Podcast | Episode 9: Physical Medicine & Rehabilitation with Dr. Kerry Maher and Dr. Parag Shah

Podcast Transcript

Michele Orallo: Welcome to the Brooks Rehabilitation Podcast. My name’s Michele Orallo.

Tracy Davis: And my name is Tracy Davis. This week we had on two of our PM&R physicians. And just so that you know, before we get into the rest of the podcast, PM&R is physical medicine and rehabilitation. And we had on Dr. Kerry Maher, she is a medical director of our admissions, and she’s also the VP of our PM&R consulting, which we get into some of a lot of the consulting within the podcast. And then we had on the medical director of our stroke program, Dr. Parag Shah.

Michele Orallo: We had great discussion about what made them become a PM&R physician. What it’s like to earn the title of a doctor and the importance of PM&R perspective within the acute care setting.

Tracy Davis: Before we get into the episode, be sure that you subscribe to the podcast. We haven’t really nailed that home a whole lot in the previous podcasts, but we’d really appreciate it if you would subscribe and leave us a rating on whatever platform it is that you listen. I think most people listen to us on Apple podcasts. So, it’s really easy to leave a star rating on there. And please follow us on social media to keep up to date with all the amazing things that we have going on. You can follow us on Instagram, Facebook, Twitter, LinkedIn, YouTube, just by looking for @BrooksRehab. And we will come up, be sure to follow us also on Brooksrehab.org. Check in there, we have a lot of blogs and updates of things that are happening from around the organization on a weekly basis. If you’d like to send us a message, a question, comment, any feedback, please send it to [email protected]. Let’s get right into the episode.

Dr. Kerry Maher: I’m Kerry Maher and I’ve been at Brooks for 15 years and I am the medical director of the admissions throughout our system here at Brooks and vice-president of consulting.

Tracy Davis: Hi, this Dr. Shah, I’ve been at Brooks about four years and I’m a medical director of our stroke program.

Tracy Davis: Let’s actually just start the podcast off by saying what a PM&R physician is, and then everything will kind of build off of that. So, you both can explain what that is from your perspective.

Dr. Kerry Maher: Well, a physical medicine and rehab physician to me is a physician that deals with function. So, it’s the medical needs of a disabled patient, excuse me, as well as the rehab needs of a patient. So, we are the physicians of function, the physicians of the disabled.

Dr. Parag Shah: Yeah, I agree. And a lot of times, especially in the inpatient care setting, you’re looking to help patients get back to a quality of life where they can get back to doing things that they used to do before their injuries. So, a lot of times I think we’re the bridge for these patients to get back to a life that they can enjoy.

Tracy Davis: What’s your history at Brooks? How did you start at Brooks and what were you doing when you first came?

Dr. Kerry Maher: Well, it’s kind of an interesting history. I actually interviewed for Dr. Shah’s position as the medical director of stroke. But when I was interviewing I said, “You know I really don’t want to do that. I’d much rather consult in the community and build the relationships and build those bridges with the acute care hospital so that they understand rehabilitation and would want their patients to come here at Brooks.” So, that’s what I’ve been doing for 15 years. I also love education. I like to lecture and really be able to inform people on what rehabilitation is. So, I’ve been able to do that throughout the whole entire state of Florida and the Southeast. And I’ve done some recent national presentations as well.

Dr. Parag Shah: So, for me, I wanted to move back close to home, grew up in Florida, and it really was meeting with Dr. Marla, Dr. Weiss and the Brooks culture that brought me to Brooks. I could tell that Brooks truly put the patient first and made their decisions regarding patient care around the patient, which was a nice to see. I came from the Midwest where I did my training and you could see a lot of medicine was becoming more financial related, budget related. And sometimes you could see that patients were not always at the front of everyone’s mind when they’re making decisions.

Tracy Davis: Mm-hmm (affirmative). It’s kind of like with some, the whole debate with for-profit not-for-profit for healthcare systems, that kind of thing. Yeah.

