Could Your Patient Benefit from Physical Medicine and Rehabilitation?
January 27, 2020
UH Clinical Update | January 2020
New Division Chief aims to maximize these beneficial services for UH patients
Michael Schaefer, MD, is just about two months into his tenure as UH’s new Division Chief of Physical Medicine and Rehabilitation, with the division now headquartered within the Department of Orthopaedics. But already, he’s optimistic about what he sees here.
“UH has made a commitment to develop PM&R as a specialty and help it grow,” he says. “There are great resources in the two freestanding rehab hospitals in Avon and Beachwood and the existing rehab unit at UH Parma Medical Center. There’s excellent infrastructure for growth in inpatient rehab and outpatient services that can benefit from PM&R influence.”
Dr. Schaefer joins UH from Cleveland Clinic, where he practiced for nine years. He earned his medical degree at The Ohio State University College of Medicine and completed his residency training in physical medicine and rehabilitation at Mayo Clinic. In addition, he completed a sports medicine-physical medicine and rehabilitation fellowship, also at Mayo Clinic. After fellowship, he was briefly on the staff at Mayo Clinic and then worked at Cleveland’s MetroHealth Medical Center for six years.
PM&R leadership duties take up about 50 percent of Dr. Schaefer’s time, he says, with the remainder devoted to his practice at UH Westlake Health Center.
“My practice in particular is sports and musculoskeletal medicine,” he says. “My fellowship was in sports medicine, but I also do spine injection procedures, diagnostic ultrasounds and ultrasound-guided procedures.
One particular area of expertise for Dr. Schaefer is using ultrasound at the bedside to make a diagnosis and direct treatment.
“It’s an extension of the examination,” he says. “The clinical advantage is the speed, and it’s much less expensive than MRI and usually approved by insurance. Guiding procedures with ultrasound also dramatically improves the accuracy.”
As he gets started in his new role at UH, Dr. Schaefer says the priority is to maximize UH’s inpatient and neurologic rehabilitation services.
“We’ve already restarted the consult service, and we’re seeking more referrals for inpatient rehabilitation at our existing facilities,” Dr. Schaefer says. “Those patients are primarily stroke, complex neurological disease, neurodegenerative disorders, low-level spinal cord injuries, complex post-surgical cases (including spine and orthopedic), trauma cases and traumatic brain injury.”
“The other thing we see quite a bit of is general debility and cancer-related diagnoses,” he adds. “In general, these are patients who are too complex to go to a skilled nursing facility, and require much more intensive therapy services that only the rehab hospital is equipped to provide.. The good news is that they have a good prognosis for getting back to their home environment. A lot of these patients start improving rapidly in response to therapy. It’s very gratifying to see people come from severe disability to discharging to home.”
For physicians who are managing hospital inpatients, Dr. Schaefer recommends contacting him or his team to see whether a PM&R consult would be appropriate. There are currently nine PM&R specialists at UH and eight PM&R residents, rotating through the system.
“Having a PM&R consult gives them a more holistic view of their needs – their home environment and functioning and comorbidities a little bit more globally,” he says. “We can also provide the inpatient providers with tips on pain management, advise the OTs and PTs and help discuss discharge options. Being able to put some of the more complex patients into the rehab hospitals also reduces the length of stay in the acute hospital. And patient satisfaction in the inpatient rehab units is very high. They all participate in at least three hours of therapy services per day. That gives them a lot of attention and they can see that they’re making progress.”