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August 2020
Reflections on F&MCW SpineCare
By Dr. Diane Braza
After 25 years of providing transdisciplinary spine care, the F&MCW SpineCare providers are embracing the next 25 years with openness to leading change. Established in 1995, MCW SpineCare’s focus was to provide “transdisciplinary treatment” for those with spine conditions. As the inaugural physiatrist to the team, I often sought clarification on “transdisciplinary” vs. “interdisciplinary” vs “multidisciplinary”! Transdisciplinary was chosen to reflect the important meaning of a team composed of different professions cooperating across disciplines to improve patient care through practice. This indeed was a novel approach in 1995, as the team consisted of a physiatrist, neurosurgery spine surgeon, chiropractic provider, physical therapist, occupational therapist and nurse manager.
In 1993, the AHCPR back pain guidelines had just been published, highlighting the assessment and treatment of acute back pain. The guidelines focused on early activation and patient self-management. Through placing emphasis on evidence-based practice, the SpineCare team collaborated and developed treatment algorithms for common spine syndromes including disk herniation with radiculopathy, degenerative spondylolisthesis and spinal stenosis. The initial SpineCare clinic was located at Froedtert Hospital in the space currently housing the PM&R Rehab medicine clinic. Over the years, with patient growth, clinical sites expanded, and the team grew significantly yet remained focused on patient centered care.
Dr. deDianous joined the team in 2001 and lead the development of the Interventional Spine Program; Dr. Nelson joined in 2003 and lead the efforts to expand the SpineCare clinic at the Menomonee Falls location (OSSC) and later at Mequon Health Care Center as well as expand electrodiagnostic medicine services. Dr. Carley Sauter joined in 2012 and has further facilitated program growth with an additional emphasis on undergraduate medical education. Dr. Chris White completed an ACGME SCI fellowship prior to joining SpineCare in late 2015; he has successfully combined an inpatient and outpatient SCI practice with outpatient SpineCare clinical practice, further expanding the knowledge base and skills of our team.
Our growth toward integrating expertise within Spine and Sports Medicine was facilitated by the recruitment of Dr. Heather Curtiss in March 2018. Dr. Curtiss further expanded US guided treatment approaches for those with coexistent spine and MSK pain syndromes. We are now delighted to welcome Dr. Carrie Miller to the team, our newest ACGME Sports Medicine fellowship trained physiatrist!
We have often heard the expression “the only constant in life is change.” So after 25 years of continued growth, expansion and optimization of medical care provided to our patients, we are journeying forward in collaboration with the Departments of Neurosurgery, Anesthesia and Orthopedic Surgery to imagine the future – a comprehensive pain and spine center, harnessing the best of all disciplines to provide evidence-based, outcome oriented patient care. David deDianous, MD, will serve as the PM&R physician leader on the Medical Executive committee for this new initiative. In a future Newsletter edition, more information will be shared about this exciting next phase.
I am deeply grateful to all our patients, SpineCare staff, colleagues and other PM&R faculty (Dr. Tova Johnson, Dr. Monika Krzesniak-Swinarska and Dr. Andrew Hsu) who also had significant contributions to the SpineCare program prior to assuming other professional opportunities. We have all learned together and remain deeply committed to providing the best physiatric care to our patients!
Dr. Maiman and Dr. Braza reviewing an x-ray
Dr. deDianous assessing a patient
Welcome back Dr. Carrie Miller as a SpineCare Faculty Member!
Dr. Carrie Miller was born and raised in the Milwaukee area. She earned her bachelor's degree in Nutritional Sciences at the University of Wisconsin-Madison followed by her medical degree at the Chicago Medical School. Dr. Miller then completed her internship and PM&R residency at the Medical College of Wisconsin. She finished her training with a Sports Medicine fellowship at Washington University in St. Louis, MO. She couldn't be happier to return to her hometown to continue her career at the Medical College of Wisconsin. Her clinical interests include prevention and management of sports and spine conditions incorporating the use of musculoskeletal ultrasound, fluoroscopic-guided spine procedures, and regenerative medicine. In her free time, she enjoys exploring the outdoors, cooking, and spending time with her family.
Congratulations to Dr. Kim Zvara for her promotion to Associate Professor in the clinical educator pathway.
Congratulations to Dr. Matt Durand for his promotion to Associate Professor in the traditional pathway.
Congratulations to Dr. Jacqueline Wertsch on been the recipient of the AANEM Lifetime Achievement Award
The Lifetime Achievement Award is the highest honor bestowed by the AANEM. It is given to members who are recognized as major contributors in the fields of NM and EDX medicine through their efforts in teaching, research, and scholarly publications.
For the first time in AANEM’s history, the recipient of the Lifetime Achievement Award is a woman: Jacqueline J. Wertsch, MD, has been named this year’s recipient for substantial contributions to her field and longtime, dedicated support to the AANEM.
Dr. Wertsch received her undergraduate degree from the University of Wisconsin (1969); she graduated medical school from The Medical College of Pennsylvania (Drexel, 1974). Her postgraduate training included University of Illinois-Rockford (Family Practice, 1975), Northwestern University (PM&R, 1980) and a Medical College of Wisconsin fellowship in Clinical Neurophysiology (electrodiagnosis and cerebral evoked potentials, 1980). Dr. Wertsch came to the Medical College of Wisconsin in 1980, where she was on faculty for 30 years until 2010, when she retired from clinical practice. Dr. Wertsch was awarded an emeritus professor appointment and continues teaching
activities thru EduDoc LLC.