Michele Orallo: Why did you choose to become a PM&R physician?

Dr. Parag Shah: In high school and then medical school I tore my ACL, the right leg in 2002 and the left leg in 2008. And I really could tell how big of a difference the quality of rehab, the intensity of rehab can make on one’s recovery, 100% feeling confident in your abilities. And getting back to what was once normal social interaction takes time. Sometimes you can feel different. You can feel out of place when you have various disabilities. And I felt that being able to give what I was given with my rehab too, our community and our patients can have a tremendous impact on feeling normal, essentially getting back to the things that they want to do at that. Bring them joy.

Tracy Davis: Sure.

Dr. Parag Shah: Yeah.

Tracy Davis: Yeah. What about you?

Dr. Kerry Maher: Well, for me, I originally started in about the eighth grade being very interested in walking and how people learn to walk again after an injury. So, I became a physical therapist that was my first love and worked for three years in an acute care hospital as a physical therapist.

Tracy Davis: I did not know that. That’s great.

Dr. Kerry Maher: So, my exposure to rehab medicine was at this 2000 bed, acute care hospital, and really enjoyed the physical therapy side of it on the burn unit and other units that I got to rotate on, I became more and more interested in the medical side. And how did the patients get here and how are they evaluated in the emergency room and what surgeries did they have? So, instead of going on for a further education or a masters in physical therapy, I really decided that becoming a physiatrist and going into medicine would be the best both worlds for me. It really allowed me to marry the rehabilitation as a physical therapist with the medical side of becoming a physician. So, I went full steam ahead and never looked back and I’ve made the right decision for myself.

Tracy Davis: Sure. It’s always interesting to hear the why you became whatever you chose to become for your career. Because sometimes it’s like that where you get to see where you get to make a difference, for both of you it was kind of like that, but then you also had personal experiences. And we’ve heard that a lot with some PTs, why did they want to become a PT because maybe they got injured a lot. They did athletics and they got to work with physical therapists, getting them back to health. And so it’s always very interesting to hear how people become what they did. So, let’s go back just a little bit. Where did you guys go to school?

Dr. Kerry Maher: For physical therapy, I went to the Medical College of Georgia and then took a three year hiatus, took some prerequisites for medical school, went back to the Medical College of Georgia. Did my internship there as well. And then I did my residency at the Rehab Institute of Chicago, which is part of Northwestern, which has been renamed Shirley Ryan.

Tracy Davis: Oh, okay. I love Chicago.

Dr. Kerry Maher: Yeah. Northwestern is wonderful.

Tracy Davis: Mm-hmm (affirmative).

Dr. Parag Shah: Yeah, I did undergrad at University of Florida, go gators, medical school at St. George’s University and a residency at Wayne State University.

Tracy Davis: Wow. So, many gators of…

Dr. Kerry Maher: I know.

Tracy Davis: From the top down, yeah. That’s funny. So, explain a little bit about, because it’s a little different, everyone has an idea of doctors and family practice doctors and ER doctors and all that kind of thing. And everyone always talks about the school and the time that it takes. So, what is the education process, the timeline for becoming a PM&R physician? And it can be different for the two of you, I’m sure but-

Dr. Parag Shah: Typically, you would say about four years, undergrad, four years medical school and four years residency.

Tracy Davis: Okay.

Dr. Parag Shah: That’s what you said typically. For myself, I did a master of accounting, so I had an extra year of undergrad.

Dr. Kerry Maher: Yeah. That’s I would say the same thing. Some of the other things that you could do after you finish your residency, you could do a year of spinal cord injury medicine. So, that would be an additional year or fifth year. You could do a year of spasticity or a year at TBI fellowship or a sports medicine fellowship. And that’s not uncommon.

Tracy Davis: Okay.

