New Providers, New Clinic, New Offerings in Physical Medicine & Rehabilitation at UH
May 03, 2022
APPs join team; new outpatient clinic for neuro rehab at UH Bedford
UH Clinical Update | May 2022
Physical Medicine and Rehabilitation (PM&R) at University Hospitals is expanding both its staff and its treatment offerings so that more Northeast Ohio patients might benefit from this cutting-edge but sometimes less familiar specialty.
One important goal is to see patients earlier in the course of their illness or injury, when PM&R procedures and therapies can have the greatest initial impact in reducing pain and helping to restore function.
“We want to see patients sooner and more often,” says Michael Schaefer, MD, Division Chief of Physical Medicine & Rehabilitation at UH.
To accommodate more patients, Dr. Schaefer has recently added three Advanced Practice Providers (APPs) to the PM&R team. Physician Assistant Andrew Chervenak is seeing medical spine patients in conjunction with Orthopedics on the Westside, at Westlake, Broadview Heights, and Medina. Certified Nurse Practitioners Pamela Bryant and Marissa Harden are on board at the two UH rehabilitation hospitals, with Bryant working in Avon and Harden in Beachwood.
These are the first APPs in PM&R at UH, and Dr. Schaefer says they’re already making an impact.
“They allow the PM&R physicians to focus on the more complicated cases,” he says. “They also provide the important follow-up care after we do procedures.”
Another new development is the establishment of the first-ever fellowship in Spine/Musculoskeletal PM&R. Current UH senior resident Lisa Liceaga, DO, will begin the one-year program starting in July, with a special emphasis on musculoskeletal ultrasound and ultrasound-guided PM&R procedures. As an associate staff member, she will have her own clinic and procedure appointments. She will also complete rotations in spine surgery and other orthopedic subspecialties.
Perhaps the biggest change in PM&R at UH, however, is the new Resident Outpatient Clinic housed at UH Bedford Medical Center. It’s designed specifically to meet the needs of patients with neurological disabilities, most commonly those recovering from a stroke, who’ve been in an acute-care hospital or rehab hospital, but still need outpatient services and support. Dr. Schaefer estimates that about half of the patients in the UH rehab hospitals could benefit from this new clinic.
“We identified a need in the system for patients with neurological disabilities to get care from PM&R in the outpatient setting, particularly patients that were seen by us in the acute hospital on our consult services and at our acute rehabilitation hospitals,” he says. “So we found space at Bedford. We have our rehab physicians that usually staff the rehab hospitals working in clinics there.”
Services at the UH Bedford clinic include ongoing therapy supervision and managing patients’ equipment needs, as well as medication management for spasms, pain, and bladder and bowel function – services PM&R specialists are well-equipped to provide.
“In many ways, that takes the burden off the primary care provider and neurologists,” Dr. Schaefer says.
One important aspect of the new PM&R outpatient clinic is a Continuity Clinic, where PM&R residents provide follow-up care to many of the same patients they treated in one of the UH rehab hospitals.
“This is an important part of their education, to be able to see the real-time impact of the care they’re providing,” Dr. Schaefer says.
Even as it expands its staff and footprint at UH, PM&R also continues to offer its unique services and procedures for patients. Dr. Schaefer and his PM&R colleague Sarah Pastoriza, DO, offer injections of platelet-rich plasma (PRP) as well as prolotherapy injections as potential solutions for reducing pain and stimulating healing. Importantly, they have the advanced training and expertise to be able to deliver these injections a patient’s spine – something unique among PM&R providers in Northeast Ohio. In addition, Dr. Schaefer also has expertise in placing peripheral nerve stimulator implants for patients with post-stroke shoulder syndrome and who’ve suffered a nerve injury due to trauma. The small wire implant is inserted with a needle, and the stimulator device itself is external to the patient.
Other PM&R services include electromyography to diagnose carpal tunnel syndrome or pinched nerves in the spine and Botox injections for neuro rehab patients struggling with spasticity, such as those with multiple sclerosis, cerebral palsy or those recovering from a stroke.
Dr. Schaefer says he hopes all the news out of the department will cause UH providers to keep Physical Medicine & Rehabilitation top of mind as a helpful option for their patients.
“We have procedures and therapies that can help with pain and healing,” he says.