Seven years in the making, UF College of Medicine inaugurated its department of physical medicine and rehabilitation and residency program July 1.
The department of PM&R became UF College of Medicine’s first new clinical department — a group of researchers, administrators and clinicians who support each other to achieve a specific mission — in 30 years. However, its journey began in September 2014, Dr. Kevin Vincent, the founding chair, said.
The role of PM&R is to help people transition back into work, their home environment and their social setting, Vincent, who is also the medical director of the UF Sports Performance Center and the director of the UF Running Medicine Clinic, said. If necessary, physicians also work with the patient’s family to reincorporate them into their home.
Physicians specializing in PM&R look at the whole musculoskeletal and nervous systems and how they work together to make a patient as functional as possible, Vincent said. Patients could have a traumatic brain injury, a spinal cord injury or a sports injury, among other things.
“We look at the entire body, and that’s what makes us different,” Vincent said.
In 2020, Newsweek ranked the UF Health Rehab Hospital as No. 1 in Florida. Vincent said they hope to build a top-10 PM&R department in the future.
“We’re number one in Florida,” he said. “Now, we want to take over the rest of the Southeast and then the country.”
As of now, the department is home to 11 faculty members, five staff members and four advanced practice providers (APPs), according to a UF Health article. Its residency program is made up of four first-year residents and four second-year residents.
Currently, there are six different sites where patients are treated, according to the department’s website. The department is looking for new sites as well, specifically in Jacksonville and The Villages, Vincent said.
The program first began as a division in orthopedics, but while the physicians were good at taking care of musculoskeletal and sports injuries, there wasn’t anywhere for patients with other needs to go, Vincent said. No one knew how to start a new clinical department, he said. Even now, they’re learning as they go.
“We’re just trying to build the plane and fly it at the same time,” he said. “At least we’re up in the air now.”
Going forward, Vincent said they want to increase the number of faculty across locations, giving them the ability to care for more people across multiple diagnoses. Over the next five years, Vincent will recruit more faculty to expand the program further. The department currently has the residency component and wants to increase fellowships.
The impact on UF College of Medicine, Vincent said, is that physicians with a wide range of capabilities can train not only the people in their specialty but also those crossing over into other areas.
Rather than just looking at a specific diagnosis, the clinical department will teach how the whole system integrates together, Vincent said.
“It exposes people to a broader way of thinking about people as more than just their diagnosis,” Vincent said.
Two years ago, Dr. Carolyn Geis, the service chief for stroke and brain injury rehabilitation and associate professor in the department of orthopedics and rehabilitation, was hired to be part of the department. She came to UF because of the opportunity to develop a new department and training program, as well as to partner with excellent researchers.
“I really have felt that sense of collaboration in developing — for what I was tasked to do — a brand new service,” Geis said. “Stroke and brain injury were really brand new when I started two years ago, and I found a lot of great partners and that’s been really a lot of fun.”
Care for stroke patients begins in the hospital, Geis said. The physiatrist helps to see what would be the best next step for the patient, she said. They practice a continuum of care model from the time the patient comes to the hospital until they can function at their maximum level, she said.
“That's really always our goal is to get people home with their family and doing those things that are meaningful for them,” Geis said.
Physiatrists are experts in taking care of people with these types of injuries from a nonsurgical standpoint, she said.
Two other important missions of the department are education, including training their residents, and excellence in research, Geis said.
“There’s lots of exciting things going on as far as research in not only musculoskeletal areas but for motion analysis — how to get people to move better after injury,” she said.
Regarding research goals, Dr. Heather Vincent, the director of the UF Health Sports Performance Center and director of the Human Performance Laboratory, wrote in an email that they’re working to discover the most efficient patient-focused methods to help individuals reach their highest levels of function or performance.
“We are the team that provides expertise in exercise and physical activity and effects on patient functional outcomes,” Dr. Heather Vincent wrote. “As medicine moves toward patient engagement with self care, PMR is well poised to serve in this role on collaborative research efforts.”
The faculty are working to determine which patients respond best to different exercise programs, comprehensive therapeutic interventions for serious conditions and procedural interventions for pain.
Dr. Irene Estores, the medical director of the Integrative Medicine Program at UF, said PM&R has come into its own by supporting the needs of faculty in their own areas. For instance, they work closely with neurosurgeons and neurologists to maximize the outcomes of their patients.
When the department of physical medicine and rehabilitation was launched, it became the new academic home of the Integrative Medicine Program, Estores said.
In her field of integrative medicine, the practitioner and the patient are partners in healing, addressing the environmental, social, spiritual, emotional, mental and physical influences on a person’s health, according to the website. Whenever possible, natural and less invasive interventions are used as treatments.
With the formation of the Integrative Medicine Program, their vision was to transform health care, supporting the patient in their journey to wholeness in spirit, mind and body, Estores said. The goal is the same for PM&R, she said, which works to restore physical function and optimal health in patients.
Previously, Estores worked as a faculty member of the department of rehabilitation medicine at the University of Miami. There, her practice was in spinal cord injury, where patients would experience chronic pain. Because it’s difficult to treat, Estores took an interest in acupuncture and other non-drug treatments.
After completing her fellowship at the Andrew Weil Center for Integrative Medicine, UF recruited Estores to develop the Integrative Medicine Program in 2013.
“With the development of the department of physical medicine and rehabilitation, it was really a natural next step for the Integrative Medicine Program because the concept of physiatry is inherently integrative,” she said.
Contact Juliana Ferrie at jferrie@alligator.org. Follow her on Twitter @juliana_f616.
Juliana Ferrie is a second-year UF journalism student. She is excited to be working for The Alligator as the Santa Fe Beat reporter. In her free time, you can find her reading or listening to music.
