Psychologist in the NYU Langone Rusk Adult Inpatient - Brain Injury Rehabilitation Program.  She provides psychological and neuropsychological intervention and assessment to patients and families with acquired brain injury, stroke, spinal cord injury and other illness/injuries. In addition, she supervises psychology interns and enjoys researching family/caregiver adjustment to medical illness.  Dr. Jessica Rivetz is the current Brain Injury Medicine Fellow at NYU Rusk Rehabilitation. She recently completed her residency in physical medicine and rehabilitation at NYU Rusk. She received her MD degree at Albany Medical College, and also has a Master's of Science in health care management. Extracurricular activities include serving as co-chairperson of the NYU GME House Staff Patient Safety Council. Within brain injury medicine, she has a special interest managing patients with moderate to severe traumatic brain injury and helping them and their caregivers navigate life after brain injury and achieve their functional and quality of life goals. Part 3 The discussion covered the following topics: phases of treatment when mindfulness and self-compassion can be introduced to achieve optimal effectiveness; the role of telehealth; extent to which a group-based approach is used; availability of commercialized digital resources on the Internet, such as apps; use of wearable devices by patients; and the impact of artificial intelligence on patient care.  

Dr. Heidi Fusco is an assistant professor of Rehabilitation Medicine at NYU LANGONE Health and the Rusk Rehabilitation hospital. She is the Assistant Director of the Traumatic Brain Injury Program at Rusk and the Medical Director of the Brain Injury Unit at Queens Nassau Nursing and Rehabilitation. She completed a fellowship in Brain injury Rehab in 2013 at the Rusk Institute and is board certified in Brain Injury medicine and Physical Medicine and Rehabilitation. Alaina B. Hammond is a board certified rehabilitation psychologist and currently serves as Clinical Assistant Professor and Staff Psychologist in the NYU Langone Rusk Adult Inpatient - Brain Injury Rehabilitation Program.  She provides psychological and neuropsychological intervention and assessment to patients and families with acquired brain injury, stroke, spinal cord injury and other illness/injuries. In addition, she supervises psychology interns and enjoys researching family/caregiver adjustment to medical illness.  Dr. Jessica Rivetz is the current Brain Injury Medicine Fellow at NYU Rusk Rehabilitation. She recently completed her residency in physical medicine and rehabilitation at NYU Rusk. She received her MD degree at Albany Medical College, and also has a Master's of Science in health care management. Extracurricular activities include serving as co-chairperson of the NYU GME House Staff Patient Safety Council. Within brain injury medicine, she has a special interest managing patients with moderate to severe traumatic brain injury and helping them and their caregivers navigate life after brain injury and achieve their functional and quality of life goals. Part 2 The discussion covered the following topics: persistence of sleep disorders and the role of physical exercise in treating them; definition of mindfulness; kinds of interventions included under the heading of mindfulness; examples of how it aims to address the severity of various TBI-related health problems; duration of mindfulness treatment; and self-compassion as another type of non-pharmacological intervention.

Dr. Heidi Fusco is an assistant professor of Rehabilitation Medicine at NYU LANGONE Health and the Rusk Rehabilitation hospital. She is the Assistant Director of the Traumatic Brain Injury Program at Rusk and the Medical Director of the Brain Injury Unit at Queens Nassau Nursing and Rehabilitation. She completed a fellowship in Brain injury Rehab in 2013 at the Rusk Institute and is board certified in Brain Injury medicine and Physical Medicine and Rehabilitation. Alaina B. Hammond is a board certified rehabilitation psychologist and currently serves as Clinical Assistant Professor and Staff Psychologist in the NYU Langone Rusk Adult Inpatient - Brain Injury Rehabilitation Program.  She provides psychological and neuropsychological intervention and assessment to patients and families with acquired brain injury, stroke, spinal cord injury and other illness/injuries. In addition, she supervises psychology interns and enjoys researching family/caregiver adjustment to medical illness.  Dr. Jessica Rivetz is the current Brain Injury Medicine Fellow at NYU Rusk Rehabilitation. She recently completed her residency in physical medicine and rehabilitation at NYU Rusk. She received her MD degree at Albany Medical College, and also has a Master's of Science in health care management. Extracurricular activities include serving as co-chairperson of the NYU GME House Staff Patient Safety Council. Within brain injury medicine, she has a special interest managing patients with moderate to severe traumatic brain injury and helping them and their caregivers navigate life after brain injury and achieve their functional and quality of life goals. Part 1 The discussion covered the following topics: concussions and TBIs; pediatric care; use of biomarkers; common causes of a TBI; common symptoms and their length of duration; involvement of informal caregivers; and occurrence of sleep disorders.

This week, Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT connect with Joanna Wolfson, PhD, ABPP about what people living with dizziness may experience on a day to day basis, and what can be done about it from a psychological point of treatment. Joanna Wolfson, PhD, ABPP is a board-certified senior psychologist on the Adult Outpatient service at Rusk Rehabilitation, NYU Langone Health and Clinical Assistant Professor of Rehabilitation Medicine at the NYU Grossman School of Medicine. She holds a doctorate in Clinical Psychology from Fairleigh Dickinson University, completed her internship at NYU Rusk, and her postdoctoral fellowship at the Manhattan VA in Health Psychology and Primary Care. She is board certified in clinical health psychology. Dr. Wolfson provides individual and group psychotherapy to patients with a wide range of medical presentations, including vestibular conditions. She co-leads a vestibular stress management group, which has been running for the past 8 years. She also supervises interns in the field of health psychology and presents on topics including integrated healthcare, motivational interviewing, and health anxiety.   Dr. Wolfson can be reached at: Joannawolfsonphd@gmail.com Episode Resources: https://www.psychologytoday.com/intl/blog/psychological-trauma-coping-and-resilience/202302/communicating-and-feeling-understood-long   https://www.psychologytoday.com/us/blog/psychological-trauma-coping-and-resilience/202102/why-am-i-so-tired Gordon, R. M., Dahan, J. F., Wolfson, J. B., Fults, E., Lee, Y. S. C., Smith-Wexler, L., Liberta, T. A., & McGiffin, J. N. (2020). Existential–humanistic and relational psychotherapy during COVID-19 with patients with preexisting medical conditions. Journal of Humanistic Psychology, 002216782097389. https://journals.sagepub.com/doi/10.1177/0022167820973890 Hosted by Dr. Abbie Ross, PT, NCS, and Dr. Danielle Tolman, PT For Episode Recommendations or Requests, email us info@balancingactrehab.com Where to find us: ⁠⁠⁠⁠https://link.me/balancingactrehab⁠⁠⁠⁠ ⁠⁠⁠⁠www.BalancingActRehab.com⁠⁠⁠⁠ ⁠⁠⁠Facebook: @BalancingActRehab Instagram: @BalancingActRehab Twitter: @DizzyDoctors TikTok: @BalancingActRehab Check out our self guided self help courses! How to Live with Dizziness How to Treat Positional Dizziness https://balancing-act-rehab-s-school.teachable.com/courses/

Host Maureen Clancy PT, DPT, OCS is joined by Joanna Wolfson PhD, ABPP and Emily Kostelnik PhD in a discussion on the integration of psychological care for patients with vestibular disorders. Dr. Kostelnik is a Clinical Health Psychologist who focuses on behavioral health education for the vestibular community through her company Rooted Behavioral Education and provides licensed consultation and therapy through her private practice, The Vestibular Psychologist. Dr. Wolfson is a senior psychologist at Rusk Rehabilitation, NYU Langone Health and Clinical Assistant Professor of Rehabilitation Medicine at NYU Grossman School of Medicine. She is board certified in Clinical Health Psychology and provides individual and group psychotherapy to patients with vestibular and medical conditions.

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.  

Enjoy the recording of New York University/Rusk Rehabilitation presentation from the 2022 PM&R Scholars Virtual Residency Fair! Check out more information about PM&R Scholars and the Virtual Residency Fair at pmrscholars.org! Check out our 2022 sponsors: PMRrecap.com and ultrasoundguidance.com

In Part 1, we discussed the incidence and prevalence of MS in the United States; whether MS is on the rise, holding steady, or in decline; kinds of symptoms that occur either singly or in combination and their impact on patients from the perspective of psychology; roles that stress and mood disturbances play in influencing various MS symptoms; how perception of illness perception by patients has an impact on psychological distress; other kinds of therapeutic interventions to treat symptoms; cultivation of resilience among patients; and helping patients to become adept as self-managers of MS. In Part 2, we discussed the use of cannabis for medicinal purposes among patients with MS; non-adherence to prescribed treatment plans; the extent to which lockdown policies have disrupted normal lifestyle and the ability to access health services; use of telemedicine with patients and how it compares in effectiveness with face-to-face interactions; and key insights observed as a result of working with  patients.  Felicia Connor is the Director of Internship and Training for an APA approved internship program at NYU Langone Health, Rusk Rehabilitation. She is Board Certified in Rehabilitation Psychology and is a licensed clinical psychologist in Delaware and New York. For the last decade, she has specialized in rehabilitation of individuals with medical and neurological conditions with Traumatic Brain Injury, concussion, stroke and multiple sclerosis. She administers neuropsychological assessment and provides cognitive remediation and individual and group psychotherapy for individuals who are adjusting to their medical conditions.  Barbara Cicero is the Program Manager of the Adult Outpatient Psychology Service at NYU Langone Health, Rusk Rehabilitation. She received her Ph.D. from the Graduate Center of CUNY and completed a post-doctoral fellowship in Rehabilitation Psychology at Mount Sinai Medical Center. In addition to her administrative responsibilities, she conducts neuropsychological evaluations and provides individual and group treatment to individuals with a variety of medical and neurological conditions. Her clinical interests include the assessment and treatment of individuals with traumatic brain injury and multiple sclerosis. 

In Part 1, we discussed the incidence and prevalence of MS in the United States; whether MS is on the rise, holding steady, or in decline; kinds of symptoms that occur either singly or in combination and their impact on patients from the perspective of psychology; roles that stress and mood disturbances play in influencing various MS symptoms; how perception of illness perception by patients has an impact on psychological distress; other kinds of therapeutic interventions to treat symptoms; cultivation of resilience among patients; and helping patients to become adept as self-managers of MS. Felicia Connor is the Director of Internship and Training for an APA approved internship program at NYU Langone Health, Rusk Rehabilitation. She is Board Certified in Rehabilitation Psychology and is a licensed clinical psychologist in Delaware and New York. For the last decade, she has specialized in rehabilitation of individuals with medical and neurological conditions with Traumatic Brain Injury, concussion, stroke and multiple sclerosis. She administers neuropsychological assessment and provides cognitive remediation and individual and group psychotherapy for individuals who are adjusting to their medical conditions. Barbara Cicero is the Program Manager of the Adult Outpatient Psychology Service at NYU Langone Health, Rusk Rehabilitation. She received her Ph.D. from the Graduate Center of CUNY and completed a post-doctoral fellowship in Rehabilitation Psychology at Mount Sinai Medical Center. In addition to her administrative responsibilities, she conducts neuropsychological evaluations and provides individual and group treatment to individuals with a variety of medical and neurological conditions. Her clinical interests include the assessment and treatment of individuals with traumatic brain injury and multiple sclerosis. 

John-Ross (JR) Rizzo, MD is a physician scientist at Rusk Rehabilitation. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury. Dr. Rizzo has been recognized as a Top 40 under 40 by Crain's for his industry-leading innovation and dedication to transforming the lives of those with vision deficiencies worldwide.  Dr. Rizzo began Part 1 of a two-part grand rounds presentation by asking, “What if the lights suddenly went out in this room?” He then proceeded to discuss virtual reality demonstrations of the three biggest vision killers in the U.S.: age-related macular degeneration, glaucoma, and diabetic retinopathy. He showed a filter and asked the audience how disturbing it would be if you had it constantly sitting on top of your visual perception?  He displayed views to demonstrate profound differences between clear visual perception and altered perception secondary to these conditions. The problem is going from bad to worse. In the U.S., there are 27 million adults ages 18 and older who report vision loss, and by 2050, the number can be expected to approach 52 million. Impaired vision can affect mobility and lead to many problems, such as massive unemployment rates, quality of life losses, and functional dependencies. He then described current mobility solutions, such as primary mobility tools. A worry is that the standard of care can lead to an immobility downward spiral. So as a consequence, obesity, stroke, and diabetes among other problems such as falls all jump upward. He provided a description of many devices being developed to deal with vision loss. The differences between the spatial world of the blind and the sighted were illustrated. Dr. Rizzo described a lengthy itemization of impediments to navigation on city sidewalks that visually impaired individuals must attempt to deal with successfully.

