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Extensivist Medicine At Summit Medical Group

If you have been hospitalized for a surgery, procedure, or an injury that leaves you with impairments, your doctor might recommend follow-up treatment in a rehabilitation center until you become strong enough to manage activities of daily living and be independent.

Our Extensivist Medicine team is comprised of board-certified physicians and nurse practitioners who are trained and experienced in geriatric medicine, internal medicine, family medicine, and rehabilitation medicine.

They help arrange the comprehensive care you need to regain your strength, lessen the time you must stay at the rehabilitation facility, return safely home, and prevent you from returning to the hospital.

Extensivist Medicine At Summit Medical Group
Featured Speaker:
Allen Khademi, MD
Director of Rehabilitative Medicine and Transition of Care Allen M. Khademi, MD, oversees the medical and rehabilitation needs of Summit Medical Group patients in post-acute and long-term care settings.
He is a member of the American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, American College of Physician Executives, and American Medical Rehabilitation Providers Association. He is the author or coauthor of articles and abstracts published in prestigious, peer-reviewed scientific journals, including New England Journal of Medicine, American Journal of Physical Medicine and Rehabilitation, and Journal of Trauma.

Learn more about Allen Khademi, MD

Learn more about Extensivist Medicine
Transcription:
Extensivist Medicine At Summit Medical Group

Melanie Cole (Host):  Summit Medical Group Extensivist Medicine Program can help you get the medical services and therapy you need after you’ve been hospitalized and when you can still benefit from care in a rehabilitation center. My guest today is Dr. Allen Khademi. He is the director of rehabilitative medicine and transition of care at Summit Medical Group. Welcome to the show, Dr. Khademi. Tell us, what is extensivist medicine? 

Dr. Allen Khademi (Guest):  Thank you, Melanie. Extensivist medicine refers to the providers at Summit Medical Group that are taking care of patients in rehabilitation settings after they have been hospitalized and are simply not doing well enough or feeling strong enough where they’re able to safely return home. 

Melanie:  It’s like a secondary care after hospitalization. Then where do they go? 

Dr. Khademi:  There’s a variety of different rehabilitation settings. Some are more intense than others. Collectively, they are called post-acute care. The hospital setting is referred to as acute care, but when a person’s ready to leave the hospital but just simply has ongoing physical and medical needs that require monitoring, they go to these rehabilitation settings where they need ongoing care. And we felt the need to be able to provide that care for our patient population to make sure that they receive an excellent quality experience. 

Melanie:  What a great quality of care. What do extensivists do? 

Dr. Khademi:  We oversee the medical and rehabilitative interventions in that setting. We do, of course, all the initial admission requirements and making sure that the patients are on the right medications and they stay on medications that were felt to be appropriate when they left the hospital. A lot of times, when there are new providers taking care of patients in the rehab setting who are not familiar at all with the patients, it’s an opportunity for mistakes or miscommunications to occur. We ensure that that isn’t the case because we are just simply following our patients who were previously being taken care of by our associates in the hospital setting. We oversee the rehabilitation program as well, and we work very closely with the therapists and nursing team to ensure that the patients are progressing well, both medically and physically, and achieving their goals in order to get home in a timely fashion.

Melanie:  You’re really the go-between, and what a great service that is because I know people get very nervous if they’re going to leave the hospital, thinking, “Where am I going to go?” or, “How am I going to coordinate all of this information?” How do you work with the patients’ families and then whatever rehabilitation center they’re going to be going to to discuss what it is that’s going to happen? People are unsure of what’s going to happen to them next. 

Dr. Khademi:  Certainly. Whenever possible, we even try to see these individuals before they even leave the hospital so that we can let them know as to the type of care and the providers that will be providing care for them in the rehabilitative settings that they choose to go to. We are able to communicate with our colleagues who took care of the patient in the hospital setting so that we know exactly what medical issues they had and what medications they were on and any adjustments that need to be made and what the goals are in preparation for getting the patient back home and what followup appointments they need. Because often, the followup appointment is something that ends up being missed or not clearly communicated, and the patients and their families aren’t clear as to what they need to do when they’re in the rehab setting, and even when they leave the rehab setting and go back home. We stay in very close communication with the patients and families, and we see these individuals three or four or sometimes even five days a week, if necessary, in order to make sure that their care is adequate, and also, their rehabilitative needs are being met. It also gives us the chance to answer any ongoing questions that they have and also to communicate to them what the entire rehab team is thinking about, when we think we can safely return them to home so that they can continue recovering from their own home. 

Melanie:  You’re with them all the way through, from when they’re going to be discharged from the hospital all the way through till they get home and even beyond. 

Dr. Khademi:  Absolutely, because at the time of discharge in the rehab setting, we, of course, arrange all of the necessary prescriptions and instructions that they would need in order to safely return home as well as any ongoing care that they would need in the home setting. Our care management team becomes informed that they’re going to be discharged to home. Our care management is then able to further assist the patient and their families once they’ve left the rehab facility, just in case there’s any new questions or issues that they need help with once they’re back at home. 

