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The New Norm  

Interprofessional practice is not just a buzz word in the healthcare industry. It is the standard. Today's practitioners do not work in silos - they work together, as partners in an interdependent, patient-centered care model. Clinicians who graduated from or serve as clinical supervisors for the School of Health and Medical Sciences' (SHMS) health sciences programs relate their experiences in this new era of healthcare delivery.

Millie LemoineYamiley 'Millie' Lemoine, MS, OT, loves her job. An occupational therapist at a leading New Jersey rehabilitation hospital, she loves the opportunities it offers for creative, problem-solving partnerships with her peers, as interprofessional practice becomes the norm in a patient-centered world.

Caring for patients who had undergone amputation of a limb enabled Lemoine, a graduate of the SHMS Occupational Therapy program, to partner with everyone from neuropsychiatrists to dieticians. For Physical Therapy alumna Andrea M. Constandis, DPT, the burn unit at St. Barnabas Medical Center in Livingston, NJ,  has fostered similar collaborations. Carol Ukstins, MS, CCC/A, FAAA, a clinical supervisor for the SHMS Speech-Language Pathology program, has built successful relationships with professionals in education and health care throughout her career as an audiologist for the Newark Public Schools. And Michael Subik, DPM, DABPS, FACFAS, ACLES, a board-certified podiatrist and foot, ankle and reconstructive rearfoot surgeon who is a preceptor for the Physician Assistant program, hails interprofessional collaboration as a diagnostic boon.

"I was working with a gentleman, 21 years old, who was in a motorcycle  accident," Lemoine says, by way of example. "His left leg had to be amputated, and he had a hard time coping with the fact that something so traumatic had happened. Based on his disengagement from occupational therapy and his behavior that was consistent with depression symptoms, I reached out to the psychologist on the team."

Another case involved a diabetic patient who also had undergone an amputation. The woman believed, wrongly, that a dose of insulin would counteract the impact of bad food choices. "As a new patient, you have so many people coming in and out of your room. It's easy to miss [information]," says Lemoine, who urges that dietary professionals be included in medication management groups on the unit.

Andrea ConstandisConstandis is a physical therapist at St. Barnabas. On the hospital's burn unit, patients need physical therapy to prevent immobility and loss of range-of-motion and strength. These patients are at risk for decreased range-of-motion due to loss of skin elasticity during the healing phase, she explains. "A medical doctor recently called me in to look at a patient's shoulder range-of-motion," says Constandis, who is also an adjunct professor at Seton Hall. "It didn't seem as if the burn injury was affecting it. Because of my experience, I could see that he needed therapy not because the skin was tight, but because of what turned out to be a rotator-cuff injury."

Physical therapists, she notes, "may be the ones to see a change in a patient before a doctor does. We're there when patients are getting their wounds cleaned and dressings changed. We often spend more direct contact time with patients."

Carol UkstinsFor Ukstins, a 20-year veteran audiologist serving the 45,000-student Newark Public Schools system, collaborating with the child study team leads to innovative partnerships with educational psychologists, school social workers, learning consultants and speech-language pathologists. For example, Ukstins consults on educational programming for children with hearing loss and central auditory processing disorder. Or, when children have parents who are deaf or hearing-impaired, she works with colleagues to address the children's unique learning styles and helps to ensure their parents have access to the school for meetings and conferences. "When we can intervene on behalf of both children and families, the outcomes are far more successful," Ukstins says. 

Michael SubikProviding a second or third opinion is another invaluable form of interprofessional practice. At St. Mary's Hospital in Passaic, NJ, where Subik is the medical director of the Advanced Wound Center and chief of the Section of Podiatry, he recalls an instance where his expertise led to a new course of treatment. "A gentleman with Hepatitis C had these large leg wounds that worsened after surgery, and I was called in as a third opinion," he says. "I recommended a biopsy that hadn't been done and, after confirmatory diagnosis of pyoderma gangrenosum was made, initiated the patient on steroids, which led to healing of the leg wound."

Subik notes that patients are increasingly becoming their own healthcare advocates, which encourages physicians "to work with other specialists, to have discussions," and arrive at conclusions together. "Interprofessional collaboration is more than beneficial," he says. "I think it's the standard."

This feature story originally appeared in INS!GHTS Magazine, published annually by the School of Health and Medical Sciences.

Categories: Health and Medicine

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