Dr. Antonio Stecco is an Assistant Professor at Rusk Rehabilitation, New York University. A physiatrist, he has been President of the Fascial Manipulation Association since 2010, Assistant to the President of the International Society of Physical Medicine and Rehabilitation from 2012 to 2014, and President of the International Myopain Society since 2020. His scientific activity is devoted to the study of the human fasciae from a macroscopically, histologically and patho-physiologically point of view. He personally made over 100 cadaver dissections for research. From 2007, he organized and personally held theoretical-practical courses about the Fascial Manipulation method in all five continents. The author of more than 50 in extensor papers about the fascia, Dr. Stecco has co-authored 5 books and is co-author of different chapters of international books. His medical degree and PhD degree are from the University of Padova in Italy. In Part 1, we discussed: what attracted him to accept a position at NYU Langone Health; whether the COVID resurgence affected his ability to do research and furnish care for patients; results of his research on a comparison between traditional rehabilitation treatment and fascial manipulation of chronic neck pain; the results of a study he conducted on the role played by fasciae in ankle injuries sustained by basketball players; differences between males and females in the kind of injuries they sustain to their ankles and other body parts playing basketball; his training of major league baseball players in using fascial manipulation to decrease injury and improve performance; how to decrease injury among soccer players; and how fascial or muscle stretching exercises are an integral part of rehabilitation and athletics.  In Part 2, we discussed: why determining the underlying cause of elbow pain can prove to be difficult; what new developments have occurred since he co-authored an article on the topic of treatment options for fascial disorders; apart from treatment modalities he described, how other interventions such as surgery, medications, and physical therapy are applied; patients' use of complementary, alternative, and integrative forms of treatment; his use of telemedicine in the treatment of patients; the time lag between when medical innovations occur and their widespread adoption; and current studies in which he is involved or expects to undertake with his NYU colleagues  

Dr. Antonio Stecco is an Assistant Professor at Rusk Rehabilitation, New York University. A physiatrist, he has been President of the Fascial Manipulation Association since 2010, Assistant to the President of the International Society of Physical Medicine and Rehabilitation from 2012 to 2014, and President of the International Myopain Society since 2020. His scientific activity is devoted to the study of the human fasciae from a macroscopically, histologically and patho-physiologically point of view. He personally made over 100 cadaver dissections for research. From 2007, he organized and personally held theoretical-practical courses about the Fascial Manipulation method in all five continents. The author of more than 50 in extensor papers about the fascia, Dr. Stecco has co-authored 5 books and is co-author of different chapters of international books. His medical degree and PhD degree are from the University of Padova in Italy. In Part 1, we discussed: what attracted him to accept a position at NYU Langone Health; whether the COVID resurgence affected his ability to do research and furnish care for patients; results of his research on a comparison between traditional rehabilitation treatment and fascial manipulation of chronic neck pain; the results of a study he conducted on the role played by fasciae in ankle injuries sustained by basketball players; differences between males and females in the kind of injuries they sustain to their ankles and other body parts playing basketball; his training of major league baseball players in using fascial manipulation to decrease injury and improve performance; how to decrease injury among soccer players; and how fascial or muscle stretching exercises are an integral part of rehabilitation and athletics.    

The following is a presentation from the PM&R Scholars Virtual Residency Fair from NYU/Rusk Rehabilitation. Check out their presentation to help guide your decisions for the residency application cycle. This year's PM&R scholar Virtual Residency Fair is supported by PM&R Recap - the best resource for your Physiatry clinical preparation, audition rotations, board preparation and beyond! PM&R Recap offers 35 hours of review videos, hundreds of review questions and oral boards cases! Head to pmrrecap.com to learn more!

This is a special two-part Grand Rounds series with Dr. Steven Flanagan, Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation.  In Part 1 of his presentation, Dr. Flanagan discusses the contributions of Dr. Howard Rusk, the father of rehabilitation medicine. He brought it to the forefront as a recognized specialty by showing that rehabilitation contributed to improving the lives of patients with disabilities. Dr. Flanagan referred to various efforts over the decades to manage health care costs through managed care and other means. Even today when it is evident that a inpatient care is necessary, barriers can offer resistance because of the costs involved. What makes the case of inpatient care more challenging is the need to have more data to justify the decision to provide care at that level. He predicts that cost containment will continue well into the future. Our aims are to improve health care outcomes and increase efficiency. He concluded Part 1 of his presentation by stating that PM&R has a critical role to play in attaining the Triple Aim. In Part 2 of his presentation, Dr. Flanagan discusses challenges involved in justifying the need for the provision of inpatient rehabilitation care in the context of controlling expenditures and the critical role that physical medicine and rehabilitation play in attaining the Triple Aim. We know that the intensity of some of our rehabilitation therapies are associated with better outcomes, for example, aphasia therapy. Early mobilization results in better outcomes with cost savings. Nonetheless, we still need more data to show that what we do is important. Mention was made of expansions at Rusk, such as a new division on Technology and Innovation to advance rehabilitation science. Health care is changing and education must change with it.  

Tara Denham, MS founded the renowned Vestibular Physical Therapy Center at Rusk Rehabilitation. She is the Outpatient Physical Therapy Program Manager at the Rusk Rehabilitation Ambulatory Care Center and she talks with Abbie and Danielle about her experience with vestibular rehabilitation. Episode Resources and Links: Insight Infrared Video Goggles (Vestibular First): https://vestibularfirst.com/store/infrared-goggles/ Rusk Vestibular Therapy: https://nyulangone.org/conditions/vertigo/treatments/vestibular-rehabilitation-for-vertigo Information on the Vestibular Competency Course: https://dpt.duhs.duke.edu/education/academics/continuing-education Vestibular Rehabilitation 4th Edition (S. Herdman, R. Clendaniel): https://www.amazon.com/Vestibular-Rehabilitation-Contemporary-Perspectives/dp/0803639708 Follow the link to submit topic or guest requests: https://forms.gle/81vh89WKCX2kx6zg7l Hosted by Dr. Abbie Ross, PT, NCS and Dr. Danielle Tate, PT Where to find us: www.Vestibular.Today www.BalancingActRehab.com Facebook: @VestibularToday / @BalancingActRehab Instagram: @ Vestibular.Today / @BalancingActRehab Twitter: @VestibularToday / @BalActRehab

This is a special two-part Grand Rounds series with Dr. Steven Flanagan, Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation.  In Part 1 of his presentation, Dr. Flanagan discusses the contributions of Dr. Howard Rusk, the father of rehabilitation medicine. He brought it to the forefront as a recognized specialty by showing that rehabilitation contributed to improving the lives of patients with disabilities. Dr. Flanagan referred to various efforts over the decades to manage health care costs through managed care and other means. Even today when it is evident that a inpatient care is necessary, barriers can offer resistance because of the costs involved. What makes the case of inpatient care more challenging is the need to have more data to justify the decision to provide care at that level. He predicts that cost containment will continue well into the future. Our aims are to improve health care outcomes and increase efficiency. He concluded Part 1 of his presentation by stating that PM&R has a critical role to play in attaining the Triple Aim. In Part 2 of his presentation, Dr. Flanagan discusses challenges involved in justifying the need for the provision of inpatient rehabilitation care in the context of controlling expenditures and the critical role that physical medicine and rehabilitation play in attaining the Triple Aim. We know that the intensity of some of our rehabilitation therapies are associated with better outcomes, for example, aphasia therapy. Early mobilization results in better outcomes with cost savings. Nonetheless, we still need more data to show that what we do is important. Mention was made of expansions at Rusk, such as a new division on Technology and Innovation to advance rehabilitation science. Health care is changing and education must change with it.

