Neurology Care in the Community | Penn Medicine
Roderick Spears, MD discusses Neurology Care in the Community. He shares how the experts at Penn Medicine are providing high quality care close to home. He talks about the benefits of having Penn Medicine in the community, and how the neurology department is able to provide service to a greater range of patients, not just geographically but across different subspecialties with more streamlined care for patients.
Featuring:
Roderick Spears, MD
Dr. Spears a Medical Director of Neurology, Clinical Associate Professor of Neurology and Associate Professor of Clinical Pathology and Laboratory Medicine at Penn Medicine. He attended Wayne State University School of Medicine. Dr. Spears completed his residencies at Akron General Medical Center and Albert Einstein-Montefiore Medical Center. He completed his fellowship at Saint Luke's-Roosevelt Hospital Center. Transcription:
Melanie Cole: Welcome to this podcast series from the experts at Penn Medicine. I'm Melanie Cole and today we're discussing neurology care in the community. Joining me is Dr. Roderick Spears. He's the Medical Director of Neurology and a Clinical Associate Professor of Neurology at Penn Medicine. Dr. Spears, pleasure to have you join us today. Tell us a little bit about the prevalence of neurological disorders. What are you seeing in the trends for your field right now?
Dr. Spears: Neurologic disease continues to increase in frequency, it appears, in the community. And I think some of this can be attributed to advancing age of the population. So we're seeing more degenerative neurologic disorders like dementias becoming more prevalent. But also some of it is awareness and new therapies coming to the market. So you have migraine patients as an example, seeking neurologic care because there are more treatment options available to them than there were even five years ago.
Host: So, tell us about the idea that started a few years ago to place Penn Medicine neurologists in the community to provide that easier access for people with chronic neurological conditions.
Dr. Spears: This initiative I think was started primarily based on a need with primary care physicians trying to get patients in to see neurology, and at Penn Medicine at that time, patients would have to travel into downtown Philadelphia to be seen by a specialist. So the primary care leader at that time was Ron Barg and the new incoming Chair of Neurology, Francis Jensen, got together and started this initiative of sending neurologists out to some of the community practices to provide neurologic care on the ground in the community. And from there the growth has just kind of exploded with need as neurologists that have been placed in these community settings. Patients have come in large numbers and it's been nice to provide high level neurologic care to patients with all the resources that come with a system like Penn Medicine, without the commute into the city.
Host: What are you seeing with the community as far as reception?
Dr. Spears: So, the reception has been overwhelmingly positive from the community because patients can be seen faster and different neurologic subspecialties are available to patients in the suburbs. I mean the majority of us in the suburbs are doing general neurology, so we are really seeing the large spectrum of neurologic needs that patients have. But there's also sub specialty care, headache, neuromuscular disease, movement disorders, stroke follow-up and things like that that are available as well. In addition to providing neurologic care. We have the resources of the different community centers like radiologic care. There's a pharmacy on site at some of our centers, so patients really are getting a comprehensive, meet your needs, kind of care with our system where they're able to fill their prescriptions, get their testing done, see their provider, close to their homes and in the communities in which they live.
The other benefit to the patients and also to the system has been access to research and cutting edge therapies at Penn where our colleagues are doing a lot of research downtown, and we're able to tell patients about clinical trials, get them involved in those clinical trials, and we also have information about the most cutting edge therapies because of our connection here at Penn. So we're able to offer those to our patients at their first visit as opposed to them seeing multiple people before they would maybe get that information.
Host: What a beneficial service to the community. Dr. Spears, how does the neurology department itself handle patients that need to visit multiple campuses?
Dr. Spears: So our goal would be to get the right patient in front of the right provider at the first visit. But if that does not happen, what we try to do is when they're seen initially, identify what the problem is, and then communicate within our department to streamline them to get to the right person or right specialty as soon as possible. The increased demand of neurologic care and the decreasing numbers of neurologists has made it a real challenge to provide care in a timely fashion that patients are satisfied with. So that is, that's an ongoing challenge. And with the trends going in the opposite direction, providers going down, and needs going up, you know, part of our strategic thinking is how do we meet that challenge in that kind of setting. So that's a challenge for us.
Host: So I'd like you to discuss a little bit about some of the most exciting advances in your field. How are you staying in touch with innovation? You mentioned clinical trials. Tell us about some of the most innovative technologies that are supporting your work today.
