[MUSIC] >> This Day in the Life, part of a series of videos showcasing the amazing diversity of health related jobs. In these interviews, we'll hear a little bit about what the day in the life of a health professional may look like. We will see perspective from a physician leader, who has devoted her career to championing for and working on the front-line with those who have disabilities. [MUSIC] Hi, I'm Kristi Kirschner, a Physician in rehabilitation medicine. We're also called physiatrist, a specialist in patients with disabilities. For the last five years, I've worked here at Schwab Rehabilitation Hospital, which is a safety net hospital. Safety net hospitals are hospitals that care for poor patients, care for patients with publicly funded insurance or even patients who are uninsured. So here at Schwab Rehabilitation Hospital, we have a lot of really neat features to make sure that our patients can get full access. We have big examination rooms with five foot turning radiuses for our patients who use wheelchairs. We have high/low tables that patients can use to transfer onto an examination table with minimal or no assistance. We have wheelchair accessible scales. It's incredibly important that patients be able to get weighed, particularly if you are pregnant. Weights are one of the most important things that we monitor during pregnancy. Basic access is one of the most important needs of our patients. Many of my patients, when I started working rehabilitation 25 years ago, we're not able to get onto an examination table. I was very interested in reproductive healthcare services for disabled women and found that many of them weren't getting examinations, because they couldn't get on an examination table for their pap smear. They couldn't get a mammogram if they couldn't stand. Many of the doctors were simply uncomfortable with the disability specific needs. So, a lot of my work actually since 1990 has been to educate healthcare professionals. About their obligations under, under the American with Disabilities Act. I do a lot of advocacy and education work around healthcare access for people with disabilities. So people don't have to come just to a rehab hospital, but they could go to a general OB/Gyn office. Primary care office and be able to get these health care access needs met. because rehabilitation doctors, we are concern ed with the whole person. We are concerned about the body, we are concerned about the mind, we are concerned about the person and their physical environment and their ability to participate in society. I have patients that I have cared for now for 25 or 30 years. I mean, what an incredible privilege to start working with somebody at. The onset of a new disability and to be able to see their life transformation over 30 years, so that's the way I like working with patients in the context of, you know, structuring their life, living with disability and making sure that they are getting their health care needs met. So, in rehabilitation, we take care of patients who have disabilities from traumatic causes as well as acquired disabilities from diseases. So we're a trauma center here at Mount Sinai Hospital and we see a lot of patients with gunshot wounds. Might cause spinal cord injuries, traumatic brain injuries. We see patients who have acquired disabilities from strokes or vascular disease. Patients may have amputations from peripheral vascular disease or have diabetes, COPD from chronic smoking. So we see patients with a broad variety of disabilities from both acquired as well as traumatic causes. I also take care of patients who have congenital disabilities. So these are patients who were born with their disabilities or acquired them early after birth. That might be cerebral palsy, spina bifida, patients with neuromuscular diseases, like muscular dystrophy or spinal muscular atrophy. So, one of the really interesting things about practicing in the safety net environment is the number of patients we see here who have acquired disability as a result of violence. There is a high rate of gang related activity, substance abuse and there are a number of people who have gunshot wounds that we see here. So, it's a, it's a prominent part of the culture that we're dealing with violently acquired disability. So, again, as a disability doctor, I, I'm not an internist or a primary care doctor. But I try to make sure that my patients are getting those care needs met, any specialty care needs met and that we're coordinating all those needs over a life span. So, I may be the person that helps them evaluate their equipment, evaluate, you know, their specialty care needs. Make sure that they're connected with the right health care professionals, but I will have a relationship with them and often time their families over many, many years. [MUSIC]