In this episode, we discuss courage and humility as essential for leading through a pandemic and beyond in order to save lives and honor your staff. Geoffrey Hall MBA, MSW has more than 20 years' experience in Healthcare Administration and earned his MBA in Management and Operations from Walden University, a Master of Social Work from East Carolina University, and a Bachelor of Social Work from Auburn University. Geoffrey joined the Cleveland Clinic Rehabilitation Hospital system in October, 2016 and currently serves as the Chief Executive Officer for the Cleveland Clinic Rehabilitation Hospital, Edwin Shaw located in Akron, Ohio. Prior to this position, Geoffrey served as the Administrator for the nationally ranked Rusk Rehabilitation as part of the NYU Langone Health system from 2009 – 2016.   Geoffrey Hall MBA, MSW on LinkedIn https://www.linkedin.com/in/geoffrey-hall-1988265a   Music Credit: Jason Shaw from Audionautix.com   THE IMPERFECT SHOW NOTES To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we'd love to offer polished show notes. However, Swift Healthcare is in its first year.  What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it's close enough - even with the errors - to give those who aren't able or inclined to learn from audio interviews a way to participate.  Please enjoy!   [00:00:00] Patrick Swift PhD, MBA, FACHE: [00:00:00] Welcome folks to the Swift healthcare video podcast. [00:00:03] Thank you for joining. I am delighted with our guests that I have for you. I believe this is a very special treat and a dear colleague and friend of mine I've known for, for 10 plus years. And I want to welcome to the show. Geoffrey Hall, Geoffrey. Welcome to the show. [00:00:18] Geoffrey Hall, MBA, MSW: [00:00:18] Thank you very much. [00:00:19] Patrick Swift PhD, MBA, FACHE: [00:00:19] Hey, I'm glad you're here. And folks, let me read you a bio for Jeffrey, and I think you're gonna enjoy this. [00:00:25] Jeffrey Hall has more than 20 years of experience in healthcare administration. Jeffrey obtained an MBA in management and operations from Walden university. A master of social work from East Carolina university and a bachelor of social work from Auburn university to hear the thread of heart in the work that he does. [00:00:42]He joined the Cleveland clinic rehabilitation hospital system in October, 2016, and currently serves as the chief executive officer for the Cleveland clinic rehabilitation hospital, Edwin Shaw, located in Akron, Ohio. Go Ohio prior to this position, Jeffrey served as the administrator for the nationally ranked Rusk rehabilitation as part of the NYU Langone health system from 2009 to 2016. [00:01:07]And, uh, as a dear personal friend of mine, . I have traveled the world with Jeff. We haven't gone to China. We've gone to Qingdao and long Joe in Beijing and, and touch many lives. And. Moved education, health, education, medical education forward, and Jeffrey with all my heart. [00:01:24] Welcome to Swift video podcast. Okay. [00:01:26] Geoffrey Hall, MBA, MSW: [00:01:26] Thank you, Patrick. That was quite the introduction. [00:01:29] Patrick Swift PhD, MBA, FACHE: [00:01:29] Well, there's a lot of love there. Right, right, right, right. [00:01:32] Geoffrey Hall, MBA, MSW: [00:01:32] Absolutely. [00:01:33]Patrick Swift PhD, MBA, FACHE: [00:01:33] So our episode for today, we are looking at leading through COVID and beyond if I had a sound effect, I would. Tied in, right. They're leading through COVID and beyond . Let's talk about this. [00:01:46]Geoffrey Hall, MBA, MSW: [00:01:46] I would start by saying that, , certainly 2020 was probably one of the most interesting and maybe personally the most challenging years as a healthcare executive that I can remember and, I think you have to look back to how this pandemic started in end of February, early parts of March, and just the uncertainty and the, the prevailing sense of, of dread and even fear. [00:02:10] , I remember just the one-on-one conversations with my frontline caregivers, nurses, therapists, doctors, , as well as our, our leadership team. And there's just so much uncertainty and so much unknown as, as COVID really started to kind of spread across the world. And I know here in our Cleveland, , Ohio area, , in the, [00:02:32] partnership with Cleveland clinic. the entire region was just preparing for this massive surge of patients that looked like it was going to, at that time overwhelm the local hospital system, there was not going to be enough beds. There was not going to be enough caregivers. the Cleveland. Clinic itself was, , Decommissioned their state-of-the-art health education building, which is their newest building on their main campus and started to build a thousand bed field hospital. [00:02:58] The convention center here in Akron was being turned into a field hospital and, , my location, , being primarily a rehab location was told, , that we were going to become a surge site and, , You know, that was a change in scope and change of focus and change of service line for us. And, , that decision was communicated to me just after five o'clock on one day. [00:03:20]And I was told I needed to put together an emergency plan over 24 hour period. So, you know, leaving work after what is normally a long day, , went home and worked on this plan, , till at least midnight and, By midnight, we had, I had pulled together almost a 50 page plan of how I was going to change my building, into a COVID hospital. [00:03:43]And, , communicating with my medical director, communicating with my leadership team. and then the next day, , 24 hours passes and I was told to kind of stand down. We're not going to do that. , We're we're, we're not, this is just a model. Let's, let's think this through. And then about three days later, , I got another call back from regional leadership and said, , not only do we need to stand this up, but how fast can you stand this up? [00:04:07]And from that moment, I think the clock started and I had about seven days to alter my building through construction, creating new patient and staff entrances and entire new workflow processes. And how was I going to create a closed and segregated COVID unit that would not mix with my other caregivers and my other rehab patients. [00:04:31], and then that plan had to be scalable depending on the size of the surge. It was a really dynamic time because when we were still as, as a community, learning about COVID and what were the risk factors? And this is before, you know, some of the lockdowns occurred. Some of the mask requirements occurred long before there was a vaccine on the horizon. [00:04:53]so there was a lot of uncertainty and I was very proud of my team because we, we did stand up a COVID unit. , , in that short period of time, we built walls. We've changed workflow processes. , and we went from a place of uncertainty and. [00:05:08] Patrick Swift PhD, MBA, FACHE: [00:05:08] for safety, right? [00:05:09] Geoffrey Hall, MBA, MSW: [00:05:09] Yeah, we built physical walls, , for safety as, as a way to, , you know, really create distinct care areas. [00:05:16], and of course, PPE and, you know, moving everybody into and 95 masks and all of the, the requirements that we've all heard about. So we did that in just over seven days. And then we started to admit, , COVID positive patients. , and we were one of the first rehab hospitals, , within our company. [00:05:36]certainly our region that started to admit COVID patients and COVID recovery patients. And that really, , Changed our model and it kind of brought back this crystal focus on total care of the patient. And one of the unique things that we did, and I actually took away as a, as a best practice, if you will, is we aligned our nursing and therapy schedules to two identical 12 hour shifts and we made. [00:06:03]Patient assignments as a team. And what was really unique in that is you had nurses, helping patients, , do their physical therapy exercises and get stronger. And you had speech therapist helping with bedside commodes and, you know, the toileting needs of patients. And it was less about your discipline and more focus on what does this patient need to get better and get stronger. [00:06:28] And as a result, , the outcomes of this unit was so impressive. We had zero acute or emergent send-outs. We had zero patient falls. We had a hundred percent of our patients discharged home. , the gold standard for most rehab hospitals is about three hours of therapy per day, , which is pretty intensive. [00:06:50] And in the early weeks of this unit, some of our patients, because. , they turned that corner with COVID and suddenly started to rapidly improve after these long hospitalizations, they were getting four or five hours of therapy a day because the team, again, around, around this total care, , was just really focused on creating great patient outcomes. [00:07:10]And, you know, there were so many unique heartfelt moments around this because my staff went from a place of fear and. We don't know anything about this. We're, we're scared, you know, how are we going to be protected and how we're going to be safe? And that unit was formed with a hundred percent volunteers, nurses, therapists, housekeepers, , case managers, everybody that went on that unit volunteered for that duty. [00:07:34] Um, and we're really at the tip of the yeah. [00:07:37] Patrick Swift PhD, MBA, FACHE: [00:07:37] I'm sorry if I may ask, how did you do that? I mean, there's some, there's, there's so much you shared right there. The, the, the preparation that then led to patients and that led to saving lives by building what you built, and then you, you use the word volunteers, that you gave folks the opportunity to serve on these units. [00:07:54]So. How did you do that? [00:07:57] Geoffrey Hall, MBA, MSW: [00:07:57] Yeah. [00:07:57] Patrick Swift PhD, MBA, FACHE: [00:07:57] saying folks who's, who's willing to volunteer? What was that like for you? W where there's so much media coverage, , and putting on pedestals healthcare providers is. Heroes. And there's actually been some backlash on that saying we're we're, we're, we're not wearing capes. [00:08:12] We're, we're real people and we're suffering and struggling too. And we're self-sacrificing so it's not just a BS invitation. There is, there is the, the depth of that offer to serve. And self-sacrifice. So how did you as a CEO lead the team and lead folks to contemplate, to serve on a unit like that? [00:08:29]Geoffrey Hall, MBA, MSW: [00:08:29] So there's a, I'll give you a little bit of a funny story to that. And then I'll, I'll give you a more serious answer. So as I'm doing this, , emergency preparation over the seven day period, our local newspaper in the Akron area ran a story. Uh, listing all of the hospitals that were preparing for this search, and this was not yet public information. [00:08:51], so I'm walking into the building, I think six 30 in the morning. And one of my night shift nurse AIDS who's ending her 12 hour overnight shift is walking out into the parking lot and stops me and says, Oh, I saw in the paper that, , our hospital is becoming a COVID hospital. And that is not how I wanted that information to roll out [00:09:14] Patrick Swift PhD, MBA, FACHE: [00:09:14] how you want your photo roll out, [00:09:17] Geoffrey Hall, MBA, MSW: [00:09:17] no, and, um, [00:09:18] Patrick Swift PhD, MBA, FACHE: [00:09:18] although it's great. You've got to engage an employee. Number one, the employees reading the headlines and, and she sees the CEO. And instead of not talking, she walks up to you and shares with you. The so kudos on that , you know, we can control everything right. [00:09:32]Geoffrey Hall, MBA, MSW: [00:09:32] It rolls out. So I walked into the building, I'm shaking my head and then call the, an emergency management team meeting, um, assembled , our medical director and medical staff. And then, , over the course of the next two hours, I walked them through this, this plan that I had put together in 24 hours. [00:09:51] But more importantly than that, , When you're dealing with something that is moving as fast as COVID and creating as much change as COVID, , I'm going to give the simple answer of you have to go beyond an email. Like you can't just send out a memo. You can't just send out an email when you're talking about people with questions and fear, and then they start personalizing this to their family, and then the reasons why they would or would not volunteer for a unit assignment like this, You can't overstate the importance of that one-to-one conversation. [00:10:21] And what we did was really powerful as my, medical staff combined with my nonclinical areas. So housekeeping, dietary office staff, , they didn't have their clinical knowledge to draw on. So we did in-services and every single day we do what we call what's. walking rounds where we're engaging our caregivers, we're asking them questions, but most importantly, we're taking that as a chance to listen, what are your concerns? [00:10:49]And then after we listen, that's when we give support. And then after we give support, that's when we give education. So it's kind of the old saying of no one cares how much, you know, until they know how much you care. So I think these walking rounds where the formula for that, I think they. Reinforced to our caregivers who were being asked to do very difficult things, things that they had never done in healthcare before. [00:11:13]first we're, we're going to listen to you so you can, you know, Push back on us and then we're gonna support you. And we're gonna reinforce that we really care about your safety and our patient's safety, and that we have the expertise to do this, and then we're gonna educate you about the right way to wear PPE and the buddy system to make sure we're wearing it appropriately. [00:11:32]You know, the, those, [00:11:34] Patrick Swift PhD, MBA, FACHE: [00:11:34] Tell us more about that [00:11:36] Geoffrey Hall, MBA, MSW: [00:11:36] yeah. So, you know, . It is pure accountability that, , they're watching your back. You're watching their back because when you're having to put on and 95 mask, eye protection, gowns gloves, and you're caring for a highly infectious patient. the PPE is proven through science that it's going to keep you safe. [00:11:55] We've been using it in healthcare for over a hundred years. That's why we wear gloves. That's why we wash our hands. But. When you're having to do this for every single patient that you're caring for having somebody to make sure that you've, you've tied your gown and it's snug, and that you've, , you're removing your gloves the right way. [00:12:14] So using the buddy system and empowering our staff to be responsible for safety, , and connecting it back to, you know, that purpose. And I think. We're lucky in healthcare that most people come into healthcare because they want to help others. , but now you have to take it to a different level and COVID it really just reinforced because it was changing so fast in those early months, we would set out a protocol in the morning and by four o'clock in the afternoon, it had changed. [00:12:45] And the confluence of, of so many different voices, both at a. National and federal level and then a local and regional level. it was things were changing so fast. I've never seen anything in my 20 years of healthcare where, you know, information had to be validated, implemented, and. Rapid cycle kickstart and to action, so quickly and every single day it was doing this. [00:13:14] So we, we ended up starting, , where we have normal morning meetings. We were having huddles at first, started the day, mid day, end of day. And we were doing these check-in calls. Just so we could rapidly get the information out. but then you had to follow it up with those walking rounds and those one-to-one conversations. [00:13:34] So, , you'll hear this a lot in my responses, but it's, it's focusing not only on the task, but it's really focusing on the people behind the task. , you know, I think, I think as leaders, we sometimes need to be reminded that we manage things. We lead people. [00:13:51]Patrick Swift PhD, MBA, FACHE: [00:13:51] I was going to ask you, how did you change your leadership style in multiple directions? Both from regional pressure. Or direction you receive from your senior leadership as well as how you supported others. And that, that dovetails right into that, that topic of how you shifted your style. And I love your point it's it's worth you saying that again. [00:14:13] I love that [00:14:14] Geoffrey Hall, MBA, MSW: [00:14:14] Yeah. No. So I think as leaders, we need to be reminded that we manage things, but we lead people. And, you know, as we went through this, , my, I watched my own leadership style change quite a bit because, , I had to one, , consider my audience, , , of how I was writing and communicating and my verbal communications. [00:14:38] And then going back to check, did you receive what I intended to say versus what you perceived? I said, and having the trust and the accountability and making myself really vulnerable. [00:14:50] Patrick Swift PhD, MBA, FACHE: [00:14:50] Ooh, I want to talk about vulnerable pleasing. Let's let's include that in highlighter, vulnerability as leaders, how you manage that. [00:14:57]Geoffrey Hall, MBA, MSW: [00:14:57] , I think, um, I think being an effective leader and today's world, you have to be able to be in touch with your emotions. [00:15:08] And I'm going to actually say that you should be comfortable using your emotions, not losing your emotions. So no one wants to have the leader or boss that loses their temper and just like flies off the handle. And I say that and I mean that, but at the same time, , our patient's safety really matters. [00:15:26] And if you got one person that's refusing to wear a mask or, , not washing their hands or not taking some of these precautions safely, it's okay to be disappointed. And to really connect it back to not just, this is a task that I'm expecting you to do, but here's the why behind it. And, , I think it's okay to be passionate about being the best and having the highest quality. [00:15:54] I think it's okay to, want your patients to get better, not worse while they're in your care. I think it's. Okay to say I'm scared and I'm tired and I'm exhausted because when COVID started, I worked three months in a row without a day off. , and to say I'm really, you know, exhausted. and I'm, I'm, I want to step back, but for me to step back, I need you to step up. [00:16:16]And I had some of those conversations with my leadership team, because we were. , convening these leadership huddles seven days a week to make sure we were on top of this. And you have to also pay attention . So when they start to get tired and they start to, you know, feel and express themes around being burned out and being exhausted or being scared, you need to give people permission. [00:16:41] To cycle down and or say, I really need help. I'm exhausted. I'm going to take Saturday off. If you can help me cover this activity. , it all goes back to communication and how we support each other. and that's one of the things that I was really proud of personally, but also I just saw countless examples of how do we care for each other and. [00:17:04] , using that emotion and passion and to create that connectivity. and just really having honest conversations, which means not just telling everybody you're doing a great job and that's important to say, but it's having the courage to say. We need to improve in this area and it's not personal. [00:17:24] It's not, you need to improve. We need to improve. and we're in this together and here's what we really need to focus on right now. If we're gonna create these great outcomes and get our patients home, more importantly, how are we going to keep our staff safe and how are they going to be able to keep their families safe? [00:17:42] So, , I, I don't know that there's a start and end to that, but this past year, There's so much more reflection on vulnerability and being authentic with people and using that authenticity to give real support, not just kind of, uh, , easy conversations. and the challenge with that, and it's really impacted our leadership style is COVID has kind of taken away all of those. [00:18:08] Social norms of eating together and celebrating together and , how do we come together? Like even now our hospital meetings are all virtual zoom based. So even the ability to be in the same room and have conversations. So we've had to kind of shift to a more virtual world and more socially distance world [00:18:30] yeah. [00:18:30] Patrick Swift PhD, MBA, FACHE: [00:18:30] you all on that, uh, how you're, how you're driving cultural engagement, , and those quality conversations in light of what you just said, that there is such disconnection at the same time as to need for us to be connected. [00:18:41]Geoffrey Hall, MBA, MSW: [00:18:41] no, I don't know that I have, , the complete formula figured out, but I think just as you would do in a regular meeting where you all come into a larger space or a conference room, when you're on a zoom call with. 10 plus people, you still have to make time for that. Pre-meeting post-meeting smalltalk, like really checking in with people. [00:19:02]And that's something that I've started to do is I run meetings via zoom quite regularly. Now is at the beginning and end of the meeting, I'm going to ask a more thought provoking, more personalized question. And I'm going to give people some time to kind of respond. And then we interact with each other off of that, because you can get so focused on this is what we're talking about in this meeting, that those small interactions that validate us as human beings and connectivity and purpose. [00:19:31] We miss that though, those water cooler conversations, those coffee pot conversations, the everybody kind of. Sidebar chatting before the meeting starts [00:19:41]Patrick Swift PhD, MBA, FACHE: [00:19:41] I want to. Jump in on that one, because you remind me of one of our heroes and someone you and I both Revere, which is Steve Flannigan, Dr. Steve Flannigan, Steven Flannigan. And in a, in a meeting this was years ago. I mean, I had hair and, um, we were at NYU. We were in a big room with a lot of folks and Dr. [00:20:01] Flannigan was speaking to the audience, the group, and he. At the end of the end of the staffing, he asked what questions do people had any explicitly sad. I'm going to count to myself to give you time. So think about what you want to ask, any, any, any was jokingly, but like one, two, it wasn't like, yeah, there we go. [00:20:25] He count to eight. Like he'd let people know, not from like, we get to eight and I'm out of here, but I really want to give you time to answer. Or, and you just touched on zoom calls where you're asking a thoughtful question and that's demonstrating the heart of leadership. That is the, the lion heart of leadership where you're not afraid of what. [00:20:45] Someone's going to say there's co-writes there's courage there. There's heart. So I appreciate your bringing up pausing and thanks for reminding me about Dr. Flanagan and his example to us [00:20:54]Geoffrey Hall, MBA, MSW: [00:20:54] Now I learned so much from, from Dr. Flanagan. And I remember those pauses at the end of meetings, because whether people had something on their mind that they were ready to talk about or , they just needed that space. Um, And people want to fill that space. So you've got to build in and [00:21:14] Patrick Swift PhD, MBA, FACHE: [00:21:14] space, right? [00:21:15] Geoffrey Hall, MBA, MSW: [00:21:15] you've got to build in some time with your virtual meetings to let people be people. [00:21:19] And I reminded of that every single day. The other thing I love about Dr. Flanagan's and she brought him up and I think it's a good reflection as a leader. Is finding ways to say yes and he just embodied that so much. And I try to bring that into my own style because it's easy for us to just say no of why something can't happen, but you start to open up all these possibilities when you start to think or give yourself permission to think or others to think what if we said yes. [00:21:49] And I think that really created a lot of success, even with this COVID unit, , not finding wise. We can't because we're a rehab hospital and we don't do COVID, but instead [00:22:00] Patrick Swift PhD, MBA, FACHE: [00:22:00] do things around here. Right? The perspective, how can I say yes. [00:22:04] Geoffrey Hall, MBA, MSW: [00:22:04] yes. And then if we're going to say yes, how do we do it well [00:22:08] Patrick Swift PhD, MBA, FACHE: [00:22:08] Hmm, right? [00:22:09] Geoffrey Hall, MBA, MSW: [00:22:09] or better? [00:22:10] Patrick Swift PhD, MBA, FACHE: [00:22:10] at the right time, at the right reason with the right goal and, and discerning that. Beautiful. [00:22:16] Geoffrey Hall, MBA, MSW: [00:22:16] It's, it's completely empowering. [00:22:18]Patrick Swift PhD, MBA, FACHE: [00:22:18] Hey, let's talk about one of the one concept you and I have touched on is responsibility to and responsibility for you. Threw that out there on another conversation we were having. [00:22:29] And I want to ask you to, to, , unpack more of that because I like the direction that's hinting. It's going, [00:22:35] Geoffrey Hall, MBA, MSW: [00:22:35] Yeah, so I use the, the. Difference between responsibility too and responsibility for, , as I'm training new leadership and new managers, because we sometimes think that. Mistakenly think that we're responsible for the actions and behaviors of other people when intellectually, we all individually know that that person is responsible. [00:22:59]But when we, we have managers and leadership, we feel a certain amount of ownership and you own your quality. You, you own your team, you own the identity and reputation of, of your organization. And you feel like that's a reflection and. You know, I think we have to make that distinction. And if you're responsible to someone you're giving them feedback, you're being honest. [00:23:25] You're giving them, , Opportunities and time to correct, and to learn from, , you're giving the training, you're giving the education and then it's up to that person to do something with that. And whereas if I'm responsible for something, then you, you. Sometimes go down the slippery slope of thinking that you're the only person that can do that. [00:23:50] Or you're the only person that can make a decision or you're the only person that can create a successful outcome. And when you start to pull it back and feel like I have to do it myself, My honest opinion is I think we're starting to fail as leaders and that doesn't mean leaders. Aren't high-performing overachieving, get things done, kind of people, , but if you're going to trust and empower and build and be a people builder, then you have to be able to identify and have that hard talk with yourself sometimes. [00:24:21] Am I being responsible to this person and giving them all the feedback and education training support to be successful. Where am I feeling responsible for this person? And there were times in this past year, thinking about the urgency of COVID in our hospital operations, I've felt a lot of responsibility for, and I. [00:24:42]To not disempower or lose or disengage or burn out my team. I had to be able to pull myself back and say, I'm going to be responsible to this person. And I'm going to trust and empower this person to be an extension of my vision, of what I want to accomplish. And we accomplished a lot more together than I could have done by myself. [00:25:01] So I just think it's, it's a really. Great topic. And I don't know that you ever completely resolved that balance cause it's a Seesaw. , where, , you do have to have some ownership and you do have to have some passion and you have to have high levels of engagement and follow through. But at the same time, if you're doing this with people in leadership, it's separating the responsible to versus the responsible for [00:25:27]Patrick Swift PhD, MBA, FACHE: [00:25:27] I like to call that the yoga of healthcare, where we're we're as leaders, we're staying flexible at the same time to support, um, the good work that's being done. It's a beautiful way to, to, to, um, Put that together. Jeffrey also want to talk with you about the patient experience and challenges and lessons learned during the past COVID adventure and, , , your future vision of how you're advancing the patient experience. [00:25:55] Geoffrey Hall, MBA, MSW: [00:25:55] That's a, that's a great question. I think it's evolving. , so in our hospital setting, we do a significant amount of family training where we involve, , Adult children, spouses, family members in the care of the patient, because our goal is to get those patients home. And you're moving from a setting where you have 24 hour nursing care and great therapy care to your home environment, which really doesn't have as much of the same supports and infrastructure. , as part of COVID, as we had to lock down and change our visitation processes, we really had to implement some new ways to continuously get our patients home, despite not having people onsite. And on-premise so. We implemented a lot of virtual FaceTime training, , where therapists and nurses working with a patient would have, , the family member on a video screen and interacting in the session. [00:26:49], we converted all of our support groups, , for brain injured patients and spinal cord, injured patients and stroke patients to virtual. And , what the unintended benefit of that was is that. , we sometimes think that we start a group and it's just accessible to everyone, but not everyone has transportation or the availability to come to a, , a group setting or a hospital setting. [00:27:14]So our participation and enrollment in some of these groups, nearly tripled because the virtual aspect gave more access to care and access to follow up. And. What was really powerful, particularly with our COVID support group was the peer support. It wasn't the healthcare professional, leading the discussion. [00:27:35]It was everyone else talking about the long haul symptoms that they had, how that had impacted their family. Um, and Mo more importantly, , I think there was such a stigma around the, the patients who were early diagnosed with, with COVID. And it started to kind of normalize that. So we really went to a virtual strategy and certainly across healthcare, you're seeing an explosion of, tele-health, which has been around for years, but it's now becoming mainstream because it's creating a better access of care. [00:28:09] If you think personally, why would you want to go to a crowded doctor's waiting room or an emergency room right now, if you could access the same doctor and actually have. A really personal conversation with that doctor about what's going on with you via your phone versus doing that. And I'm not saying healthcare should be all virtual because there from a patient experience, , one of the, because we had to do when we, we limited our visitors and had no visitors during the hall days, is we just task staff every day to say, You need to go do some social rounding. [00:28:43] Like I want to, like, there's no task, there's no activity, there's no procedure. I just need you to go in and have a conversation with how this person is doing and keeping that human connection. you know, we brought in musicians and it was one of the best things I saw in 2020, where I had a opera singer and a violinist in a hallway. [00:29:05] And because we had to be socially distance. Our patients came to their doorways of their patient rooms and sat in the doorways so that they were more than six feet apart. And in the center of the hall, I've got somebody playing a violin and an opera singer and lots of hospitals do those kinds of things on a regular basis, but doing it in a COVID [00:29:24] Patrick Swift PhD, MBA, FACHE: [00:29:24] during COVID that's that's, that's unusual and it speaks to patient family centered care. And I love what you said earlier about it. Not just being a top-down , the clinician. Doing training to the family. But you said that the family are speaking up and part of the conversation during those, the peer to peer support, that's patient, family centered care where they, they, they have the voice, it's the collective it's us together, as opposed to a sense of separateness. [00:29:54] Geoffrey Hall, MBA, MSW: [00:29:54] And I would say in healthcare settings, we often focus on our patients and you'll hear patient centered care. And that's been a buzzword for the industry for years, but I want to expand that because we had to go through this. And this was a hard learned lesson for us. Is when we first went through our COVID rollout and our changed our operations, we were really well focused on the staff experience and the staff education and the staff safety. [00:30:21]And I actually had a patient in our hospital who was, , recovering from a spinal cord injury and was hospitalized before the COVID lockdown and then was with our hospital as we made all of these. Drastic changes with COVID precautions. And he came to me and he said, your staff are great. You know, they really know what they're doing. [00:30:40], I really see that they, they feel like you've got this COVID thing under, under control, but my family is concerned. And so what can you do around that? So I sat with him for a couple of hours and he. Rattled off a number of questions. And then as a leadership team, we went back and we had to revisit every single one of those questions with the lens of how do we communicate this to not only this one patient, but patients going forward. So as a result of that, we came up with a new family communication plan and who is making the calls. [00:31:13] And how often are we making the calls? And what's the content of this call and how are we. Passing this off and how are we just acknowledging that families are anxious because they can't see their loved ones right now. And all of this other stuff is happening in the world. , so let's kind of raise the bar on customer service and you know, some of that was FaceTime calls and, and our rec therapists did an amazing job of using FaceTime to do virtual visits. [00:31:42], We did a virtual 70th wedding anniversary for one of our, our patients and their families. , cause the spouse was hospitalized. You know, we had to rethink of how do we help families celebrate birthdays and anniversaries. And I really want to stress that family communication. Cause it's real easy to go rounding and go talk to a patient and explain to the patient. [00:32:04] But you've got to do that two or three times. If they've got a son and daughter that live out of state, a family member that lives in the local area, like sometimes you would learn that you're having all these update conversations with a family member, but they're not the decision-maker family members. [00:32:21] So really trying to and not be defensive about that and say, Okay. You're not here. So we can't share this information in person. So what extra level can we go to, to make sure that your experience matches the same care that we're providing to the patient? [00:32:38] Patrick Swift PhD, MBA, FACHE: [00:32:38] Outstanding. Standing [00:32:39]One of the questions I love to ask, and I want to ask you, if you were standing at the top of the world and you had the attention of all the healthcare folks, physicians, nurses, therapists, staff, leadership, all the folks who work in healthcare for a brief moment what would you say to, to healthcare across the planet right now? [00:33:01] Geoffrey Hall, MBA, MSW: [00:33:01] Well, I'll answer that with what I wish somebody had told me, and I've had to figure out and continuously remind myself of, and it's to focus on the people, providing the care. And it's my belief that if our caregivers feel supported and, , we're really developing them from a skill enhancement, but just focusing on empathy and their overall experience. [00:33:26] Then it's not unreasonable to expect great patient experience and great outcomes, but we have to focus on the caregivers. I think oftentimes we bury people with tasks and audits and activities, and we need to remember that there's a person that's behind that. And, , I think I want us to become more, , accountable for. [00:33:51] Development and resilience versus a burnout culture. , because that was one of the key things that I was reminded of this year was we had our third wave of COVID surge across our community. , and I started to see at one point our local area was that a 33% positivity rate and. There was no backups. [00:34:14] There was no additional nurses or nurse AIDS or therapist on the bench that could come in and take care of our patients. , so it was mission critical that we tried to keep our own staff safe. and just managing that because even one person calling out was the difference between a good shift and a bad shift, a good day and a bad day. [00:34:37] So. For me, I wish somebody had even earlier had reminded me to just focus on the caregivers. And if you do that, the caregivers will remember and take, take great care of the patients. [00:34:50] Patrick Swift PhD, MBA, FACHE: [00:34:50] you're here , and that is global thought leadership in healthcare. Right there to a T when I ask you if folks who are interested in following up with you or had a question, uh, , how could they, uh, get in touch with you? [00:35:02] Geoffrey Hall, MBA, MSW: [00:35:02] Sure, absolutely. And thanks for the time Patrick. I always enjoy our conversations. the best way to reach me would be, , my email address. And, um, would you like personally? [00:35:11]Patrick Swift PhD, MBA, FACHE: [00:35:11] uh, well, I'm not gonna put that on the show, but how about, how about your LinkedIn profile? If, if folks are interested in connecting with you on LinkedIn, [00:35:18] Geoffrey Hall, MBA, MSW: [00:35:18] yeah, I'm not on other social media channels, but you can certainly find me on LinkedIn.  , , , but I am the kind of CEO that gives my personal cell phone number out to my patients, their families, my staff. , cause I don't know if you can care about people and just have a start and stop time. [00:35:34]Patrick Swift PhD, MBA, FACHE: [00:35:34] beautifully said beautiful leadership, beautiful perspective. . Jeffrey, thank you so much for, for being on the show. Thank you for being on the Swift video podcast with healthcare video podcast and, uh, folks, , , I hope that you, , take away nuggets from what Jeffrey had to share and, , , Jeffrey, thank you so much for being on the show. [00:35:51]Geoffrey Hall, MBA, MSW: [00:35:51] thank you, Patrick. [00:35:52]  

