Evo Terra (Host): It's always good to get to know the person behind the doctor, so we're excited to get to know Dr. Rebecca Shappley, leader of the Complex Care Program for Le BonHeur Children's Hospital. I'm Evo Terra. Dr. Shappley, welcome.

Rebekah Shappley, MD, FAAP: Thank you.

Host: So let's start with the question I think a lot of people want to know about their doctors. Why did you choose to go into medicine?

Rebekah Shappley, MD, FAAP: Well, that's a funny story. So I, I thought I wanted to be an engineer, and I very, very quickly learned that that wasn't the right place for me. So then I did a 180 and I changed my plan to teaching and spent a little time doing, and actually majored in child development. Very quickly realized that teaching was very, very difficult. But I do love children and I do love science and I do love serving others. So put those together and here we are.

Host: Great. What kind of engineering major were you?

Rebekah Shappley, MD, FAAP: Chemical engineering.

My dad was a chemical engineer, and I worked with him some when I was in college, and really enjoyed it, and thought that that was my path, but didn't enjoy it when it got down to it.

Host: Right, right. You said you loved kids that you were teaching for a while. What grade level? My wife was a middle school teacher for the majority of her life, so I'm always curious to meet teachers to ask them two questions. What grade did you teach and what is wrong with you? But you've already answered the what is wrong with you question. So what grade did you teach?

Rebekah Shappley, MD, FAAP: Well, you know, I actually got through a lot of the degree for child development and when I had to do my practicals for teaching and working in a classroom I recognized that a room full of children is very challenging and I did better one on one. So I never actually taught outside of being the student teacher, but I, um, quickly realized that I was better one on one.

Host: Yeah, every time my wife asked me to do something or asked me to do something with her students when she was teaching, it was remember, you're the one that likes these children. I, not, certainly I like kids, but yeah, in that many, that's too many. That's just way too many children. I understand it, I understand it.

So, interesting, did you consider pediatrics for a while, possibly?

Rebekah Shappley, MD, FAAP: When I went through med school, I loved everything. But I kept coming back to, I love the kids and, and the truth of the matter is you can do any sort of medicine just about, and do pediatrics. And so, because I loved everything, I knew that I wanted to be a physician who took care of the whole body and not necessarily specializing in one particular organ system. So that's how we ended up in my current role.

Host: Well, let's talk a little bit about that role and the hospital you're at. You're with Le BonHeur's Children's Hospital. When did you start there and what all have you done at Le BonHeur's?

Rebekah Shappley, MD, FAAP: So, I came here in 2009 for my critical care fellowship and actually worked here for a while and actually worked with one of the local groups in town as a general pediatrician, came back and was faculty here in the ICU, where I was medical director of the intermediate care unit, where a lot of children have technology dependence and medical complexity. And, I was drawn into some conversations about how we can best care for children with medical complexity and technology dependence in our community. And given my experience doing both primary care and in critical care, doing the technology dependent care in the intermediate care unit, I jumped at the opportunity to build something for kids.

Host: Let's talk about that. I mean, you've brought up this idea. I know you're the leader of the Complex Care Program. I get critical care. I think I get intermediate care. What is complex care all about?

Rebekah Shappley, MD, FAAP: That's a great question. So, about 5 percent of the population of children, so it's actually a huge number of children who have some degree of medical complexity, and that's going to be children who have two or more specialists, and kind of multi system disease, and so it's really a large part of pediatric patients who have complex disease. So, the focus of the complex care program is really going to be on those children who have neurologic deficits, of some sort, and, often have or are at risk for technology dependence. So you're thinking children with cerebral palsy, so children with genetic syndromes, feeding tubes, tracheostomies, that kind of population.

These children use a lot of resources, and our system isn't always designed to meet their needs well, for a variety of reasons. And so we've designed this program to hopefully meet the needs of children and their families in a more comprehensive way with closer doctor patient relationships, nursing patient, case manager relationships. So hopefully, uh, we are achieving that.

Host: Well, I, clearly your past history of your engineering and your love of science background and kids, clearly you need the synthesis of all things together. And I think that's what you're doing there at the Complex Care Program. So how is it going and how are you measuring success?

Rebekah Shappley, MD, FAAP: Oh, that's a great question. You know, the challenges that you anticipate sometimes are the ones that are there, and then there's sometimes challenges that you don't anticipate. We have met our initial goals of incorporating certain populations into our program. And we've gone ahead, we've added a second physician and, half time nurse practitioner. We're still struggling to find the right balance of nursing, staffing, and that kind of thing, which is a challenge I think in every industry right now in 2024.

So that's our, our areas for growth right now. We are looking at resource utilization and our initial preliminary data does actually show a very significant reduction in hospital days upon entry into our population and it does show that children are staying out of the ICU and staying out of the ER and staying out of the critical care units, the ICUs and IMCUs on program entry.

So we're very encouraged by that and look forward to more years of seeing the effectiveness of our program.

Host: I think I want to ask a question that may sound a little weird, so bear with me. How much of Dr. Rebeka h Shappley went into this complex care program. Is, does this match up with your own personal philosophy of care and treatment?

Rebekah Shappley, MD, FAAP: Oh, it does. I just really enjoy having a little bit more time to think about the multi-system processes going on that affect kids, and not just the medicine side of it, but the social side, there's so much that these families and children need to be successful and thrive, to their fullest extent in the community.

That's always our goal, right? For every child to thrive in their, in their community as best they can. And, having fewer patients allows me to spend more time with each child and family and to really think through the processes and get to know the families and see how we can best support them.

Host: Those are all important things and more time you can spend with someone to do better for them, especially if they've got complex challenges. I'll end with this question. Tell me what you love most about working with Le BonHeur Children's Hospital.

Rebekah Shappley, MD, FAAP: Oh, the people, the community here. You know, there's a group of us here who just really have a heart for Memphis and the Mid South. You know, I'm a native Southerner, so I, I love, this community. And we've been here now for 15 years and I thoroughly enjoy the people I work with and the families and the passion that comes from Le BonHeur that's growing this hospital to serve our community better.

Host: Well, Dr. Shappley, we have enjoyed getting to know you a bit better and want to thank you very much for your time. And viewers, you can learn more about Dr. Shappley and the Complex Care Program at lebonheur.org. That is L-E-B-O-N-H-E-U-R.org Thanks for watching!