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Volume 5 / Issue 2 / February 2013

PM&R - The journal of injury, function, and rehabilitation

Few Spots Remain for MarchMusculoskeletal Ultrasound Course

Diagnostic and Interventional MusculoskeletalUltrasound of the Upper ExtremityMarch 22–24, 2013Oquendo Center, Las Vegas, NVCourse Director: Jonathan Finnoff, DO

Attend this course to learn how to perform musculoskel-etal ultrasonographic examinations and ultrasound-guidedinterventional procedures on the shoulder, elbow, wrist, andhand. Plus:

● Earn up to 21 AMA PRA Category 1 Credits™.● Gain 16 hours of hands-on, advanced-level diagnostic

scanning using live subjects and interventional procedureson upper extremity cadaveric specimens.

● Experience 10 dynamic demonstrations and lectures re-lated to diagnostic and interventional musculoskeletal ul-trasound.

● Enjoy three bonus lectures to teach you how to code forultrasound-guided procedures, market for referrals, andpurchase the best musculoskeletal ultrasound machine foryour practice.

● Reconnect with course faculty and get your questionsanswered with a postcourse conference call after you re-turn home and integrate your refined skills into yourpractice.

A few spots are still available for this course. Visitww.aapmr.org to learn more about this course and to

egister today.

Academy Launches Leadership Program

AAPM&R’s Board of Governors is keenly aware of the valu-able role played by the growing number of Academy mem-bers who give time and energy volunteering to supportAcademy initiatives that serve to advance education, advo-cacy, and awareness of the specialty.

The board established a Volunteer Task Force in 2010 totake a closer look at how to recognize these outstandingmembers and how to recognize and cultivate the leaders oftomorrow. To that end, we are announcing an exciting newprogram: the Academy Leadership Program.

This prestigious program will debut in 2013. Its goal is toidentify a limited number of promising physiatrists in orderto help them develop the skills to prepare to assume futureleadership positions in the Academy and in the field of

physiatry.

The program requires applicants who demonstrate inter-est, energy, and commitment to become a volunteer leader.In return, the selected individuals will experience unprece-dented access to mentoring from AAPM&R’s Board of Gov-ernors and to the process of building Academy initiatives.The program will be best suited for Academy fellows who areearly-career physiatrists who have completed residencyand/or fellowship training, and have been in practice forroughly four to 10 years and who want to fill leadershippositions in the future, or those who may be ready to pursueleadership positions in midcareer.

Selected individuals will be taken through a two-yearcurriculum beginning in October 2013 that will introducethem to understanding the workings of an association: lead-ership, strategic planning, finances, collaborative problemsolving and decision making, media skills, advocacy, Acad-emy governance, products, and services. The curriculum willcombine facilitated sessions, reading assignments, peer dis-cussion, mentorship to help facilitate leadership skills devel-opment, and opportunities to participate in a committeeactivity. In return for this advanced level of training andmentorship, trainees will be expected to be committed andparticipatory (without being overwhelmed). It is estimatedthat a participant will need to commit two to three days peryear for the two-year program, plus approximately 25 hoursduring each of the two years in extracurricular activities—committee work, assigned reading, peer discussions, etc.

The task force felt that providing an educational pro-gram focusing on leadership training and developmentwould provide valuable skills to program participants asthey progress through their careers—and ultimately to theAcademy and to the specialty. It is anticipated that uponcompletion of the training program, participants will beassigned to a committee or task force.

The Academy is pleased to make this program availableand will be inviting all interested, engaged, qualified mem-bers to apply. For more information about how to apply,contact info@aapmr.org.

Physiatrists in Practice: Unique Models ofPatient Care for the Future

AAPM&R’s Public and Professional Awareness Committee isseeking members who are involved in a unique or innovativepractice model and would be willing to be interviewed toshare their experience. The information gathered from theseinterviews will document the value and diversity of the

specialty of PM&R and will help the Academy position the

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specialty within the future of the changing health care envi-ronment in regard to reimbursement, quality, and practicemanagement. Once information is gathered, it can be used toreach policymakers, consumers, and other stakeholders todescribe the value of the specialty. As the committee catalogsthe different ways our members are practicing, it will sharethat information with Academy members as a resource formembers considering a transition to a new practice model.

In the months ahead, the committee will share some of themember stories it collects. This month, the focus is on aunique practice model developed by Benton Giap, MD.

Member Profile: Benton Giap, MD

Q: Can you explain the model you initiated?A: While working at Kaiser Permanente, I saw an oppor-

tunity and made a case to start a physiatry consult service atthe Center for Neurosurgery/Neurosciences to assess themedical and rehabilitation needs of patients immediatelyfollowing surgeries and other interventions. Since many sur-geons/interventionalists are not as readily available as physia-trists, I believed that physiatrists could play an important rolein providing the leadership in this setting in coordination ofcare, managing appropriate use of resources and therapyservices, and determining the level of care by facilitating theflow through the continuum. For some of these patients, itmeans getting them to an acute rehabilitation hospital in amore efficient manner.

Q: How and why did you get involved with this modeland how successful has it been?

A: This model was implemented in an integrated deliveryealth care system. It was designed to integrate assessmentnd care coordination of patients to create a better flow ofatients across the continuum and between acute neurosur-ical, medical, and rehabilitation settings. I believe thathysiatry has an important role in early involvement in theehabilitation and recovery of a patient. Because of our train-ng and comfort of the various levels of care, rehabilitationhysicians can easily identify the care that is needed postsur-ery.

I participated in rounds in the neurointensive care unitnd also started rounds on the neuroscience unit three timeser week.

Patients, as well as families, are happier because there isomeone to guide them with appropriate information and

irectives, such as giving the OK as to when to get out of bed,

when a patient can start driving again, and when they canwalk up and down stairs. The leadership and guidance weprovide to the therapy staff is also important since this is amedically challenging population. In addition, we also play arole in working with patient care coordinators in anticipatingthe level of care needed. In this uncertain period following anacute neurological event, it is important that patients knowwhere and what they are supposed to do and what thefollowing phase of rehabilitation will be. We have been ableto reduce hospital stays in the neurosurgical and acute med-ical care setting by an average of 1.25 days using this model—the rate of savings at the time for an acute medical/surgicalbed was approximately $7,000 to $9,000 per day.

Q: Can this model be easily reproduced by otherphysiatrists and used for a specific diagnosis?

A: With health care reform implementation and the re-quirement for accountable care organizations to efficientlymanage quality, costs, and resources, the role of the physiatryconsulting model is important, not just for the neurologic-specific diagnoses, but also for other patient populations inour acute medical centers.

This model is alive and is sustainable; I recruited twoadditional physiatrists for this consulting service.

Q: How has this model impacted patient care, satisfac-tion, outcomes, and cost and time savings?

A: We have had a great, positive response to this model.The collaborative model across specialties is rewarding. Thismodel really highlights the value of a physiatry consult ser-vice (beyond determining whether someone meets the acuteinpatient rehab criteria). We could play an important role inimproving outcomes of using this model by reducing (poten-tial) medical complications of immobility and transitioningpatients to the appropriate level of care. There has also beena reduction in avoidable days spent in the hospital, whichleads to major cost savings. From the patients’ experienceperspective, we are able to interface with our patients andtheir families and improve the perception. There has beenimproved coordination and communication, improved utili-zation, better risk management, elimination of significantpractice variations, and cost containment.

If you are involved in a unique practice model,please share your story with the Academy. E-mailpracmod@aapmr.org and an Academy staff member

will contact you.