Her accomplishments cannot be overstated. She has authored 100 scientific reviewed publications, 25 book chapters and countless national and international presentations. Some of her accolades include the New Jersey Medical School Excellence in Teaching award in 2007, the Dawn Janisse Award for Education/Research and Advocacy in 2006, PM&R Department Teacher of the Year 1990, 1992, 2005, and 2008, and the PM&R Department Teaching Honor Roll 1985-1989 and 1991, 1993, and 1995.
Dr. Wertsch’s earliest inspiration was her mother, a school teacher who graduated from college when she was 18. She would ride her horse to the one-room school house in town and taught children all the way through high school, according to Dr. Wertsch. “She also figured out a way to become a pilot. My mom very much gave me and my brother a love for reading and science, and eventually that led me to DNA. DNA was first discovered when I was in high school! It changed our whole understanding of life.”
She recalled the battling the stereotype of being a woman trying to break into the medical field. “Women weren’t doctors in those days – it actually never occurred to me to become a doctor. I planned on going to nursing school. But I desired to attend medical school because I found it so interesting. I had no preconceived notions of what being a physician was. So I went for it.”
Dr. Wertsch says every success and positive outcome in her career can be traced back to Dr. John Melvin, who exposed her to the possibilities in EMG. Until she met Dr. Melvin, she hadn’t even considered EMG as a career option. “He recruited me in 1980 for
an EMG fellowship at the Medical College of Wisconsin. The fellowship was very thoughtfully structured, with lots of opportunity for exploration and networking. I worked closely with the surgical hand fellows, learning the valuable role EMG can fill in trauma and surgical management.”
She would go on to train up to 5 fellows per year for the next 3 decades as the EMG Fellowship Director. Dr. Wertsch is most proud of the numerous awards her students have earned, including many trainees winning AANEM Junior Member Recognition Awards, numerous President’s Research Initiative Awards and 2 EMG fellows winning the Golseth Young Investigator Award (Dr. Gulapar Phongsamart in 2000, and Dr. Niles Roberts in 2008).
Dr. Wertsch has made an incredible impact in the field of PM&R and has been an important contributor to the AANEM. At the Medical College of Wisconsin, she was the Director of Research for the Department of PM&R from 1990-2004. She also was the EMG Fellowship Program Director – Rehabilitation Medicine Service at the Zablocki VA Medical Center from 1982-2010. She served on the AANEM Board of Directors as President and Board Member, and on multiple AANEM Committees as a member and chair including: Annual Meeting Coordination Committee, Course Committee, Disciplinary Committee, Ethics and Peer Review Committee, Finance Committee, Member Retention Task Force, Nomenclature Committee, Program Committee, Regional Workshop, and Workshop Committee. She served on the Editorial Board of Muscle & Nerve and received AANEM’s Distinguished Research Award in 2003. “I know
many of the other people who have received this Lifetime Achievement Award. I consider them true friends, and that’s a big part of AANEM. I appreciate the networking and the support for each other. When I saw the list of past winners, it struck me that I know all of these people quite well. There’s no question about AANEM’s value with regards to networking, AANEM’s vast resources, and the tremendous support system of thousands of members at your disposal.”
One of Dr. Wertsch’s more notable memories as President of AANEM occurred during the AANEM Annual Meeting in Toronto that year. It just so happened that Queen Elizabeth II of England was in town that weekend…and staying at the same hotel the AANEM Annual Meeting was taking place. Dr. Wertsch recalls walking into the lobby just as the Queen was walking by, wearing a similarly designed suit and the same color that Dr. Wertsch had on. “Many attendees asked me if I coordinated what I wore with the Queen of England. She bumped me out of the presidential suite!”. Aside from her brush with royalty, Dr. Wertsch is most proud of creating the President’s Research Initiative Awards that continue to be awarded every year, and for sticking to what she thought would be a great plenary topic in 2002. “I chose ulnar neuropathies as the plenary topic. Some
thought it was too simple and that there wouldn’t be many in attendance. But I knew the outcomes were not where they should be, and we ended up having the highest membership attendance to date.”
Dr. Wertsch’s body of work exemplifies the fact that one person can make an enormous contribution to a field. With 25 years of NIH, CDC and VA continuous extramural funding, Dr. Wertsch has mentored numerous predoctoral and postdoctoral biomedical engineers in addition to clinical teaching 30 years of residents and a generation of electrodiagnostic physicians as her fellows (46 EDX fellows from 1981-2010).
Dr. Wertch is grateful for Dr. Melvin's encouragement to learn about electrodiagnostic medicine and is happy to have returned the favor by devoting her time to training others.
“That’s what medicine is. It’s constant learning. And the trainees ask the best questions – they challenge things. EMG had a lot of processes that needed challenging, and trainees would force me to think about things differently. We were able to do 25+ years of research in the field of EMG. Working with our hand surgical fellows, I realized I was able to answer questions for them through EMG that they had no other way to answer.”
Dr. Wertsch has a simple message for any young physicians breaking into their field.
“Remember to always be a physician: that means you are your patient’s advocate. You do not work for an administration. You work for the patient. Medicine has always been based on an authority-down hierarchy. You have to stay true to your responsibility for the patient, and break out of the hierarchy to make sure they are being served. Don’t let others redefine the job for you. There’s only one boss – the patients we’re trying to serve.”
Have news to share with your PM&R colleagues? We would love to hear from you for our next issue, so please email any recent publications, awards, presentations, shout-outs, etc. to Beatriz Envila at benvila@mcw.edu.
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