Melanie:  Dr. Khademi, let’s talk about one of the scariest parts of all of this—all of the insurance and medical records and coordinating all of this to make sure that all gets to the rehabilitation center and to the other doctors when they have followup appointments and dealing with the insurance companies. How do you help them with that? 

Dr. Khademi:  Certainly. Our care management team is participating in all of the insurance issues and nuances and authorizations that are necessary, and the rehab centers have their own social work and care management team also facilitating the patient and their families regarding authorization for coverage for the various treatments. We work very closely with the team at these different rehab centers even though they’re not a part of Summit Medical Group so that we’re really able to provide collaborative care across all disciplines. 

Melanie:  You visit them even when they’re in the rehabilitative center, sometimes as you said, five days a week. What do you with them when you visit? Is it to go over their situation and their condition? Do you then watch them do their physical therapy, make sure it’s all going well? What do you do with them when you’re there? 

Dr. Khademi:  We certainly examine them to make sure there’s no new medical issues, to make sure their pain is adequately controlled, to make sure there’s no new symptoms, to make that their previous symptoms are getting better, to see if there’s any medication adjustments that are needed. Also, the rehabilitation professionals such as myself work very closely with the multidisciplinary rehab team at the rehab centers to ensure that they are getting the right types of treatment. Sometimes, special equipment such as brace or assistive devices for walking are needed, and we oversee the decision-making process as to what’s the best fit for the particular patient. We actually meet with the rehab team on a weekly basis as well as with nursing and nutrition and any other discipline that’s involved in the patients’ care to ensure that all of their needs are being met and also being met in a timely fashion, because our goal really is to assist these individuals in getting home as soon as possible and recovering from home as opposed to unnecessarily staying in the facility for a prolonged period of time. 

Melanie:  This certainly would ensure that patients receive that seamless flow of services that are designed to aid in their recovery. It’s wonderful. Now, what about when they do have to go home? How do you work with the family? When you mentioned helping them with any devices that they might need—and we’re talking walkers or hospital beds at home or a visiting nurse—how do you coordinate that and work with the family? 

Dr. Khademi:  We identify the particular individuals’ needs, the type of equipment that they may need, the type of training that may be needed for an individual’s family in order to assist him or her when they are home. The ongoing services that are necessary, such as homecare services, outpatient rehabilitative services, because an individual often still has an ongoing recovery process to continue even when they’re home. Of course, we write all the prescriptions for their medications and instructions for followup appointments. We actually have a transitions of care navigator at Summit Medical Group who is working behind the scenes to ensure that the followup appointments are being made for the patients so as to make it as easy as possible for them to clearly understand what it is they need to do when they leave home and in order for them to stay healthy and to continue to recover. 

Melanie:  Dr. Khademi, sometimes patients worry that once they’re out in the world, that their doctors are not going to be in touch with them anymore. Do you keep their primary care physician in contact with the whole situation as it’s going on? 

Dr. Khademi:  Absolutely, and that’s the biggest role of the care management team upon discharge. When the extensivist team, the providers taking care of an individual in the rehab centers, alert the care management team that an individual is going home so the care management team can ensure that their primary care physician is fully aware that the individual will be returning to his or her office and what the active medical issues are. In fact, all of our documentation, the notes that we do in the rehab center, are being done in the electronic medical record for our group. So all of it, everything that’s happened to the individual while they’re in the rehab center becomes readily transparent to any Summit Medical Group provider because all they have to do is just look in the notes to see all of the medical issues that have occurred while the patient was in the rehab center. 

Melanie:  You take care of so many details, Dr. Khademi. What about mental coping, lifestyle management, that sort of thing? 

Dr. Khademi:  Often, an individual needs a rehab center because they have limitations that they didn’t have before. They’re not able to do all the things that they wanted to do before. We, together with the rehab providers at the rehab facilities, have lengthy discussions with individuals and their families about what types of initial adjustments may be necessary, what types of things may be difficult at the time of going home that we will continue to help to work them towards, such as driving, such as going out in the community, and shopping again, such as returning to a complete, independent lifestyle. Because often, the recovery process continues even after a person is able to leave the rehab center. We really want the patient and their family to be clear as to what is necessary moving forward so that they can recover to their maximal potential and resume their complete quality of life. 

Melanie:  In just the last minute, Dr. Khademi, please tell the listeners why they should come to Summit Medical Group and utilize the Extensivist Medicine Program. 

Dr. Khademi:  Summit Medical Group has just such unusual opportunity for an individual to have an extremely multidisciplinary approach to their medical care. We have over 70 specialties and over 400 providers, really, meeting all of the medical and physical needs that this individual may have throughout their lifetime. We’re just able to work so closely together and stay in such close communication with each other that it really is such a seamless approach to an individual receiving their healthcare. It really results in a higher quality of care, in my opinion. 

Melanie:  It certainly does. Thank you so much, Dr. Allen Khademi. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening, and have a great day.