What is your hometown?

Rancho Palos Verdes, a suburb outside of Los Angeles, CA.

When did you join the UI faculty?

In 2000, after I finished my residency in Physical Medicine and Rehabilitation at the Mayo Clinic.

How/when did you become interested in science and medicine?

I was accepted to a combined undergraduate and medical school program at Brown University after finishing high school. I was always interested in science and medicine so I chose to study Biomedical Engineering as an undergraduate.  That naturally led me to medical school where I found the nerves similar to electrical wires, the muscles similar to rubber bands, and the joints similar to mechanical hinges.

What interested you to pursue a career in Physical Medicine and Rehabilitation?

I guess the approach of treating the whole person and not just a diseased organ made a lot of sense to me. In physical medicine and rehabilitation, we see patients who have various nerve, bone, or muscle diseases. Regardless of their diagnosis, most patients with these conditions may have trouble walking, exercising, working, playing sports or doing other things in their lives. Therefore, I can help patients who have simple ankle sprains, or back pain as well as complicated spinal cord injuries, brain injuries, strokes, or even amputations.

Is there a teacher or mentor who helped shape your career?

I worked with Dr. John Parziale, a physiatrist at Brown University School of Medicine, and he laid the foundations of physical medicine and rehabilitation in my education.

How or why did you choose the UI?

Dr. Joseph Buckwalter and Dr. Reginald Cooper were instrumental in recruiting me to UI. They gave me the support and opportunity to introduce UI to a specialty of medicine previously known very little in Iowa. I was the first physiatrist (fiz-e-a-trist) at the University. Most other academic medical centers have a large Department of Physical Medicine and Rehabilitation with 20-50 active faculty. While I doubt we’ll ever have that many physiatry faculty, I also love the ability to work with amazing faculty in one of the best Orthopaedic Surgery Departments in the country.

What kinds of professional opportunities or advantages does being a faculty member at Iowa provide? What about challenges?

The opportunities in physical medicine and rehabilitation are nearly endless. I can develop a practice focusing on back pain, musculoskeletal conditions, spinal cord injury, stroke, amputee rehabilitation, or anything else that I’m interested in. The main challenge is that many physicians and patients don’t exactly know what a physiatrist does and think of seeing either a physical therapist or orthopaedic surgeon for their initial musculoskeletal problem. A physiatrist can offer a whole range of diagnostic options including ordering x-rays, bloodwork, MRI, EMGs or other medical tests, as well as a full range of treatment options; not only referrals to physical therapy but also medication management, specialized joint injections, or various bracing alternatives.

Please describe your professional interests.

I like seeing patients with chronic pain because usually there is some abnormal physiology as well as some interesting psychology at play. I also like trying to think about medical practice management and good ways to improve the delivery of musculoskeletal and rehabilitation care.

What are some of your outside interests?

I’ve always liked cars and driving. I’ve attended a few driving events sponsored by a local car club near Chicago. I drive my own car after it’s been safety-checked, and instructors teach me how to take the fastest line on a specially-paved closed race course. It burns off a lot of brakes pads, gas, tires, and more importantly, stress.

Do you have an insight or philosophy that guides you in your professional work?

As a rehabilitation physician, I see many patients who could benefit from our holistic approach to disease and chronic medical conditions. I see medicine not just being about technicians performing a procedure, but doctors educating and counseling patients about what their options are and how to get back to leading active lives.

If you could change one thing about the world (or the world of medicine), what would it be?

In the world of medicine today, too much emphasis has been placed on what procedures physicians can do to a patient rather than the more time-consuming and often under-appreciated counseling and education that patients need about their choices. Too many people are looking for the quick pill or the quick fix.  There is too much emphasis on expensive medical or surgical procedures and not enough emphasis on healthy living, diet, and exercise.  Many of my chronic pain patients would be “cured” if they understood and followed a better diet and exercise program and left surgeries for clear indications where surgery is expected to fix the disease process, which is often not the case in chronic pain.

What is the biggest change you've experienced in your field since you were a student?

Medicine is constantly changing. We’re learning more about how the brain, the spinal cord, and muscles can fix themselves. We still have much to learn before we know how to intervene in the complicated processes involving repairing, regenerating, and reprogramming the brain, spinal cord nerves, and muscles.

What one piece of advice you would give to today's students?

Today’s medical students should be aware that as medicine advances, there will be more and more people living longer with chronic diseases and conditions.  Rehabilitation will become even more important in integrating those people back into society so that they can lead active and productive lives in society.

What do you see as "the future" of medicine?

I think the future of medicine will incorporate the interdisciplinary team approach that we use at the UI Spine Center. We have a team of specialists working with the physicians including physical therapy, psychology, vocational counseling, nursing, and social work. Patients with chronic or complex medical problems appreciate that they have not only one physician caring for them but a whole team of health care providers all who have differing areas of expertise.

Some patients will need physical therapy to get moving, others may need psychology to help manage stress or learn how to manage their condition, others may need help getting back to work or finding community resources that can help them manage their chronic conditions so that they can participate in their daily activities. 

It would be wrong to think of medicine as only a narrow set of specialized technical skills that physicians learn to fix a person’s condition. The future of medicine should include help from physician assistants, nurse practitioners, and physical therapists who can help manage many of the common medical or musculoskeletal conditions that the majority of the population will experience.  However, they will also need physicians to help manage the more complicated or unusual medical conditions. We should all work as a team of specialists because we are learning that the impact of medical disease is more far-reaching than just biology or chemistry. Patients will get the most from the medical care system if those treating them are all on the same page communicating and sharing in their education and treatment.

In what ways are you engaged with the greater Iowa public?

I’m President of the Iowa Academy of Physical Medicine and Rehabilitation, the state medical society for physiatrists. We encourage and teach medical students to learn more about this specialty which will be even more important as Iowans age and want to remain active. I also do lectures to the public and hold conferences on various topics such as back pain, spine injuries, and other musculoskeletal conditions.