Dr. Kerry Maher: I trained with people that also doubled, majored I guess you could say, or have their internists as well as PM&R physicians. I worked with somebody that had that and it just broadens your scope to do that. So…

Tracy Davis: What did you learn on your residency fellowships? That’s a long period of time. So, what did you guys learn that it kind of helps set your direction of what you were looking for? Or is it more set at that point as to what you want your final job to be?

Dr. Parag Shah: You get a general overview of rehab medicine. So, inpatient setting, outpatient setting, sports medicine, pain management, and then a lot of the neurological disorders like spinal cord injury, brain injury stroke. And then depending on your care setting, you might be managing a lot of those diagnoses here at Brooks because we’re more programmatic. We have physicians that manage just one program, for example, a stroke program, brain injury program or spinal cord injury program.

Dr. Kerry Maher: Yeah. I would agree with that as well. I’m a little bit older than Dr. Shah. So, I finished my residency and decided to do academics first. So, I joined the academic faculty for eight years. I really enjoyed that a lot. I enjoyed the teaching of residents and fellows. In PM&R, I did a little bit of everything. I did skilled nursing, I did sports medicine for eight years. I did dance medicine. I actually did consults and I had outpatient clinics. So, I kind of did a little bit of everything in my first eight years before coming to Brooks.

And then coming to Brooks for 15 years I was really able to broaden my horizons by really getting into the community even more since this is not an academic institution, but more of a private institution, even though we’re becoming more and more academic because we teach nursing students and physical therapy students and eventually one day have a residency. But one of the things I really loved about Brooks is it truly has a culture of kindness and that the patient is first. And that’s what really drew me to Brooks. You see it on your first day here.

Tracy Davis: Sure. With PM&R physicians what are the types that you can end up at? I’m sure there’s inpatient, outpatient and the different specialties and stuff like that. So, what are the different physician types for that?

Dr. Parag Shah: Most popular would be outpatient care settings. So, usually you’re hearing sports medicine or pain management. But then you can have like a general rehab physician that kind of does everything, inpatient and outpatient. And at Brooks we have quite a few PM&R physicians who do inpatient care setting and a skilled care setting. So, … and the university … And then myself and Dr. Maher we also do consults at acute care hospitals. So, we’ll see patients at acute care facilities, help with plan of care, guidelines, recommendations, things like that.

Tracy Davis: Okay. So, that kind of leads us into the main topic here is, what is important about the perspective of PM&R physician in acute care? What should acute care know before they send a patient off to Brooks or another rehab facility? What should they be considering?

Dr. Kerry Maher: If they have a PM&R physician, they really should utilize the PM&R physician in the ICU or on the floors. It’s very different than just the therapist approach to the patient. For us, it’s the medical and rehabilitative approach to the patient. Sometimes when I and Dr. Shah walk into the ICU, we’re really the visionary for that patient. We’re seeing them intubated in the ICU, diagnosed with spinal cord injury, but I’m already thinking of one week later, one month later, six months later, a year later. Every patient I go into I already have a game plan of what they’re going to be like when they’re out of the ICU, at Brooks and then in adaptive sports. And I think that’s important. They do a phenomenal job in the intensive care units, as trauma surgeons, ICU intensivists, neurointensivist, saving their lives and minimizing the effects of what has occurred to these patients like traumatic brain injury and spinal cord injury and major multiple trauma. But we have a very unique perspective of seeing beyond the ICU.

So, for me, it’s medically managing them, making sure they’re on the correct meds for that traumatic brain injury, but also early mobilization and getting those patients out of bed, no excuses. There’d better be a really good reason as to why a patient is not moving. As human beings were not meant to lay down, we’re meant to move. And that’s so important. And that’s a culture that you have to really change in the intensive care unit. We have a strong focus on that. And we’re already physicians that work in teams, interdisciplinary teams. So, we try to take that interdisciplinary approach as much as possible to the acute care hospital.

Tracy Davis: Mm-hmm (affirmative).

