|Dr. Dennis Hart Brings a Broader Approach to Care as All Children’s First Physiatrist|
In an effort to expand the scope of its rehabilitative services program, All Children's Hospital has welcomed a new doctor whose specialty takes a broader look at the issues confronting children with chronic illnesses or acute injuries and diseases.
Dennis Hart, M.D., joins All Children's as Administrative Director of Developmental & Rehabilitative Services and is the hospital's first physiatrist, a physician expert in the field of treating a patient's full spectrum of needs.
Dr. Hart joined All Children's in September after serving as Medical Director of Pediatric Rehabilitation Medicine and Medical Director of California Children's Services Clinics. One of only a handful of pediatric physiatrists in Florida, his arrival widens the range of care offered by ACH.
"One of the biggest differences between rehab medicine and some of the more acute care medical fields is that we really take a broad overview of the patient," he says. "So a lot of times, I'm not just treating a patient's physical needs. Kids with cerebral palsy, for instance, have cognitive needs or other developmental issues that I'll address as well. I help them deal with a lot of issues they have dealing with their disabilities, with the schools and out in the community. I do a lot of education with the parents."
That is the role of a physiatrist, also known as a pediatric rehabilitation medicine specialist: a doctor who looks at multiple factors in crafting a treatment plan. In addition to his administrative role, Dr. Hart will devote a day-and-a-half each week to hands-on patient care early in 2014, and will also focus on research and outcomes. And the overall plan is to keep the program growing, adding a second physiatrist to the ranks soon.
"Probably my first priority is going to be adding a partner, because 50 percent of my time is going to be in an administrative role with the therapists," he explains. "We can already tell that there is going to be more than I can do here. One of my priorities with the therapists is to broaden them from just a clinical approach to one that embraces the Hopkins model of research and advocacy. But I have to say that this program is outstanding."
Bill Horton, Senior Vice President of Strategic Business Services, looks forward to the important contribution Dr. Hart will make in shaping the breadth of care offered at ACH.
"Dr. Hart provides All Children's with the long needed resource and knowledge base to guide the future direction of our habilitative and rehabilitative care and align these services more strongly with the medical model," he says. "Additionally, his specialization in pediatric physical medicine will uniquely complement other medical and surgical specialties in the care and management of the chronic, complex patient, facilitating improved outcomes with greater quality at lower costs."
Dr. Hart was immediately drawn to the opportunity at All Children's, in spite of his fulfilling work in northern California. In addition to his job leading the California Children's Services Clinics, he served as Vice-Chairman of the Pediatric Department at Sutter Medical Center in Sacramento, as well as on the medical staff of Shriners Hospital and as a faculty member and medical staffer at the University of California Davis Medical Center. He liked the idea of building a physiatry program from the ground up at ACH.
"That's a large part of it," he says. "They also have a really well-established therapy program. And one of my goals is to help them bring the therapy program into the pediatric medical model so there's a strong connection between the two."
"My role is going to be working with neurosurgeons and sports medicine physicians, as well as a lot of others," he adds, "taking care of those kids after an acute injury or if they have a developmental delay that includes motor issues."
Dr. Hart sees part of his role as enhancing communication between the physicians who evaluate and treat a patient - and the therapists who oversee the rehabilitation.
"Rehab medicine kind of fills that gap," he says. "We work directly with the therapists and we communicate with the therapists about what it is that we do. And we bring the medical portion of it to them."
In addition, Dr. Hart's desire to relocate across the country was rooted in a desire for a new challenge - and the chance to work in a top-tier, freestanding children's hospital.
"Being a children's hospital makes a big difference to me," he says. "Because when you're in a large health system that's primarily adult oriented, you get very frustrated when kids aren't getting what they need."
Dr. Hart didn't know anything about rehab medicine until his third year of medical school. He was doing a surgery rotation at the time. "I was in the ICU, caring for a trauma patient, and the rehab resident was there as well," he recalls. "I started asking him what he did, and it sounded very interesting."
From that point on, he did his rotations in rehab medicine, though his plan was to specialize in adult pain management. But three weeks into a rotation at a Shriners hospital, a nurse who had observed his work gave him some advice. "She said, 'You know, Dr. Hart, you need to do pediatric rehab," he says. "I asked, 'Why is that?' And she goes, 'Well, when you first came here, you weren't very happy. I see how these kids light up your eyes - you need to do this.' "
That was the turning point in his career, putting him on a path that ultimately would lead to All Children's. Dr. Hart is excited about the scope of his new department, which has 170 therapists throughout the main campus and different regional Outpatient Care Centers. "And they are very well run," he adds.
Though he regards the thriving sports medicine program as a separate entity, Dr. Hart will still oversee the therapists. "From my standpoint, I'm there to support them," he says. "For certain diagnoses, I probably will be involved - at least to some extent. I've done a fair amount of mild traumatic brain injury and so I certainly could see those kids in my clinic. But the sports injuries, I'll leave them to the orthopedic surgeons."
Maggie Reilly, ACH's Director of Physical Therapy, is excited about what Dr. Hart brings to the mix.
"We've never had a doctor of rehabilitation medicine in our hospital, and he knows better than anybody the value of looking at the whole child, the whole family," she says. "If you go to an orthopedist, they might look at a joint. If you go to a neurologist, they might look at the brain scan. But the physiatrist looks at the whole child and what their needs are to get more involved in the community, in school or in everyday life.
"We have a strong program," she adds. "but he'll bring us to another level."
In the process, he is focused on one ultimate outcome.
"My goal is to get our patients as highly functioning as we can by the time they're an adult," he says. "Eighty percent of kids with disabilities live into adulthood. We need to make sure they're as highly functioning as they can be so they can be productive members of society."