I love having conversations that shift my perspective. I don’t even have to initially disagree with someone for it to be a meaningful experience. It’s simply the gift of being given a window into someone else’s world that I enjoy so much. That’s exactly the kind of conversation I had on a recent episode of my podcast with Dr. Steven Kirshblum. When it came to the optimization of spinal cord injury care, I thought the way forward was through research, innovation, and technique alone. I was unaware that one of the biggest challenges for better SCI care is access. Spinal cord injury patients have to deal with the denial of specialty spinal cord injury rehabilitation care, significantly shortened lengths of stay, and the denial of needed equipment and adaptive devices on a regular basis. Dr. Kirshblum believes that there are three key reasons why spinal cord injury patients need specialized spinal cord injury care.
General versus specialized rehab
A big step to optimizing SCI care is recognizing the a difference between general rehabilitation and rehabilitation specialized for spinal cord injury. Hospitals are typically eager to move patients quickly without truly understanding their needs. This isn’t intentional, but it’s often the outcome in a system that desperately needs better spinal cord injury care integration.
The first way that better integrating specialized SCI care into the medical system will improve patient outcomes is through specialized training. Spinal cord injury medicine is an approved ACGME subspecialty meaning that medical professionals with these credentials are best trained to make critical patient treatment decisions. Not that primary care physicians are inessential to the healing process, but they may lack the experience and training to put their patients on the best path to success.
The power of patient-specific care
The second reason we need better access to specialized SCI care is that specialized rehab centers are typically better at diagnosing issues related to spinal cord injury. Spinal cord nurses, recovery therapists, psychologists, and neuropsychologists all play an important role in the overall patient outcome. It’s an unparalleled level of staff, experience, and expertise that general rehabs just can’t provide. There is also the issue of misdiagnosed and undiagnosed complications that typically stem from traumatic spinal cord injury. For instance, a car accident that damages the spine could also damage the brain but not necessarily show brain damage on an MRI or CAT scan. Specialty centers are trained to notice manifestations of brain injury early so that patients get the quickest and most effective care.
Finally, specialized SCI care is so important because large specialized centers provide peer support through large peer groups. Dr. Kirshblum highlights the fact that he can just walk out of the exam room. ASpinal cord injury is not as personal for him as it is for his patients. He can tell them all there is to know about neurogenic bowel and bladder or spasticity neurogenic pain, but when they hear from a patient, from a person who’s lived it and lives with it, and how they were able to overcome some of the deficits, it means so much more! I love what Dr. Kirshblum is doing and I can’t wait to see how he continues to optimize care for spinal cord injury patients.