Dr. Parag Shah: Yeah, I think that was a tremendous answer.

Dr. Kerry Maher: Thank you, Dr. Shah.

Dr. Parag Shah: Of course. So, Dr. Maher is my mentor. I greatly appreciate everything that you’ve done for me and brought me to where I am today. The acute care setting, a lot of times I’m doing the exact same things that Dr. Maher is describing. And I see that we’re talking with patients’ families to kind of give some insight as to what to expect over the next few months. What are the options as far as care?

Tracy Davis: That must be very relieving to the family and patient to have someone like you there because obviously the acute care is doing their job for why the patient is there. And I would imagine a lot of acute care employees, they don’t get to really see what happens after. Whereas when we when we get them in our system, we’re kind of seeing more of kind of what they’re going to be and where they’re going to end up-ish. But having someone like you there, giving them comfort at least, because I’m sure there’re all these things floating in their head. They’re not sure what’s next, what’s going to be the process after this? How are we going to get them to get back to being who they were before this, whatever the accident or injury was?

Dr. Parag Shah: Yeah. I mean, I usually do see some relief just having those simple conversations, that there is a plan and that there’s a team, a rehab team in our setting with Brooks that manages this type of diagnosis, this type of injury every day. And we have a lot of options available. I think that brings a lot of comfort to patients and families, and then educating providers in acute care settings as to what Brooks can provide for their patients in our multiple different care settings. I think that has tremendous value. And I enjoy every bit of it.

Tracy Davis: So whenever you guys are there consulting, is this just consulting because they are going to become a Brooks patient or is that not even been determined yet? Or are these hospitals just using you guys to kind of help set the course of action for these people or how does that work?

Dr. Kerry Maher: That’s actually a good question. A lot of times people think that we’re just there because every patient’s going to Brooks, but actually we’re physicians first. So, we’ll be consulted because we are a rehab physician and they want that perspective to look at the patient and then we’ll help them medically and also figure out what’s the best suited post-acute site to handle these patients and really kind of help the families figure that out. Because they’re pretty overwhelmed in the acute care hospital with their 25 year old son or their 58 year old wife, or their 75 year old grandmother. They’re pretty overwhelmed and most people don’t understand rehabilitation unless you’re kind of thrown in the middle of it.

So, you really do have to help them through that. We do also handle a lot of team conferences, which usually incorporates the family, getting the family at the bedside, kind of figuring out who’s going to be kind of the leader of the family for the injured patient or loved one. And trying to set up accurate expectations for the care in rehabilitation. I think that’s important as well. And then like Dr. Shah said, giving them a game plan, giving them an idea of what to expect. Sometimes doing that in and of itself decreases the stress for a lot of families.

Tracy Davis: Mm-hmm (affirmative). I can imagine. Yeah.

Dr. Parag Shah: Yeah. I think it helps them have a much better experience. And you hear a lot of times in healthcare now, patient experience. So, I think when the Brooks team in general, all of our providers, our nurse liaisons throughout the entire organization communicate well with the acute care providers and any of the patients providers for that matter. I think they have a much better experience and they feel much more at ease. In the acute care setting, the goal with this communication and coordination of care is that if all the medical needs for a patient are addressed prior to coming to rehab, patients can focus on the rehab once they get there. And that’s really going to help jumpstart their recovery.

And so that’s why that coordination, sometimes you’re trying to work on because in the acute care setting, there’s usually some pressure as far as patient length of stay and they need to discharge. And when we get both of those goals in line getting patients discharged in a timely manner to help acute care setting’s length of stay, but also get patients ready for rehab, they have a much better outcome, much better experience and their feedback to acute care setting and the Brooks rehab setting typically is remarkable.

Tracy Davis: Yeah. That’s great. That’s all very interesting. Is there anything else that you want people to know about the PM&R perspective for acute care, any kind of final thoughts?