Dr. Spears: Headache medicine is my sub specialty and there's been kind of an explosion of different therapies and options for patients both on the medication treatment side and neuromodulation side. Because of the volume of headache patients that I see and connections at meetings and in the community, I quickly find out about these different neuromodulation options that are available for the treatment of migraines specifically, and sometimes cluster headache, and these new therapies that are available both by prescription and by infusion My colleagues in multiple sclerosis also are doing clinical trials downtown and the therapy options there have been increasing over the last several years as well. Probably the greatest interest for most patients has been in the area of dementia and cognitive decline. And there are some clinical trials going on in that area. Although the advances as far as treatment options being available to patients is not been as robust as we would like to see.
Host: So Dr. Spears, tell us what makes this program unique when we're talking about utilizing other providers and bringing it all together for the patient?
Dr. Spears: Well, we have an initiative here at Penn Medicine called the Neuroscience Service Line where we're really trying to bring neurology, neurosurgery, and psychiatry, under one umbrella. beyond that, inside of the system of Penn Medicine, we're trying to do a better job of collaborating with one another and communicating with one another, whether it would be primary care OB GYN, so that again, patients are getting a comprehensive look and comprehensive care in the system of Penn Medicine.
Host: Give us a good summary of what you would like other providers to know about the Penn Medicine neurological care for the community.
Dr. Spears: We've been able to provide service to a greater range of patients, not just geographically but across different subspecialties over the last five years, I think as a result of this initiative. I think patients are getting excellent care and that's demonstrated by good outcomes where patients are actually getting their headaches managed better, getting their seizure disorders manage better. And if those things aren't able to be managed in the community then we are able to get them down to our colleagues on the main campus. Not only to participate in clinical trials but also for more subspecialists care if that's required. So large catchment servicing more patients, collaborating with more systems in the area, better outcomes for patients with improvement in their lives. And the other thing that I guess is really nice is that the connection with the primary care providers. Because we're here in the communities, there has been more of a collegial, improved communication between I think the primary care primary providers and those of us in the specialties because we're side by side.
So we're able to talk to each other, communicate more effectively. And it is more streamlined for patients because maybe they're seeing their primary care provider in the same space or building, or within a couple of miles of where they're seeing their specialists. And you could say that's just geography, but for patients it really does provide them with more of a community sense where again, it's kind of an old fashioned perspective, but where you know, you live in a community and you get your services in that community and you know the people that you're dealing with. And I do think that enhances patients’ outcomes, how well they do, how that sense of family and community that is sometimes lacking when you're going to a center where you don't really know anyone and you know, it's just a little less personal.
Host: Thank you so much, Dr. Spears for coming on and explaining this so very well to us. That concludes this episode from the experts at Penn Medicine. To refer your patient to Dr. Spears, please visit our website @pennmedicine.org/refer, or you can call (877) 937-PENN for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Penn Medicine podcasts. I'm Melanie Cole.
Melanie Cole: Welcome to this podcast series from the experts at Penn Medicine. I'm Melanie Cole and today we're discussing neurology care in the community. Joining me is Dr. Roderick Spears. He's the Medical Director of Neurology and a Clinical Associate Professor of Neurology at Penn Medicine. Dr. Spears, pleasure to have you join us today. Tell us a little bit about the prevalence of neurological disorders. What are you seeing in the trends for your field right now?
Dr. Spears: Neurologic disease continues to increase in frequency, it appears, in the community. And I think some of this can be attributed to advancing age of the population. So we're seeing more degenerative neurologic disorders like dementias becoming more prevalent. But also some of it is awareness and new therapies coming to the market. So you have migraine patients as an example, seeking neurologic care because there are more treatment options available to them than there were even five years ago.
Host: So, tell us about the idea that started a few years ago to place Penn Medicine neurologists in the community to provide that easier access for people with chronic neurological conditions.
Dr. Spears: This initiative I think was started primarily based on a need with primary care physicians trying to get patients in to see neurology, and at Penn Medicine at that time, patients would have to travel into downtown Philadelphia to be seen by a specialist. So the primary care leader at that time was Ron Barg and the new incoming Chair of Neurology, Francis Jensen, got together and started this initiative of sending neurologists out to some of the community practices to provide neurologic care on the ground in the community. And from there the growth has just kind of exploded with need as neurologists that have been placed in these community settings. Patients have come in large numbers and it's been nice to provide high level neurologic care to patients with all the resources that come with a system like Penn Medicine, without the commute into the city.
Host: What are you seeing with the community as far as reception?