Dr. Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also in Pediatrics. Her area of specialization includes the pediatric disorders cerebral palsy and spina bifida. This is a special two-part Grand Rounds series. In Part 1 of her presentation, Dr. Gold contrasted a time 50 years ago when she made a presentation on the topic of spina bifida. Today, we have a change in attitude and a change in medical information since that earlier period and we also need to be aware of long-term care needs and the need for continuity of care of these patients, and all our patients who are aging out. She cited professional literature from 1971 that described many kinds of pediatric patients whose conditions were such that rather than try to treat them, they should be allowed to succumb. For example, comments made back then about these patients being incontinent and socially unacceptable were not true. By 1996, it was shown that most of the previous assumptions were wrong. A child in a wheelchair is worth living. Many surgical deformities that once were present can be corrected today. Incontinence is not inevitable and bowel function can be controlled. She discussed the role of folate in reducing the incidence of spina bifida. She mentioned the implications of providing care for these patients. Most of the surgical procedures undertaken today are neurosurgical. Various generalizations can be made. One is that adult spina bifida patients are likely to have fewer primary care visits than patients under the age of 18 and she explained reasons why it is so. She concluded Part 1 of her presentation by talking about the role that urinary complications may play in the death of many patients. Listeners to Part 1 of Dr. Gold’s presentation will recall she indicated that it probably is the urinary complication that is the cause of death in most of these patients, which is critical. In Part 2, she began by asking what multilevel care elements should exist for patients with spina bifida? She mentioned that as a result of pushing wheelchairs, some patients experience rotator cuff injuries. Although therapeutic services do not have to be performed for all patients, she described some kinds of assistance that they may need. Some patients may experience functional regression. Once able to walk at ages five and 10, they no longer can do so. There is a higher incidence of neuroses. These patients need vocational, nutritional, and social work services. A problem for many patients is when they have to travel a considerable distance for hospital care, the facility they go to may lack the personnel necessary to provide appropriate kinds of spina bifida care. She indicated some surgical concerns. Most shunted patients have long term motor and cognitive behavioral deficits. She described urological issues that are most paramount and frequent. She asked what kinds of things should we do when we assess patients within a therapeutic realm? We should look at their transportation skills, perceptual motor skills to drive, be knowledgeable of their medical management and history, and try to establish some autonomy with money management, household skills, and community living skills. Also, there is a need to work on their parenting skills and on obtaining adequate health care for themselves and their children. There are issues with cardiovascular disease. Studies show that as many as 73% of spina bifida patients have chronic pain. A final portion of the presentation was on the topic of women with spina bifida giving birth.