Dr. Parag Shah: The PM&R physician usually will have the most information as far as what’s going to be the best care plan for a patient. And I think that’s important to make sure that this patient gets into the right care setting. Because of the way the insurances work in our current healthcare system, if they don’t get to the right care setting, it really could impact their ability to have a remarkable or miraculous recovery. And that’s where getting that opinion from a PM&R physician can make a difference or else you might see in some care settings that it could be a case manager driving discharge, which most of the time might work out but sometimes having that a physician’s opinion can have a tremendous impact.

Tracy Davis: Mm-hmm (affirmative). True.

Dr. Kerry Maher: I agree with Dr. Shah with that. Also, it’s extremely important to know that we’re interacting with the patient and family, but we’re interacting every time we’re in the ICU with the trauma surgeons and the physicians involved with these patients and showing them the rehab perspective which they don’t ever get to see. So, a lot of times what I try to do, and I know Dr. Shah does this as well we try to bring back stories of their patients who have recovered and how well that they are doing. So, that means an awful lot to those physicians.

Also we interact with the physical therapists, the ICU nurses, the case managers, and bring the stories back of how well a traumatic brain injury may have emerged from a disorder of consciousness. They love to hear that because they’ve dealt with these patients for two weeks in the ICU. They got them extubated and then they’re wondering how did they do, did they walk again? Did they talk to their loved ones again? Did they go home? And so when you’re able to bring back little snippets of how the patient did it fuels them to do better, even the next time.

Tracy Davis: Because they’re probably thinking, did the things I did here matter after they left our care? Yeah. I’m sure-

Dr. Kerry Maher: I’ve heard nurses actually say that, like “I know I helped save their life and I’ve took care of them in ICU, but I always wondered, did they ever go home and interact with their families?” So, if you could bring that back, it’s really wonderful. Dr. Shah and I have both been lucky enough to be involved in what we call a heroes event. That’s with one of our trauma hospitals here, where they honor all of the trauma staff that is taken care of a trauma patient. But not only do they honor the acute care staff, but they also honor the rehabilitation staff here at Brooks that also helped with the care-

Tracy Davis: That’s great.

Dr. Kerry Maher: …getting that patient back to their-

Tracy Davis: The full circle.

Dr. Kerry Maher: … lives. So, that’s been a wonderful and rewarding experience to be part of that.

Dr. Parag Shah: Yeah. It really has. And it’s been excellent working alongside Dr. Maher. Recently we’ve been trying to-

Dr. Kerry Maher: Dr. Shah is easy to work with. He’s wonderful.

Dr. Parag Shah: Thanks. But yeah, we’ve been trying to help improve coordination of care and communication with some of our acute care providers. So, we try to attend their conferences, their lectures. We’ll go to meet them at their acute care site to have a brief meeting, just to talk about how are patients doing? What can we do better to help a patient outcomes? And sometimes they’ll also come to Brooks. And I think that’s really made a big difference having that relationship, making sure we’re on the same page to meet the patient’s needs. It’s been exciting.

Dr. Kerry Maher: Yeah. We have really good acute care hospital relationships. Each acute care hospital is very different in the Jacksonville market. And not only do we encourage students to come and train and shadow and see what we do here, but we tell families to come and tour Brooks. We have physicians, new physicians come and tour Brooks, training physicians. Because if you can see what goes on here and feel the energy at Brooks, you’re sold that this is where you want your patients to come. And it’s palpable.

Tracy Davis: And I’m sure that’s another benefit for you guys being in the hospitals like that, seeing “Hey, they worked at Brooks. I want to go there.” I’m sure it doesn’t hurt that, not that there’s specialty for inpatient. There’s not a lot of places around here they could go unless they traveled far. I’m sure it’s great for the Brooks brand itself, but also them seeing that you’re not selling Brooks at that time. You’re just selling future hope, possibilities, things like that.

Dr. Kerry Maher: Exactly.