Dr. Spears: So, the reception has been overwhelmingly positive from the community because patients can be seen faster and different neurologic subspecialties are available to patients in the suburbs. I mean the majority of us in the suburbs are doing general neurology, so we are really seeing the large spectrum of neurologic needs that patients have. But there's also sub specialty care, headache, neuromuscular disease, movement disorders, stroke follow-up and things like that that are available as well. In addition to providing neurologic care. We have the resources of the different community centers like radiologic care. There's a pharmacy on site at some of our centers, so patients really are getting a comprehensive, meet your needs, kind of care with our system where they're able to fill their prescriptions, get their testing done, see their provider, close to their homes and in the communities in which they live.
The other benefit to the patients and also to the system has been access to research and cutting edge therapies at Penn where our colleagues are doing a lot of research downtown, and we're able to tell patients about clinical trials, get them involved in those clinical trials, and we also have information about the most cutting edge therapies because of our connection here at Penn. So we're able to offer those to our patients at their first visit as opposed to them seeing multiple people before they would maybe get that information.
Host: What a beneficial service to the community. Dr. Spears, how does the neurology department itself handle patients that need to visit multiple campuses?
Dr. Spears: So our goal would be to get the right patient in front of the right provider at the first visit. But if that does not happen, what we try to do is when they're seen initially, identify what the problem is, and then communicate within our department to streamline them to get to the right person or right specialty as soon as possible. The increased demand of neurologic care and the decreasing numbers of neurologists has made it a real challenge to provide care in a timely fashion that patients are satisfied with. So that is, that's an ongoing challenge. And with the trends going in the opposite direction, providers going down, and needs going up, you know, part of our strategic thinking is how do we meet that challenge in that kind of setting. So that's a challenge for us.
Host: So I'd like you to discuss a little bit about some of the most exciting advances in your field. How are you staying in touch with innovation? You mentioned clinical trials. Tell us about some of the most innovative technologies that are supporting your work today.
Dr. Spears: Headache medicine is my sub specialty and there's been kind of an explosion of different therapies and options for patients both on the medication treatment side and neuromodulation side. Because of the volume of headache patients that I see and connections at meetings and in the community, I quickly find out about these different neuromodulation options that are available for the treatment of migraines specifically, and sometimes cluster headache, and these new therapies that are available both by prescription and by infusion My colleagues in multiple sclerosis also are doing clinical trials downtown and the therapy options there have been increasing over the last several years as well. Probably the greatest interest for most patients has been in the area of dementia and cognitive decline. And there are some clinical trials going on in that area. Although the advances as far as treatment options being available to patients is not been as robust as we would like to see.
Host: So Dr. Spears, tell us what makes this program unique when we're talking about utilizing other providers and bringing it all together for the patient?
Dr. Spears: Well, we have an initiative here at Penn Medicine called the Neuroscience Service Line where we're really trying to bring neurology, neurosurgery, and psychiatry, under one umbrella. beyond that, inside of the system of Penn Medicine, we're trying to do a better job of collaborating with one another and communicating with one another, whether it would be primary care OB GYN, so that again, patients are getting a comprehensive look and comprehensive care in the system of Penn Medicine.
Host: Give us a good summary of what you would like other providers to know about the Penn Medicine neurological care for the community.
Dr. Spears: We've been able to provide service to a greater range of patients, not just geographically but across different subspecialties over the last five years, I think as a result of this initiative. I think patients are getting excellent care and that's demonstrated by good outcomes where patients are actually getting their headaches managed better, getting their seizure disorders manage better. And if those things aren't able to be managed in the community then we are able to get them down to our colleagues on the main campus. Not only to participate in clinical trials but also for more subspecialists care if that's required. So large catchment servicing more patients, collaborating with more systems in the area, better outcomes for patients with improvement in their lives. And the other thing that I guess is really nice is that the connection with the primary care providers. Because we're here in the communities, there has been more of a collegial, improved communication between I think the primary care primary providers and those of us in the specialties because we're side by side.
So we're able to talk to each other, communicate more effectively. And it is more streamlined for patients because maybe they're seeing their primary care provider in the same space or building, or within a couple of miles of where they're seeing their specialists. And you could say that's just geography, but for patients it really does provide them with more of a community sense where again, it's kind of an old fashioned perspective, but where you know, you live in a community and you get your services in that community and you know the people that you're dealing with. And I do think that enhances patients’ outcomes, how well they do, how that sense of family and community that is sometimes lacking when you're going to a center where you don't really know anyone and you know, it's just a little less personal.
Host: Thank you so much, Dr. Spears for coming on and explaining this so very well to us. That concludes this episode from the experts at Penn Medicine. To refer your patient to Dr. Spears, please visit our website @pennmedicine.org/refer, or you can call (877) 937-PENN for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Penn Medicine podcasts. I'm Melanie Cole.