Dr. Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also in Pediatrics. Her area of specialization includes the pediatric disorders cerebral palsy and spina bifida. This is a special two-part Grand Rounds series. In Part 1 of her presentation, Dr. Gold contrasted a time 50 years ago when she made a presentation on the topic of spina bifida. Today, we have a change in attitude and a change in medical information since that earlier period and we also need to be aware of long-term care needs and the need for continuity of care of these patients, and all our patients who are aging out. She cited professional literature from 1971 that described many kinds of pediatric patients whose conditions were such that rather than try to treat them, they should be allowed to succumb. For example, comments made back then about these patients being incontinent and socially unacceptable were not true. By 1996, it was shown that most of the previous assumptions were wrong. A child in a wheelchair is worth living. Many surgical deformities that once were present can be corrected today. Incontinence is not inevitable and bowel function can be controlled. She discussed the role of folate in reducing the incidence of spina bifida. She mentioned the implications of providing care for these patients. Most of the surgical procedures undertaken today are neurosurgical. Various generalizations can be made. One is that adult spina bifida patients are likely to have fewer primary care visits than patients under the age of 18 and she explained reasons why it is so. She concluded Part 1 of her presentation by talking about the role that urinary complications may play in the death of many patients. Listeners to Part 1 of Dr. Gold’s presentation will recall she indicated that it probably is the urinary complication that is the cause of death in most of these patients, which is critical. In Part 2, she began by asking what multilevel care elements should exist for patients with spina bifida? She mentioned that as a result of pushing wheelchairs, some patients experience rotator cuff injuries. Although therapeutic services do not have to be performed for all patients, she described some kinds of assistance that they may need. Some patients may experience functional regression. Once able to walk at ages five and 10, they no longer can do so. There is a higher incidence of neuroses. These patients need vocational, nutritional, and social work services. A problem for many patients is when they have to travel a considerable distance for hospital care, the facility they go to may lack the personnel necessary to provide appropriate kinds of spina bifida care. She indicated some surgical concerns. Most shunted patients have long term motor and cognitive behavioral deficits. She described urological issues that are most paramount and frequent. She asked what kinds of things should we do when we assess patients within a therapeutic realm? We should look at their transportation skills, perceptual motor skills to drive, be knowledgeable of their medical management and history, and try to establish some autonomy with money management, household skills, and community living skills. Also, there is a need to work on their parenting skills and on obtaining adequate health care for themselves and their children. There are issues with cardiovascular disease. Studies show that as many as 73% of spina bifida patients have chronic pain. A final portion of the presentation was on the topic of women with spina bifida giving birth.

Dr. Chelsea Schoen provides psychological and neuropsychological assessment and intervention services to a wide range of adults recovering from traumatic brain injury, stroke, other complex neurologic conditions, spinal cord injury, and orthopedic/musculoskeletal conditions. Her clinical and research interests include psychological factors associated with fear of falling. She received her PhD in Clinical Psychology with a Health Emphasis and specialization in neuropsychology from the Yeshiva (Yeshiva) University. Dr. Philip J. Uy is a Senior Psychologist at Rusk Rehabilitation and works at Cardiopulmonary/Medically Complex on the Main Campus and at the Neurorehabilitation (Langone Orthopedic Hospital) acute inpatient rehabilitation. His clinical and research interests are in neurologic disorders, cardiopulmonary conditions, and adjustment to medical disability. He also has expertise in substance use disorders. He obtained his doctorate in Clinical Psychology from Fairleigh Dickinson University.  In Part 1, they discuss the following: kinds of patients treated involving COVID-19; possible after-effects either caused or associated with the onset of coronavirus symptoms; types of challenges treating coronavirus patients;  mental health conditions that persist long-term; and mental health services provided for clinical colleagues.   In Part 2, they discuss the following: work involving telehealth care of patients; Acceptance and Commitment Therapy;  sleep disturbance or disorders experienced by patients; kinds of coronavirus patients at an increased risk for emotional disorders; and topics where more research could prove to be advantageous in improving patient care.  

Dr. Chelsea Schoen provides psychological and neuropsychological assessment and intervention services to a wide range of adults recovering from traumatic brain injury, stroke, other complex neurologic conditions, spinal cord injury, and orthopedic/musculoskeletal conditions. Her clinical and research interests include psychological factors associated with fear of falling. She received her PhD in Clinical Psychology with a Health Emphasis and specialization in neuropsychology from the Yeshiva (Yeshiva) University. Dr. Philip J. Uy is a Senior Psychologist at Rusk Rehabilitation and works at Cardiopulmonary/Medically Complex on the Main Campus and at the Neurorehabilitation (Langone Orthopedic Hospital) acute inpatient rehabilitation. His clinical and research interests are in neurologic disorders, cardiopulmonary conditions, and adjustment to medical disability. He also has expertise in substance use disorders. He obtained his doctorate in Clinical Psychology from Fairleigh Dickinson University.  In Part 1, they discuss the following: kinds of patients treated involving COVID-19; possible after-effects either caused or associated with the onset of coronavirus symptoms; types of challenges treating coronavirus patients;  mental health conditions that persist long-term; and mental health services provided for clinical colleagues.   In Part 2, they discuss the following: work involving telehealth care of patients; Acceptance and Commitment Therapy;  sleep disturbance or disorders experienced by patients; kinds of coronavirus patients at an increased risk for emotional disorders; and topics where more research could prove to be advantageous in improving patient care.      

Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Langone Health. He joined NYU Langone Medical Center in 2008 as Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation after serving as Vice Chairman of Rehabilitation Medicine at Mount Sinai School of Medicine. He serves on numerous medical advisory boards and is a peer reviewer for several scientific journals. He has authored numerous chapters and peer-reviewed publications, and has participated in both federally- and industry-sponsored research. His medical degree is from the University of Medicine & Dentistry of New Jersey and he completed his residency at Mt. Sinai Medical Center/Cabrini, Rehabilitation Medicine. PART 1 In Part 1 of his presentation, Dr. Flanagan discussed the value that physical medicine and rehabilitation (PM&R) add to health care.His objective in this session is to give an overview of health care reform and its impact on PM&R. Many changes have occurred since he began practicing medicine three decades ago. Health care reform is real. From 1960 to 2010, wages and GDP increased, but nowhere close to the enormous rise in health care expenditures, which are not sustainable. Also, we no longer can claim that we have the best health outcomes compared to other nations. Recognizing that health spending could no longer continue at such a rapid pace, the government came up with something called the Sustainable Growth Rate (SGR) to limit the outlandish expansion of health care costs. The attempt never achieved what was intended and Congress terminated the SGR in 2015. It was replaced by MACRA, the Medicare Access and CHIP Reauthorization Act of 2015, which redefined how physicians would be reimbursed and it is based on quality measures that they would have to meet. The objective is to achieve the triple aim of health care reform: improve health care quality, produce better outcomes, and improve the patient experience. A quadruple aim includes improving the satisfaction of providers. He indicated that management of post-acute care is of importance and that PM&R is uniquely situated to be involved in achieving the triple aim.  It can do so by focusing on patient-centered coordinated care that is comprehensive across the entire continuum. PART 2  Listeners to Part 1 of Dr. Flanagan’s presentation may recall that he discussed health reform efforts to control health care costs and how the provision of physical medicine and rehabilitation (PM&R) services has a unique role to play in achieving health reform’s triple aim. In Part 2, his comments had a focus on intensive care unit patients, a group associated with large health care costs and one not usually associated with the provision of rehabilitation services. What about safety? It’s feasible, but is it wise? Should we get folks up and walking who are so critically ill? Aren’t we putting them at risk of all sorts of bad things from happening? It is safe and the outcomes are fine and there is research to prove it. We are enhancing mobility, decreasing the number of days patients are on ventilators, and in some cases, not only are we not causing worse mortality, we are decreasing mortality. If you are doing all of this, the last question is what about costs? Despite increasing the use of PT, OT, and Speech staff, by getting patients out of the hospital faster, there is a cost savings. A pilot study was done at NYU to look at what happens to patients after they left the hospital to see if there were any additional savings. The results show that it was possible to reduce hospitalization, reduce the average direct cost per day, and there was a significant increase in the proportion of patients who were discharged to the community with no services at all. The latter outcome represented an overall cost savings for the health system. He also provided information about something that is relatively new and what they are working on at NYU, which is site neutral payments. A question and answer period followed his presentation.

Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Langone Health. He joined NYU Langone Medical Center in 2008 as Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation after serving as Vice Chairman of Rehabilitation Medicine at Mount Sinai School of Medicine. He serves on numerous medical advisory boards and is a peer reviewer for several scientific journals. He has authored numerous chapters and peer-reviewed publications, and has participated in both federally- and industry-sponsored research. His medical degree is from the University of Medicine & Dentistry of New Jersey and he completed his residency at Mt. Sinai Medical Center/Cabrini, Rehabilitation Medicine. PART 1 In Part 1 of his presentation, Dr. Flanagan discussed the value that physical medicine and rehabilitation (PM&R) add to health care.His objective in this session is to give an overview of health care reform and its impact on PM&R. Many changes have occurred since he began practicing medicine three decades ago. Health care reform is real. From 1960 to 2010, wages and GDP increased, but nowhere close to the enormous rise in health care expenditures, which are not sustainable. Also, we no longer can claim that we have the best health outcomes compared to other nations. Recognizing that health spending could no longer continue at such a rapid pace, the government came up with something called the Sustainable Growth Rate (SGR) to limit the outlandish expansion of health care costs. The attempt never achieved what was intended and Congress terminated the SGR in 2015. It was replaced by MACRA, the Medicare Access and CHIP Reauthorization Act of 2015, which redefined how physicians would be reimbursed and it is based on quality measures that they would have to meet. The objective is to achieve the triple aim of health care reform: improve health care quality, produce better outcomes, and improve the patient experience. A quadruple aim includes improving the satisfaction of providers. He indicated that management of post-acute care is of importance and that PM&R is uniquely situated to be involved in achieving the triple aim.  It can do so by focusing on patient-centered coordinated care that is comprehensive across the entire continuum. PART 2  Listeners to Part 1 of Dr. Flanagan’s presentation may recall that he discussed health reform efforts to control health care costs and how the provision of physical medicine and rehabilitation (PM&R) services has a unique role to play in achieving health reform’s triple aim. In Part 2, his comments had a focus on intensive care unit patients, a group associated with large health care costs and one not usually associated with the provision of rehabilitation services. What about safety? It’s feasible, but is it wise? Should we get folks up and walking who are so critically ill? Aren’t we putting them at risk of all sorts of bad things from happening? It is safe and the outcomes are fine and there is research to prove it. We are enhancing mobility, decreasing the number of days patients are on ventilators, and in some cases, not only are we not causing worse mortality, we are decreasing mortality. If you are doing all of this, the last question is what about costs? Despite increasing the use of PT, OT, and Speech staff, by getting patients out of the hospital faster, there is a cost savings. A pilot study was done at NYU to look at what happens to patients after they left the hospital to see if there were any additional savings. The results show that it was possible to reduce hospitalization, reduce the average direct cost per day, and there was a significant increase in the proportion of patients who were discharged to the community with no services at all. The latter outcome represented an overall cost savings for the health system. He also provided information about something that is relatively new and what they are working on at NYU, which is site neutral payments. A question and answer period followed his presentation.

The Rusk Rehabilitation/NYU Langone Health PM&R program joined us to discuss their residency.

This discussion is a special presentation from Rusk Rehabilitation that features a group of faculty and staff battling the pandemic on the front lines at the middle of the epicenter in New York City.  Questions from around the country are answered in this exciting and extremely important episode! Please excuse any issues with sound. 

This discussion is a special presentation from Rusk Rehabilitation that features a group of faculty and staff battling the pandemic on the front lines at the middle of the epicenter in New York City.  Questions from around the country are answered in this exciting and extremely important episode! Please excuse any issues with sound. 

This discussion is a special presentation from Rusk Rehabilitation that features a group of faculty and staff battling the pandemic on the front lines at the middle of the epicenter in New York City.  Questions from around the country are answered in this exciting and extremely important episode! Please excuse any issues with sound. 

This discussion is a special presentation from Rusk Rehabilitation that features a group of faculty and staff battling the pandemic on the front lines at the middle of the epicenter in New York City.  Questions from around the country are answered in this exciting and extremely important episode! Please excuse any issues with sound. 

As we start to wind down our series on Healing Gardens and Therapeutic Landscape design, we’re joined by Matthew J. Wichrowski, MSW HTR, Clinical Assistant Professor in the Department of Rehabilitation Medicine and Senior Horticultural Therapist at Rusk Rehabilitation at NYU Langone Health. A longtime educator and practitioner in the field of horticultural therapy. From acute care bedsides to locked ward psychiatric care, plants make everything better. Join us. Cultivating Place now has a donate button! We thank you so much for listening over the years and we hope you'll support Cultivating Place. We can't thank you enough for making it possible for this young program to grow even more of these types of conversations. The show is available as a podcast on SoundCloud, iTunes, Google Play and Stitcher. To read more and for many more photos please visit www.cultivatingplace.com.

Dr. JR Rizzo is a physician scientist at Rusk Rehabilitation. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury. Dr. Rizzo has been recognized as a Top 40 under 40 by Crain’s for his industry-leading innovation and dedication to transforming the lives of those with vision deficiencies worldwide. This is a two-part Grand Rounds presentation. In Part Two, Dr. Rizzo discusses assistive technology. There is lots of it for physical impairments, but what about for sensory impairments, such as mobility? Visually impaired patients may use a white cane while walking, but it misses large physical objects. So, they came up with something they called the Dragon Fly, which may become available commercially by the end of 2019. A form of push and clear technology, it should prove to be highly useful. He talked about advanced driver assist systems (ADAS), systems which, for example, help motor vehicle drivers by improving road safety. Rear end collisions are being reduced significantly. Why can’t we do this for falls experienced by patients with sensory impairments? This work is being done now and he gave examples of how visually impaired pedestrians are being assisted. He also described assistance devices that can help patients in their homes, such as reaching and grasping accurately.

Nature has a way of healing the soul, providing clarity and bringing peace to a troubled mind. Did you know there is a clinical specialty that uses plants and nature to heal? It is called horticultural therapy and it is absolutely incredible. In this interview I interview an expert in the field, Matthew J. Wichrowski, MSW HTR, Clinical Assistant Professor in the Department of Rehabilitation Medicine and Senior Horticultural Therapist at Rusk Rehabilitation at NYU Langone Health. He is also Editor-in-Chief of the American Horticultural Therapy Association’s Journal of Therapeutic Horticulture. I first learned about horticultural therapy and Matthew when I read the book, How to Make a Plant Love You, by Summer Rayne Oakes. (See my interview with her here. https://youtu.be/KFPgNrhhUoY ) I was amazed to learn how plants were helping people with debilitating depression and anxiety but it could also be used to help with stroke victims and much more. Such an intriguing area that many of us could put to work in our daily lives. I hope you find this interview as helpful and educational as I did. You can learn more about Matthew and horticultural therapy here. https://med.nyu.edu/faculty/matthew-j-wichrowski https://www.ahta.org As always thank you for listening. Please check out http://healthyhumanrevolution.com for more about how plants can improve your health!

Dr. JR Rizzo is a physician scientist at Rusk Rehabilitation. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury. Dr. Rizzo has been recognized as a Top 40 under 40 by Crain’s for his industry-leading innovation and dedication to transforming the lives of those with vision deficiencies worldwide. This is a two-part Grand Rounds presentation.  In Part One, Dr. Rizzo focuses on how hand-eye coordination is pervasive in rehabilitation. How do we actually build this hand-eye coordination? Every day, an individual experiences a quarter of a million eye movements. He asked how eye-hand coordination intersects with stroke. Patients who have had a stroke have to do a lot more work in conducting eye movements. It is exhausting to do a simple reach. A great deal of work is necessary to complete basic tasks. Hand-eye coordination is being impeded through interference. So good questions are what comes next and how do you actually deal with it? Currently, they are trying to understand the cognitive implications of what is happening. For example, what happens if we look at the way work is done by considering it as sequential steps, e.g., first look and then reach, first look and then reach. Improvement occurred. Instead of considering biofeedback of the limb, they began doing biofeedback of the eye.

In this episode we speak with Dr. Antonio Stecco, MD, PhD. about further research in the area of fascia. This is our second interview with him and a continuation of our first conversation. Dr. Stecco is Assistant Professor at Rusk Rehabilitation, New York University. Physiatrist, President of Fascial Manipulation Association, Assistant to the President of the International Society of Physical Medicine and Rehabilitation (ISPRM) from 2012 to 2014. His scientific activity is devoted to the study of the human fasciae from a macroscopically, histologically and physio-pathologically point of view. He personally made over 100 cadaver dissections for research. Since 2007 he has organized and personally holds theoretical-practical courses about the Fascial Manipulation method in all five continents. He is author of more than 40 in extensor papers about the fascia. He has co-authored of 5 books and is co-author of different chapters of international books published by Elsevier. Learning Points: • Signs of a distressed liver and how to support a healthy liver • The Importance of promoting healthy fascia • Recent findings in the area of neuropathy and fascia • What is fascia manipulation Social Media: http://www.fascialmanipulation.com/en/

This special panel presentation features three leaders in the space:  Tara Denham, supervisor of vestibular physical therapy, is a leading expert in the field of vestibular therapy and founder of the Vestibular Physical Therapy Center at Rusk. As an American Physical Therapy Association certified vestibular clinician, she lectures extensively to a wide range of audiences.    Eva Mihovich has served as a Senior Psychologist at Rusk Rehabilitation, NYU Langone Health Centers for over 20 years, and is a clinical instructor at the NYU School of Medicine. She currently coordinates Psychological Services at the Vestibular Rehabilitation Department at Rusk Rehabilitation. Her Ph.D. is from New York University.    Dr. Jennifer Fay is a board-certified clinical specialist in Neurologic Physical Therapy through the American Board of Physical Therapy Specialties and is a clinical instructor in the Department of Physical Medicine and Rehabilitation in the NYU School of Medicine.    Artmis Youssefnia is Senior Level II in the vestibular therapy department at Rusk Institute: NYU Langone Health System. She has over 20 years of experience working with patients with pulmonary disease and vestibular dysfunction and does extensive community outreach/education. She also is adjunct professor for Cardiovascular Pulmonary Examination at NYU Physical Therapy school.   This is the second of a two-part series. In this episode, the panel covers: whether any patients report out-of-body experiences associated with 3PD, evaluation techniques used in developing treatment plans for patients; dominant treatment approaches; roles played by gait training and gaze stabilization; status of clinical practice guidelines and evidence-based treatments; research gaps where more studies may be necessary; factors that may characterize patients, such as fear of the future or threats to self-image that possibly could detract from the success of rehabilitation kinds of interventions; major components of a cognitive-behavioral approach to treating 3PD; whether plateaus ever occur where further treatment is not associated with additional improvements; and current research and proposed studies on the drawing board aimed at shedding additional light on 3PD.

This special panel presentation features three leaders in the space:  Tara Denham, supervisor of vestibular physical therapy, is a leading expert in the field of vestibular therapy and founder of the Vestibular Physical Therapy Center at Rusk. As an American Physical Therapy Association certified vestibular clinician, she lectures extensively to a wide range of audiences.    Eva Mihovich has served as a Senior Psychologist at Rusk Rehabilitation, NYU Langone Health Centers for over 20 years, and is a clinical instructor at the NYU School of Medicine. She currently coordinates Psychological Services at the Vestibular Rehabilitation Department at Rusk Rehabilitation. Her Ph.D. is from New York University.    Dr. Jennifer Fay is a board-certified clinical specialist in Neurologic Physical Therapy through the American Board of Physical Therapy Specialties and is a clinical instructor in the Department of Physical Medicine and Rehabilitation in the NYU School of Medicine.    Artmis Youssefnia is Senior Level II in the vestibular therapy department at Rusk Institute: NYU Langone Health System. She has over 20 years of experience working with patients with pulmonary disease and vestibular dysfunction and does extensive community outreach/education. She also is adjunct professor for Cardiovascular Pulmonary Examination at NYU Physical Therapy school.   This is the first of a two-part series. In this episode, the panel covers:  why terms previously used were abandoned and how the classification 3PD represents an improvement over them; core symptoms of 3PD; kinds of health professionals involved in making an accurate differential diagnosis; specific clinical tests to detect the presence of 3PD; how well patients perform in describing their symptoms in constructive ways that aid in arriving at a correct diagnosis; what is known about the exact etiology of 3PD from the standpoint of any common initial events that might precede its development; whether 3PD can co-exist with other kinds of dizziness problems; if onset of 3PD associated in any way with certain demographic factors; and episodes that can trigger the onset of 3PD, such as a panic attack or generalized anxiety disorders

Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her areas of specialization include the pediatric disorders cerebral palsy, and spina bifida. In her own words, she stated that she has had the pleasure of watching her patients and learning from their strengths for 45+ years. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board-certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also Pediatrics.  This is the second of a two-part series. In this Part 2, she discusses: pregnancy among patients with cerebral palsy, effect of pregnancy on balance and coordination if a motor functional impairment exists; challenges and resources available for patients who become parents; identification of the felt needs of patients; improvements needed in diagnosis and treatment; time period for adoption of rehabilitation treatment innovations; and key topics in rehabilitation research. In Part 1, Dr. Gold discussed: number of adults in the U.S. with cerebral palsy; their life expectancy; challenges involved in the transition from pediatric to adult care for these patients; kinds of health problems adult patients experience; treatment for dystonia; the impact of additional physical deterioration on quality of life and mental health; and the ability to participate in physical activities, work, family, and recreational activities.  

Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her areas of specialization include the pediatric disorders cerebral palsy, and spina bifida. In her own words, she stated that she has had the pleasure of watching her patients and learning from their strengths for 45+ years. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board-certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also Pediatrics.  This is the first of a two-part series. In Part 1, Dr. Gold discusses: number of adults in the U.S. with cerebral palsy; their life expectancy; challenges involved in the transition from pediatric to adult care for these patients; kinds of health problems adult patients experience; treatment for dystonia; the impact of additional physical deterioration on quality of life and mental health; and the ability to participate in physical activities, work, family, and recreational activities. In Part 2, she discusses: pregnancy among patients with cerebral palsy, effect of pregnancy on balance and coordination if a motor functional impairment exists; challenges and resources available for patients who become parents; identification of the felt needs of patients; improvements needed in diagnosis and treatment; time period for adoption of rehabilitation treatment innovations; and key topics in rehabilitation research.            

In this episode we speak with Dr. Antonio Stecco, MD, PhD, Assistant Professor at Rusk Rehabilitation, New York University and expert in the study of fascia and fascia manipulation. Learning Points include: • The role of Vitamin D and the common source of the supplement D3 • What fascia is • Why fascia so important • How manual therapy treats fascial problems http://www.fascialmanipulation.com/en/

Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others.    Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU.    Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety.   At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019. 

EPA Podcast Series: Giving First!- An Interview with Physiatrist Baruch Kim, MD -Networking -Bestdocz -Eastern Pain Association Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others.    Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU.    Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety.   At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019.      Baruch      

EPA Podcast Series: Giving First!- An Interview with Baruch Kim, MD -Networking -Bestdocz -Eastern Pain Association Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others.    Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU.    Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety.   At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019.      Baruch      

David Biderman is a Clinical Assistant Professor in the Department of Rehabilitation Medicine at NYU Langone Health and serves as supervisor of the Brain Injury Day Treatment Program. He joined Rusk Rehabilitation, NYU Langone Health in 1996 as a research assistant and started working at the Brain Injury Day Treatment Program in 1999, becoming the supervisor in 2010. A New York City native, he earned his Doctoral Degree in Health Psychology from the Albert Einstein College of Medicine.  Prior to coming to Rusk, he worked in research at other major medical centers in New York. Most recently he has presented and published on the role of significant others in the rehabilitation of individuals with a brain injury. He currently is working on cognitive retraining software to improve attention functions and continues his efforts to educate Brain Injury fellows, Psychology Doctoral Interns, and other professionals interested in learning about the comprehensive neuropsychological rehabilitation of individuals with an acquired brain injury.   This discussion includes: assessments performed to determine if cognitive remediation is an appropriate intervention for patients who experienced a traumatic brain injury; aims pursued when engaging in cognitive remediation; the effect of TBI level of severity on kind of treatment and anticipated outcomes; the influence of demographic factors such as age, gender, and race/ethnicity on the attainment of successful outcomes; the role music can play in cognitive remediation; ways in which cognitive remediation could be enhanced through the use of existing and emerging kinds of social media platforms, along with other modalities, such as apps, wearable devices, and virtual reality technology; self- or family caregiver-treatment plans outside the clinical setting;  and current research and proposed studies at NYU aimed at producing a greater understanding of the effectiveness of cognitive remediation kinds of intervention.  

Dr. Douglas Elwood is a board-certified physician with over 15 years experience in health and wellness who has led innovation efforts for a number of companies and has dedicated his career to improving education, communication, and outcomes for patients, caregivers, and healthcare providers. As a thought-leader in the space, he has consulted to companies throughout the industry, presented at conferences worldwide, and has multiple publications including a featured chapter in the esteemed annual HIMSS publication on mHealth. He is on part-time faculty at NYU Langone Medical Center at Rusk Rehabilitation and led one of the country's first and largest clinical studies on the use of technology in clinical care at Rusk and how social media, digital, mobile, and connected health influence communications, patient behavior, and physician workflow. Along with his part-time work at Rusk, Dr. Elwood is the Chief Medical Officer for PWNHealth where he leads over 150 physicians and genetic counselors, creates clinical protocols, oversees all clinical quality issues, and provides virtual care to large numbers of patients on a daily basis. A graduate of Amherst College and Jefferson Medical College, he is the holder of both MD and MBA degrees. In Part 2 of this two-part series. Dr. Elwood reviews: how his health career journey after medical school and residency training brought him to where he works today and how he arrived there; promising uses of virtual care technology with patients; and the importance of forecasting key trends and identifying potential new opportunities in the emerging American health care scene.

Dr. Douglas Elwood is a board-certified physician with over 15 years experience in health and wellness who has led innovation efforts for a number of companies and has dedicated his career to improving education, communication, and outcomes for patients, caregivers, and healthcare providers. As a thought-leader in the space, he has consulted to companies throughout the industry, presented at conferences worldwide, and has multiple publications including a featured chapter in the esteemed annual HIMSS publication on mHealth. He is on part-time faculty at NYU Langone Medical Center at Rusk Rehabilitation and led one of the country's first and largest clinical studies on the use of technology in clinical care at Rusk and how social media, digital, mobile, and connected health influence communications, patient behavior, and physician workflow. Along with his part-time work at Rusk, Dr. Elwood is the Chief Medical Officer for PWNHealth where he leads over 150 physicians and genetic counselors, creates clinical protocols, oversees all clinical quality issues, and provides virtual care to large numbers of patients on a daily basis. A graduate of Amherst College and Jefferson Medical College, he is the holder of both MD and MBA degrees. In Part 1 of this two-part series, Dr. Elwood addresses: his involvement in a number of research activities exploring the use of technology to enhance patient care while serving as a resident/chief resident at Rusk and then later as a part-time clinical instructor; how technology has enhanced patient engagement in improving health care; value-based care as an emerging/blossoming approach to contain costs while enhancing care; shifts that may be occurring away from traditional providers, such as physician offices, clinics, and hospitals to a more technology-driven way of doing business; and how developments in the commercial sphere, such as the creation of apps and virtual technology parallel and augment what is unfolding in the clinical care and biomedical research domains. 

Dr. Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also in Pediatrics. Her area of specialization includes the pediatric disorders cerebral palsy and spina bifida.   In this second part of the interview, Dr. Gold continues her discussion on the medically complex nature of pediatric patients with cerebral palsy and spina bifida; transition from care in the pediatric setting to adult health care; adequacy of  transition guidelines; preparation of patients and their parents at Rusk to achieve a successful transition; and the role of medical homes in the transition process.

Dr. Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also in Pediatrics. Her area of specialization includes the pediatric disorders cerebral palsy and spina bifida.   In this interview, Dr. Gold discusses the medically complex nature of pediatric patients with cerebral palsy and spina bifida; transition from care in the pediatric setting to adult health care; adequacy of  transition guidelines; preparation of patients and their parents at Rusk to achieve a successful transition; and the role of medical homes in the transition process.    

This interview is with a panel of three Rusk leaders: Dr. Tamara Bushnik, Dr. Brian Im, and Michelle Smith.  Dr. Tamara Bushnik is an Associate Professor and Director of Inter-Hospital Research and Knowledge Translation at Rusk Rehabilitation. She is  is the Project Director of the current RuskTraumatic Brain Injury Model Systems (TBIMS) at NYU. She has over 50 peer-reviewed manuscripts since joining the project. She has been the Chair of the TBIMS Knowledge Translation Committee since 1999 and has led the selection of topics for the popular traumatic brain injury Fact Sheets and end-of-grant-cycle special issues/sections highlighting TBIMS research. Dr. Brian Im is the director of brain injury rehabilitation at Rusk where he treats both inpatients and outpatients in the brain injury rehabilitation program. He is heavily involved in program development and academic medicine. He is the program director for the ACGME accredited brain injury medicine fellowship at NYU School of Medicine, has an active role in TBI research, and in the TBIMS projects. His research focus of interest is in studying the health care disparities and differences that exist in TBI care for different populations.  Michelle Smith is an Assistant Research Scientist where she manages day-to-day activities of studies, including the TBIMS National Database. She has a professional background and interests in health communications with the goal of providing vital information to patients to help improve their health through increasing health literacy. Prior to her current role, she managed the development and implementation of  research studies to improve health in the underserved community of Harlem by developing and maintaining a website and a randomized-controlled trial to reduce hypertension.   During the interview, the three discuss: treatment of older patients who sustained a traumatic brain injury; interventions necessary when patients' health literacy levels are low; addressing patients’ treatment preferences when they have different beliefs about the nature of health problems; and how patients' level of emotional functioning can affect treatment outcomes.

This interview is a continuation of a panel discussion on TBI. This is the second of a two-part series featuring Dr. Prin Amorapanth and Dr. Brian Im. Dr. Prin Amorapanth is a clinical instructor and a member of the research faculty at Rusk. His  fellowship at NYU Langone Health focuses on brain injury medicine. His current research interests include identifying markers of visuospatial impairment following acquired brain injury as well as the use of non-invasive brain stimulation as both a therapeutic and investigational tool for maximizing rehabilitation and better understanding mechanisms of recovery following brain injury. He is certified by the American Board of Physical Medicine & Rehabilitation. His medical degree and PhD are from the University of Pennsylvania. He completed his residency training in rehabilitation medicine at the Rehabilitation Institute of Chicago. Dr. Brian Im is Associate Director of Brain Injury Rehabilitation at Rusk. He also is program director for the ACGME-accredited brain injury medicine fellowship at NYU School of Medicine.  Following medical school at SUNY, Syracuse, rehabilitation residency at NYU School of Medicine/Rusk Rehabilitation, and fellowship in BI rehabilitation medicine at UMDNJ/Johnson Rehabilitation Institute, his subsequent 5-year tenure at NYU Bellevue Hospital focused upon an interest in improving brain injury rehabilitation for underserved populations.  He has an active role in TBI research at NYU and the TBI Model Systems Project at Rusk Rehabilitation, specifically as co-director of the Bellevue program.  His primary research interest is in disparities in TBI health care for different U.S. populations.  In Part 2, the discussion includes: kinds of tests employed to assess patient emotions and the possibility of the results being compromised; differences between male and female athletes in TBI injuries; key rehabilitation research topics involving TBI where it would be beneficial to conduct more investigations; and changes that may occur as more patient care services  occur mostly outside the hospital setting

This interview is a continuation of a panel discussion on TBI. This is the first of a two-part series featuring Dr. Prin Amorapanth and Dr. Brian Im. Dr. Prin Amorapanth is a clinical instructor and a member of the research faculty at Rusk. His  fellowship at NYU Langone Health focuses on brain injury medicine. His current research interests include identifying markers of visuospatial impairment following acquired brain injury as well as the use of non-invasive brain stimulation as both a therapeutic and investigational tool for maximizing rehabilitation and better understanding mechanisms of recovery following brain injury. He is certified by the American Board of Physical Medicine & Rehabilitation. His medical degree and PhD are from the University of Pennsylvania. He completed his residency training in rehabilitation medicine at the Rehabilitation Institute of Chicago. Dr. Brian Im is Associate Director of Brain Injury Rehabilitation at Rusk. He also is program director for the ACGME-accredited brain injury medicine fellowship at NYU School of Medicine.  Following medical school at SUNY, Syracuse, rehabilitation residency at NYU School of Medicine/Rusk Rehabilitation, and fellowship in BI rehabilitation medicine at UMDNJ/Johnson Rehabilitation Institute, his subsequent 5-year tenure at NYU Bellevue Hospital focused upon an interest in improving brain injury rehabilitation for underserved populations.  He has an active role in TBI research at NYU and the TBI Model Systems Project at Rusk Rehabilitation, specifically as co-director of the Bellevue program.  His primary research interest is in disparities in TBI health care for different U.S. populations.  In Part 1, the discussion includes: whether different patterns of outcomes occur upon discharge of different racial and ethnic TBI patients from inpatient rehabilitation facilities; challenges involved in predicting the degree of cognitive, motor, and psychological recovery and the timeline of such recovery after sustaining a TBI; diagnostic tools to explore chronic traumatic encephalopathy pathophysiology; progress being made in identifying suitable biomarkers; kinds of emotional impairment among TBI patients; and the usefulness of incorporating patient self-reports in assessments of their emotional state.    