Dr. Parag Shah: Yeah, it’s interesting. When we do have our acute care providers come tour Brooks, they all are impressed and amazed with how well organized Brooks is, the facilities, the quality of care that patients get and outcomes. I mean, it truly is-

Tracy Davis: I’m sure our system too. Seeing the full breadth of our whole system of care is probably impressive too, because there’s not a lot of places that do everything that we do especially in our area.

Dr. Parag Shah: Yeah.

Dr. Kerry Maher: And the recent opening of Helen’s House and the hospitality house has been a huge success and housing families while while their loved ones are here at Brooks or at one of our skilled sites, or are using our day treatment programs or neuro recovery center. I mean, that’s the best thing we could have ever done is provide housing not just for the families to just come across the street and participate, but also have that camaraderie amongst other families to share a common goal and to go through something very difficult together. People that are from very different walks of life. It’s really wonderful.

Tracy Davis: They never would have met otherwise, probably.

Dr. Kerry Maher: Correct.

Tracy Davis: I’m sure we’ll have Helen’s House on at some, at some point because it’s a great topic. But Helen’s House has been open for only a few years now. And for those that don’t know, it’s literally right across Beach Boulevard from our main inpatient and university crossing campus. And they can stay over there and it’s extremely affordable and they can stay as long as they need to and they keep coming over here to get care. Like you said, whether that’s in the neuro recovery center or inpatient or UC or whatever. So, that was great. That was very informative of everything you guys said. I just thought of something a little bit the more on the fun side. I thought of it after you guys were talking about college. What is it like after you’ve gone through, you said like 12 years worth of work and now you get the doctor title? What is that like to be able to say you’re Dr. Maher, Dr. Shah? Because most of us are never going to have that. So, what is that like?

Dr. Parag Shah: It’s interesting. The first time you hear it, it surprises you.

Tracy Davis: Like who’s that, that’s not me.

Dr. Parag Shah: Yeah. Yeah. I mean, when you complete all of your education and your practicing though, having the ownership for the patient where it’s your patient, the patient is admitted to your service. It’s really nice because essentially you’re the patient’s coach, right? Coaching them through their rehab and their recovery. You’re responsible for their care and their outcome is directly tied to the quality of care that you provide. So, it really is cool. It’s hard when you’re in medical school or in residency to feel that because you’re not the ultimate decision maker. Typically you have a physician who’s overseeing the patient and you’re assisting that physician.

Tracy Davis: You are still trying to earn your way.

Dr. Parag Shah: Yeah.

Tracy Davis: Yeah.

Dr. Parag Shah: Yeah. So, when the patient’s your patient, it’s a world of a difference. And you hear a lot you while you’re in training how medicine has become paperwork heavy or administrative heavy or how difficult insurances can be. But once you start practicing and you’re able to do it on your own without someone that has to co-sign all your notes, for example, it really is exciting. And it’s well worth it.

Dr. Kerry Maher: I agree. It’s very exciting. I tell people like my children, when I finished high school going on to medical training is like starting at kindergarten all over again and ending 12 years later. And most of the time I go, “Oh, I don’t think I ever want to do that.” So, now I have a daughter who’s actually applying to medical school. So, I’m very excited about that. But it’s a real honor to be a physician and it’s a privilege to be able to have a very intimate relationship with a patient when they’re going through probably one of the most difficult struggles in their life.

So, you just know when you hear the word doctor that you have an education behind you, you have a training behind you and you hope that you can bring all of that forward along with some of your own personal experiences, maybe what you’ve gone through with your own family’s health issues. And you kind of put that all together and hopefully that’s acceptable to the patient on the other side. Most of the time I would say it is. If you’re respectful of them, they’re very respectful and open to you.

Tracy Davis: Yeah, that’s great. I’ve always wondered what that was like.

Dr. Kerry Maher: I like that question.

Tracy Davis: Yeah.

