What is rehabilitation medicine? A conversation with Janna Friedly, MD, MPH
Have you ever been curious about physical medicine and rehabilitation? It's a medical specialty dedicated to helping people with disabling injuries and illnesses recover, restore function, and improve their quality of life. In this video, Dr. Janna Friedly, a physiatrist, professor, and chair of the Department of Rehabilitation Medicine at the University of Washington School of Medicine, talks about what rehabilitation medicine is, what drew her to it, and what inspired her to enter the field. She also discusses cutting-edge advancements, new technologies, including the clinical use of noninvasive spinal cord stimulators to improve limb function in people with spinal cord injuries.
Watch the video or listen to the podcast to learn more or follow along with the transcript below (lightly edited for clarity).
Video Transcript
Rehabilitation medicine is a medical specialty that's very broad, and it's a specialty that's defined by helping people with disabling injuries and illnesses recover, function, or restore function and improve their quality of life.
Melinda Johnston: Welcome. And if you've ever been curious about rehabilitation medicine, you have come to the right spot. My name is Melinda Johnston, and I'm here today with Dr. Janna Friedly. She is a professor and chair of the Department of Rehabilitation Medicine here at the University of Washington. Dr. Friedly, why don't you introduce yourself a little bit?
Dr. Janna Friedly: Great. Well, thanks for having me here today. I'm happy to be here. And, my name is Janna Friedly, and I am the chair of the Department of Rehabilitation Medicine here at the University of Washington. I am a physiatrist, by training. So, I'm trained in the medical specialty of physical medicine and rehabilitation. And I was trained here at the University of Washington. I did my residency training here, about 20 plus years ago, and have stayed on faculty ever since. I have been chair here at the University for about two and a half years now.
Johnston: Wonderful. And what inspired you to pick rehabilitation medicine as your specialty?
Dr. Friedly: So, I was first introduced to rehabilitation medicine when I was in college. I had a close friend who had a spinal cord injury from a football injury. And I watched him undergo rehabilitation and live his life as someone with a high-level cervical spinal cord injury. And seeing him go through that experience and live his life with a disability really inspired me to become a physician and be able to care for people with disabilities. I was able to see what a dramatic difference in his life with the care he received and rehabilitation that he received made. The quality of his life, and how he was able to get back to many of the activities that he loved to do, and be able to get back into college and his social life, and live a very fulfilling life, after a very devastating injury.
Johnston: Wow. That is a compelling story. But perhaps just to backtrack a little bit, and maybe it's a dumb question, but could you define rehabilitation medicine for us?
Dr. Friedly: Many people don't know what rehabilitation medicine is. Rehabilitation medicine is a medical specialty that's very broad. It's a specialty that's defined by helping people with disabling injuries and illnesses, recovery, function, or restore function and improve their quality of life. It's a very broad specialty that works with people with diagnoses of all kinds, and the unifying feature of rehabilitation medicine is really helping people to achieve their goals and to help them improve their function and their quality of life. We work primarily as a team, and with a large team of people. Typically, we, as physicians in the specialty, work with physical therapists, occupational therapists, speech therapists, rehabilitation psychologists, vocational counselors, recreation therapists, social workers, and a very large team of professionals to help people recover.
Johnston: Wow, and that certainly explains a little bit about this department, which is such a broad department. We have physical medicine and rehabilitation physicians, rehabilitation psychologists, specialists in physical therapy, occupational therapy, prosthetics and orthotics, and speech-language pathology. I'm sure there's more. As a department, how do all the specialties fit together, and how does everyone collaborate?
Dr. Friedly: Yeah. Our department includes more than just the physicians and the rehab psychologists that provide clinical care. We train the next generation of our specialty, including a doctoral program in physical therapy, a master's program in occupational therapy, a master's program in prosthetics and orthotics, as well as a PhD program in rehabilitation science. We all work together and collaborate on research, the education and training of our residents, fellows, and students, and clinical care.
