![]() Department of Physical Medicine and Rehabilitation |
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Faculty
Affiliated Hospitals Spinal Cord
Injury
4th Year Extramural Elective |
Long Beach Memorial Medical Center (LBMMC) is an 816-bed, voluntary, nonprofit facility encompassing four separate hospitals: Memorial Hospital of Long Beach, the Earl and Lorraine Miller Children's Hospital, the Women's Hospital and Memorial Rehabilitation Hospital. The Department of Rehabilitation serves in- and outpatients of all four hospitals and maintains a total of 84 beds in the Rehabilitation Hospital: 42 acute rehabilitation beds and 42 skilled nursing facility (SNF) beds. The Medical Director of the Service is a board-certified physiatrist who is assisted by 4 other physiatrists. There are 90 employees, including staff in Physical Therapy, Occupational Therapy, Speech Pathology, Audiology, Psychology, Recreational Therapy, Program Case Management, Nursing, Liaison services, clerical and other supportive personnel. Administration is comprised of an administrator, 4 therapy managers, a clinical director of nursing and 2 nurse managers. In addition to the usual PM&R diagnostic and therapeutic procedures, specialized interdisciplinary programs are offered in stroke and brain injury, spinal cord injury, and orthopedics. The Stroke Program and Head Trauma Program is under the leadership of a physiatrist, and consists of a special team of therapists. The Spinal Cord Injury Program is under the leadership of a physiatrist who has an interest in the rehabilitation of SCI patients. The Spine Pain Program accepts patients for evaluation and management of chronic back pain. All patients are evaluated by the physiatrist, a family practitioner, a neurologist, and an orthopedist, as well as by staff in Physical Therapy, Occupational Therapy, Psychology, and Rehabilitation Counseling. The first week is one of evaluation, and at the end of the week a special multidisciplinary intake conference is held to determine if the program might be of help to the patient. If accepted into the program, weekly conferences are held with progress and completion of the pro-gram determined at these conferences. The average length of stay is 3-4 weeks. The Pain Center has been developed for the evaluation of patients with chronic pain not necessarily related to the musculoskeletal system. After initial evaluation by a physiatrist and selected physicians from all disciplines interested in the management of pain (e.g., neurology, psychiatry, anesthesiology, orthopedics, neurosurgery), a multidisciplinary conference discusses each case and appropriate management plans are developed and implemented. In addition to the special programs, there is one general rehabilitation team headed by a physiatrist also. The team treats patients in need of comprehensive rehabilitation who do not fit into one of the above special programs (e.g., patients with Guillian-Barre syndrome, multiple trauma). The Department of Rehabilitation accepts patients from MMC and outside hospitals for inpatient rehabilitation. The physiatrists are responsible for the PM&R management of 50 to 60 inpatients (35 to 40 on the Rehab bed service, and 15 to 20 on medicine, surgery, pediatrics, etc.) at any one time. Residents rotating through MRH spend time on each of these programs. The resident, working with an attending physician, is the initial point of contact with each new patient. The resident performs a PM&R evaluation, presents the case to the attending physician, and, after discussion, orders the appropriate evaluations and therapies as needed. Residents make daily resident rounds and present patients at the appropriate rehabilitation conference. In addition, the resident and attending physician make joint rounds on all patients regularly. There is, thus, time to provide in-depth, one-on-one teaching for all types of patients seen on the inpatient service. Residents at Memorial provide the physiatric management of patients in Miller's Children's Hospital who have acquired physical disabilities. The pediatric physiatrist supervises the resident. Residents are encouraged to attend various conferences held in the Continuing Education Center that may be pertinent to their training. |