Dr. Kerry Maher: That was a really good question.

Michele Orallo: How has rehabilitation changed and what excites you about the future?

Dr. Kerry Maher: I would say rehabilitation has changed as there’s much more technology now in rehabilitation. So, it’s not just the patient and the physician and the patient and the therapist. There’s a lot of robotics and technology that we can use to augment the experience here in rehabilitation. And I think that’s a good thing so that if a therapist can only do 40 repetitions, but for neuro recovery, we need 4,000 and a machine can do that or a technology can do that, or a robot can do that. Then that’s really helpful to the patient because we still have ongoing research for neuro recovery and we don’t have the absolute script of exactly how much frequency intensity we need. So, until then to me more is better and get it earlier rather than later.

Tracy Davis: Mm-hmm (affirmative).

Dr. Parag Shah: Yeah. That’s, that’s excellent. It is exciting to see how technology can impact patients in rehab. Particularly recently we’ve had a Cyberdyne. I think it’s also interesting to see how in healthcare in general, the community is becoming more aware of how important rehabilitation is and their patient’s outcomes and quality of life. Now you can hear the term is prehabilitation. So, it’s really cool to see how far the field is coming and where it’s headed.

Tracy Davis: What would prehabilitation be? What does that mean exactly?

Dr. Parag Shah: So, for example, if you know that a patient could be having a procedure or a treatment that could knock them down that typically is known to decrease their ability to function, that you try to get them to a spot that they’re a little bit better than where they would have been potentially, so that after the procedure, they’re in a little bit better shape.

Tracy Davis: Okay. So that can be expected that something’s coming, so like, “Let me see what I can do now to make my recovery better.”

Dr. Parag Shah: Yeah. For example, let’s say somebody was going to have like a transplant or chemotherapy and you know that this is potentially going to bring them down a few levels. Then you might try to get them stronger mentally, physically work on their endurance. So, post-treatment, they’re in a little bit better spot to help with their outcome quality of life. And really those are the important things. If get back to things we enjoy and improve our experience in life, that’s important.

Dr. Kerry Maher: Because we also know that patients who are very athletic and work out and they’re in their seventies, and then they have a major multiple trauma or a stroke. Those patients who have really have been very athletic before do very well after. So, we have some experience with it to some patients are already like exercise and do their part even before they became hurt.

Tracy Davis: So, that’s obviously something you would recommend. People just stay active, stay, moving, eat healthy all these kinds of things. Because from what I’m getting just personally is, you never know what’s to come in the future and we can’t control a lot of that kind of stuff, but we can control our health as far as exercise and what we eat and all those kinds of things. And it could benefit us greatly in the future.

Dr. Kerry Maher: Absolutely.

Dr. Parag Shah: Yeah. It’s interesting. I was listening to a talk on Warren Buffett where he’s talking to a bunch of elementary school kids and he’s telling them, if you can pick one car, any car, what car would it be? And then his catch was essentially, you get one body your entire life. So, right. You got to take care of that body. And that’s why these things are important. Diet, exercise our mental strength, all of that. But yeah, that that’s exactly it. And every day we should try to do the best we can.

Dr. Kerry Maher: Very true.

Tracy Davis: So, just this final question, what excites you guys the most, every day coming into work? What makes you the most excited to drive in?

Dr. Parag Shah: For me, it’s just being a part of Brooks. I think it’s an amazing system. I think we have excellent leadership. People at Brooks want to work at Brooks. You always have positive comments and feedback from patients about how wonderful and caring their team is. So, to me that’s exciting. It’s a place that I want to be a place I want to work and a place I want to grow with.