Johnston: That's wonderful. So, with so much going on, what is exciting you lately in the field of rehabilitation medicine? New technologies, new treatments, maybe just philosophies of care. What's interesting:
Dr. Friedly: There's so much going on. So that's a hard question to answer succinctly. Because there are a lot of advances and because we work with so many different kinds of patients with various diagnoses, there are lots of different innovations and technologies that are used to help people with disabilities.
Some of the things that have recently been introduced into clinical practice that I'm most excited about are, one is, spinal cord stimulators. Noninvasive spinal cord stimulators, which are placed on the back of your neck, can be used to help restore arm function in people with spinal cord injuries. They are now being used clinically here at Harborview Medical Center. We were the first site in the world to use these newly FDA-approved devices. These studies were conducted here at the University of Washington, with our faculty led by Dr. Fatma Inanici and Dr. Chet Moritz, in collaboration with the Division of Physical Therapy, and are now being used clinically at Harborview.
But we are also studying the use of these devices for people with multiple sclerosis, stroke, and other neurologic disorders, as well as spinal cord injury. So that's an exciting advance, because it has really helped people with very disabling spinal cord injuries improve their hand function and be able to do things that they were otherwise not able to do.
Johnston: That's a spectacular technology. And I understand that Dr. Inanici did some of that research as part of her PhD. It shows the importance of these academic programs leading into clinical care here at Harborview.
Dr. Friedly: Absolutely. It was a fantastic team she worked with under the mentorship of Dr. Moritz. It is also an example of the multidisciplinary and interdisciplinary care that we provide. It was really a team effort between engineering and rehabilitation medicine, as well as physicians in rehabilitation medicine and neurological surgery. It was a great example of how we all worked together as a team to solve a very challenging clinical problem. And so, it’s an exciting advance for rehabilitation medicine. So that's just one example. We have lots of other examples that I'm happy to share with you.
Johnston: That's fantastic. And we will certainly keep this podcast going and share more examples. I did have one question for you, Dr. Friedly. Of course, being a working physician is a huge job, and being chair of a department like this is also a huge job. What motivates you every day to come in and do this work? We know it's a big one.
Dr. Friedly: Yeah. What motivates me and what has always motivated me throughout my career is the people that I work with at the University and here at Harborview, where I work clinically. I think we have fantastic faculty and staff who are driven by the mission to help people with disabilities. I'm very privileged to work with amazing people who have accomplished an incredible amount and are so driven to help others. It is one of the most motivating things for me.
And the other motivating part is the patients. I have found this specialty to be the most rewarding specialty that I could imagine. As I knew, going into this specialty, being able to help people with disabling conditions would be rewarding. It certainly has been, for me. For me, it is just the experience of being able to share with a patient their achievements and being able to see them accomplish something important to them. It's a remarkable experience. It's incredibly motivating.
One example that I think about is a patient of mine. I work primarily with people with limb loss and amputations. And I have a patient who lost all four limbs due to sepsis. And she had a goal of walking in high heels, and I remember we had many conversations about how we needed to focus on getting her to do her daily activities, help her adjust to her disability, and work on basic tasks. She was so motivated. She really wanted to walk in high heels. That was her goal. There was nothing that I could do to stop her from achieving that goal. And I remember the day she came into my clinic, walking in high heels, and the look on her face and how happy she was, having achieved her goal. That is something that stays with me. And it's something that motivates me. Every day, I help my patients achieve what they want to achieve.
Johnston: That is fantastic. If you had just one word of advice for people who are considering rehab medicine, whether it is OT, PT, or a physician, what would you say to them?
Dr. Friedly: Do it. I think, as I said, it's an incredibly rewarding field. It's also an extremely important field. Now more than ever, we need people trained in rehabilitation medicine in all aspects, whether physicians, psychologists, or therapists; we really need more people to go into this field. And there are more people in the community who need access to rehabilitation services. And so, I would just highly encourage people to explore the different options available for rehabilitation medicine.
Johnston: Fabulous. Thank you so much. And certainly, if you're interested, you can explore some of those options on our website, rehab.washington.edu. Thank you so much, Dr. Friedly, for being here today.
Dr. Friedly: Thank you so much for having me.