This episode is part two of a panel discussion on TBI with Dr. Steven Flanagan and Dr. Erika Trovato. Dr. Steven Flanagan is Director of the Rusk Rehabilitation Institute. He is highly recognized, nationally and internationally, as one of the leading experts in the area of brain injury rehabilitation. He serves on numerous medical advisory boards, including the Brain Trauma Foundation and is a peer reviewer for several scientific journals. He currently is chairperson of the Medical Education Committee and sits on the Board of Governors of the American Academy of Physical Medicine and Rehabilitation Medicine. The author of numerous chapters and peer-reviewed publications, he has received awards from several organizations and been continually listed as one of America’s Top Doctors by Castle Connolly. Dr. Erika Trovato recently completed her fellowship in Traumatic Brain Injury Rehabilitation at Rusk. She obtained her medical degree from New York College of Osteopathic Medicine and completed her residency in Physical Medicine and Rehabilitation at Rusk Rehabilitation before beginning her fellowship. Her current research interest involves sleep dysfunction after traumatic brain injury. She has accepted a TBI attending physician position at Burke Rehabilitation in White Plains, NY and will begin working there in October 2017.  In this interview, the two discuss: how to deal with situations when a patient’s resilience and positive willingness to want to participate actively in all aspects of rehabilitation are not present; long-term motor dysfunction and movement disorders in the kinds of research being conducted; progress being made in the incorporation of advances in technology to patient care; availability of prognostic tools to predict and define outcomes after a TBI; ways in which the rehabilitation of TBI patients could benefit from the development of more innovations of a non-technology nature; breaking bad news to patients and their family members about reduced chances for significant recovery; and kinds of interventions effective in dealing with fatigue.

This episode is part of a panel discussion on TBI with Dr. Steven Flanagan and Dr. Erika Trovato. Dr. Steven Flanagan is Director of the Rusk Rehabilitation Institute. He is highly recognized, nationally and internationally, as one of the leading experts in the area of brain injury rehabilitation. He serves on numerous medical advisory boards, including the Brain Trauma Foundation and is a peer reviewer for several scientific journals. He currently is chairperson of the Medical Education Committee and sits on the Board of Governors of the American Academy of Physical Medicine and Rehabilitation Medicine. The author of numerous chapters and peer-reviewed publications, he has received awards from several organizations and been continually listed as one of America’s Top Doctors by Castle Connolly. Dr. Erika Trovato recently completed her fellowship in Traumatic Brain Injury Rehabilitation at Rusk. She obtained her medical degree from New York College of Osteopathic Medicine and completed her residency in Physical Medicine and Rehabilitation at Rusk Rehabilitation before beginning her fellowship. Her current research interest involves sleep dysfunction after traumatic brain injury. She has accepted a TBI attending physician position at Burke Rehabilitation in White Plains, NY and will begin working there in October 2017.  In this interview, the two discuss: the TBI Model System at Rusk; activities undertaken in the Rusk Fellowship Program; advice for incoming Rusk Fellows; when a patient is ill, how decisions are made regarding which different kinds of therapy should commence and when;​ and use of family caregivers to assist in the pain assessment of TBI patients.  

Samantha Muscato is a clinical specialist in pediatric occupational therapy acute care at Rusk Rehabilitation, where she has been for nine years. She has worked in all pediatric rehabilitation departments including: outpatient, the former preschool program, inpatient acute rehabilitation, and acute care. Her experience includes assessing needs regarding assistive technology, seating and mobility, splinting, as well as standard occupational therapy assessment of fine motor, visual motor, sensory processing, cognitive skills, and activities of daily living. Her current work primarily is in the neonatal intensive care unit, the congenital cardiovascular care unit, and the acute care unit providing feeding therapy to infants born prematurely and babies with complex medical/surgical histories. Her Bachelor’s and a Master’s degree in Occupational therapy are from D’Youville College in Buffalo, NY. She has taken certification courses for Kinesiotaping, neonatal oral motor assessment scale, and she is a Certified Lactation Counselor. In this interview, Samantha discusses: the ages of her patients and the kinds of conditions they have that necessitate the provision of occupational therapy services; feeding therapy to infants born prematurely and babies with complex medical and surgical histories; what specifically distinguishes the work of an occupational therapist in the pediatric intensive care unit; whether certification is necessary for an occupational therapist to work in that unit; tools for conducting assessments; occupational therapy strategies employed when addressing the complex health care needs of children at different ages; the role of assistive technology; mentoring and training new pediatric occupational therapists for all aspects of acute care; and developing programs and providing education for staff in other health professions.    

Nettie Capasso is an inpatient occupational therapy supervisor at Rusk Rehabilitation, NYU Langone Medical Center. She has presented at national and international conferences including the American Occupational Therapy Association, the International Seating Symposium, and the Rehabilitation and the Engineering and Assistive Technology Society of North America. She was a co-investigator for the Impact of Stroke prevention Education in Changing Stroke Risk Behaviors research study at Rusk from 2005-2009.  Her publications include Optimizing motor planning and performance for individuals with neurological disorders, in the 7th edition of the textbook, Occupational Therapy for Physical Dysfunction. She is certified in both the Neuro-Integrative Functional Rehabilitation And Habilitation treatment, and the A-ONE assessment of cognitive/perceptual impairment in adults with brain injury. Holder of a Master’s degree in Occupational Therapy from New York University, her Bachelor’s degree in Clinical Nutrition is from Hunter College, City University of New York.   In this interview, she discusses an update on an earlier study called the Development and Preliminary Reliability of the Functional Upper Extremity Levels (FUEL) that is useful in treating stroke patients regarding the tool's reliability and validity, educational approaches to change stroke risk behaviors, the role of neurofeedback therapy for stroke/brain injury patients, the role of occupational therapy in addressing needs of stroke patients who want to continue being employed, and how to prioritize other needs of stroke patients, such as self-care and wanting to fulfill social roles with family members.

Dr. Dallas Kingsbury is accredited in sports medicine by the Accreditation Council for Graduate Medical Education as an instructor in the Rusk Rehabilitation department at NYU Langone Medical Center. He has an interest in interventional sports and regenerative medicine and has had the unique experience of working with the performing arts, aerial acrobatics, and flying trapeze communities. It also is worth mentioning that he is particular adept himself as a man in the flying trapeze. Dr. Kingsbury combines his interest in treating patients with an involvement in clinical research pertaining to osteoarthritis, knee injections, and the treatment of chronic tendon problems. His medical degree is from the University of Medicine & Dentistry and he did his residency at the Icahn School of Medicine at Mount Sinai, Rehabilitation Medicine.   In this interview, Dr. Kingsbury discusses the kinds of patients he treats for musculoskeletal conditions, reasons for patient delays in seeking​ treatment, patient resilience and willingness to participate actively in all aspects of rehabilitation, role of being overweight plays in onset of musculoskeletal health problems, how outcomes are affected by time between occurrence of injury and provision of treatment, smartphone usage as a cause of musculoskeletal problems, and translation of clinical research to bed site care.

Dr. Greg Sweeney is the Program Manager of the Joan and Joel Smilow Cardiac Prevention & Rehabilitation Center at Rusk Rehabilitation. He has close to 20 years of experience in cardiopulmonary rehabilitation, spanning a continuum of care that includes acute care, inpatient rehabilitation, home care, and outpatient settings. He is an American Physical Therapy Association board-certified cardiopulmonary clinical specialist. A Past President of the New York State Chapter of the American Association of Cardiovascular and Pulmonary Rehabilitation Program, he has a strong interest in research related to the population with cardiopulmonary disorders. He has produced several publications, including a book chapter and peer-reviewed journal articles. His bachelor’s degree is from Manhattan College. He has a Master's Degree in Physical Therapy from Long Island University and his doctorate in physical therapy is from the University of Scranton.   In this interview, Greg discusses settings where cardiopulmonary rehabilitation is provided, the role of physical therapy in cardiopulmonary rehabilitation, types of patients treated, tests involving cardiorespiratory fitness used to aid in a determination of the most effective physical therapy forms of treatment to employ, special challenges involved in treating patients who have implanted left-ventricular assistive devices, responding to situations where a patient may be concerned about the safety of engaging in a program involving physical activity, and key topics in rehabilitation research pertaining to physical therapy aspects of cardiopulmonary care.

Mary Fischer is a clinical specialist in acute care at NYU Langone Medical Center. She is a board-certified Geriatric clinical specialist with over 25 years of experience in acute care, inpatient rehabilitation, outpatient, and home care therapy. Along with making presentations on geriatric topics at multiple Physical Therapy Conferences and the American Delirium Society Conference, in October 2016, Rusk Rehabilitation hosted a day-long event called: "Comprehensive Examination and Treatment of the Patient with Delirium: An Interprofessional and Evidence Based Approach" in which she was a content planner and faculty member. Some of her other important activities include serving as the principle investigator for a research project on fall risk assessment in acute care and being a member of the post-operative delirium prevention committee. She has a master’s degree in physical therapy from Columbia University and a doctorate from Stony Brook University. Prior Rusk podcast interviews that she participated in with Dr. Kristine Josef were posted on iTunes on May 18 and May 25, 2016. In Part 2, the discussion includes how delirium can be triggered in the intensive care setting by sleep deprivation/disturbance, non-pharmacological interventions to treat delirium, long-term consequences such as mental health problems, the role of falls in causing delirium, and future activities involving delirium in which she plans to engage.

Mary Fischer is a clinical specialist in acute care at NYU Langone Medical Center. She is a board-certified Geriatric clinical specialist with over 25 years of experience in acute care, inpatient rehabilitation, outpatient, and home care therapy. Along with making presentations on geriatric topics at multiple Physical Therapy Conferences and the American Delirium Society Conference, in October 2016, Rusk Rehabilitation hosted a day-long event called: "Comprehensive Examination and Treatment of the Patient with Delirium: An Interprofessional and Evidence Based Approach" in which she was a content planner and faculty member. Some of her other important activities include serving as the principle investigator for a research project on fall risk assessment in acute care and being a member of the post-operative delirium prevention committee. She has a master’s degree in physical therapy from Columbia University and a doctorate from Stony Brook University. Prior Rusk podcast interviews that she participated in with Dr. Kristine Josef were posted on iTunes on May 18 and May 25, 2016. In Part 1, the discussion includes symptoms of delirium, length of delirium episodes, predisposing/precipitating risks for the onset of delirium, and how physical therapists are involved in recognizing and preventing delirium.

November 2017 episode discussing the Las Vegas shooting, rehabilitation traumatology, Stronger - the rehab-focused Boston Marathon bombing film, and how firearm TBI survivors differ with Dr. Hilary Bertisch of Rusk Rehabilitation at NYU Langone Health. RehabCast is part of the national conversation in PM&R and Rehabilitation Medicine, brought to you by the Archives of Physical Medicine & Rehabilitation - tune in!

Dr. JR Rizzo is a board-certified physician specializing in Physical Medicine and Rehabilitation. He is a researcher at NYU Langone Medical Center and is well versed in exercise physiology and the interplay between physical ailments and medical diseases. Dr. Rizzo received a Bachelor's degree in Neuroscience from New York University and went on to receive an M.D. from New York Medical College, before starting residency training in Physical Medicine and Rehabilitation at Rusk Rehabilitation at NYU. Dr. Rizzo is also an entrepreneur, launching his company, TNT, in 2013. TNT offers multiple products designed to improve the lives of those with vision deficiencies and to promote better awareness for a myriad of other stakeholders. TNT was recently featured in leading publication Crain's and JR was named a Top 40 under 40 for NY's Rising Stars.In this interview, Dr. Rizzo provides us with a glimpse of what TNT will offer the future of health and the backbone of his amazing patented sixth-sense technology including the underpinnings of the Google Driverless Car technology. Firefighters, police, military personnel, and those with neurological disorders could all benefit from this, well worth the listen! Dr. Rizzo also shares personal stories and reflections that are inspirational.