Dr. Kerry Maher: For me, waking up in the morning and coming to work is trying to learn something new every day. I think we learn from our patients, we learn from people that work around us. Doesn’t have to be another physician. It could be nursing, it could be the person who’s cleaning the room. It doesn’t matter. You can learn from everyone. I like people of different cultures, I enjoy that. I’m a people person, so I enjoy being around others. As far as my position here at Brooks, I’m very passionate about access to care. I think it’s very important that people are given a choice, but they’re given the correct choice and on educated what is in their community and that they have access to the right rehabilitation. I think that’s very, very important. And another thing that really interests me is education too.

Medical students in particular, who, depending on whether or not they have a physical medicine and rehab program, a part of their university that they’re attending medical school, they may not know anything about the specialty. And I think that’s sad. Where I went to medical school, we didn’t have the specialty. So, I had to learn it on my own, but with my physical therapy background, it wasn’t too far away. But I think that that’s very important is educating the next generation of physicians.

Tracy Davis: That’s great. And final, final question. So, that was my pre-final question. Final question. What’s, and you don’t have to go to the whole depth or say any names or anything like that, but what’s a Brook success story that always sticks out in your mind? And I’m sure you have many, but what’s one that you can always think of?

Dr. Parag Shah: There was a patient that I had private in the first year of starting at Brooks rehab. Came from Orlando and had a tremendous family support. And I think just seeing every day that the patient was getting better. And some of these patients, they have devastating injuries. And when you see that patient getting better every day, the family members seeing their potential. And then they actually, I guess you could say, get close to where they were before or they see that they can still enjoy life knowing that they still have limited function when compared to where they were before. It’s rewarding to see that patients and their loved ones they’re happy and they’re able to do what they want to do with their time.

Dr. Kerry Maher: For me, it was a patient who had traumatic brain injury and was on the intensive care unit, very bad brain injury. There was definitely a disorder of consciousness and the father at the bedside. Very limited insurance plan. We explained everything to him, but the dad said, “No, we’re gonna give it the best shot we can now.” And the patient came to Brooks and slowly but surely improved. That’s before we had a complete system of care here at Brooks. So, he had to leave our system and then come back into it after his inpatient stay at Brooks, but he utilized our home health our outpatient our day treatment program. And I think his next goal is to move out on his own. It’s been a good 12 years since injury. He gets better and better each year. And he had an amazing family and they never gave up and this patient never gave up. And he’s doing extremely well. And I still get emails. I still say hello to the patient as he comes into the neuro recovery center. I still keep up with the father and he’s one of my happiest stories.

Tracy Davis: And I know we have many stories like that at Brooks, in the system. So, I don’t want to take any more of your time. Is there any other things you guys want people to know about PM&R and what you guys do and from the acute care side or anything we might’ve missed or… I think we covered some great stuff. I thought it was really good.

Dr. Parag Shah: Yeah. I think from acute care standpoint, if your loved one or family members in a hospital setting, just try to do your own research, look at the information that’s being provided to you, but also do your own research. And if you have time, tour the facilities that are available to make sure that’s a care setting that you and your family members or friends will be happy in.

Dr. Kerry Maher: Yeah. Ask the case manager who will visit you, do you have a physical medicine and rehab physician, demand a referral or demand to consult? Like Dr. Shah said, research the area to see what inpatient rehab facilities or hospitals are present and ask that you meet with one of their liaisons.

Dr. Parag Shah: I guess that’s pretty empowering to know what, I think I’ve never had to go to the hospital for me or any family members for anything traumatic, but knowing what power you have to ask, things like that. Do you have a PM&R physician we can consult with? Instead of just letting the hospital kind of take you down whatever track that they have planned for you, but you kind of knowing what you should be asking. That’s probably very empowering.

Dr. Kerry Maher: Yeah. That’s very important for your own care.

Tracy Davis: Great. Thank you guys. Thank you.

Dr. Kerry Maher: Thank you.

Dr. Parag Shah: Thank you.

Dr. Kerry Maher: Dr. Shah and I are the bomb.

Tracy Davis: That’s right. You did great.

Dr. Kerry Maher: Did we really?

Tracy Davis: Yeah.