The Pediatric Neurology Division at Floating Hospital for Children has grown considerably in its offerings and staff since David Griesemer, MD, became the division’s chief in 2010. In that year, Griesemer has recruited new faculty, established outreach clinics in two – soon to be four – community locations, and made care more accessible with service enhancements that enable patients to be seen more quickly.
The impetus for all these changes is simple. “We genuinely share the referring physicians’ commitment to serve their patients,” Griesemer says. “We want to provide them with best possible service and coordination of care that we can.”
The ability to fulfill that commitment has been strengthened with the recent recruitment of three new faculty members.
“Doug Hyder, MD comes to us from Dartmouth Hitchcock Medical Center. He is taking the lead role for ambulatory neuropediatrics and making our community outreach as efficient as possible,” Griesemer says. “He’s also a tremendously enthusiastic teacher and has assumed responsibility for teaching the medical students who rotate through our service each month.”
“This is an exciting time to be at Floating Hospital,” Hyder says. “There’s a real focus on teamwork, both with referring providers and within our division.”
Tomo Tarui, MD was recruited from Children’s Hospital Boston where he completed advanced training in fetal-neonatal neurology.
“Tomo Tarui will really develop our fetal-neonatal neurology program, bringing his expertise and interest in neuro-imaging as well as his research focus on fetal brain development,” Griesemer says.“He’s also counseling parents when we find a fetal brain abnormality. This is something we didn’t do in Pediatric Neurology before, and Tomo will make us a leader in this area.”
“We try to be proactive during the fetal period,” Tarui says. “Even though sometimes we must give parents a serious message regarding potential cognitive impairment, it’s better than getting no information or poor information and swinging between hope and desperation. Once they know the facts, they can make the most appropriate decisions about their child’s care. We also provide neurological management in the Neonatal Intensive Care Unit, which is critical for babies who suffer from neurological problems such as seizures, brain malformations or genetic abnormalities in their earliest life. After these babies go home, we will follow them at our clinic to closely watch their development and manage any ongoing neurological problems.”
The third new subspecialist to join the Pediatric Neurology faculty is Ju Tang, MD, who is responsible for the pediatric EEG lab, video EEG monitoring, and growing Floating Hospital’s respected pediatric epilepsy program.
“There are many aspects to building this program, and we’ve moved on several fronts to improve seizure management,” Griesemer says. “We’re involved in clinical trials of new medications, we’ve hired a nutritionist to help get patients started on a ketogenic diet (a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy), and we’ve ramped up our capability to implant and monitor vagus nerve stimulators. In addition, Floating Hospital has hired a second pediatric neurosurgeon, Steven Hwang, who expands our capabilities for epilepsy surgery.”
The newest addition to the pediatric neurology division is Tanzid Shams, MD, who comes from Columbia University in New York City, where he developed his interest in Concussion and Head Injury Care and in Sports Neurology.
The division’s talent also includes neuropsychologist Patricia Lee, PhD, pediatric nurse practitioner Kristen Padulsky, CPNP, and four pediatric neurology fellows.
“Plus, although not an official member of our division, Neel Madan, MD is a pediatric neuroradiologist who joined the Floating’s Radiology faculty around the same time I began at Floating,” Griesemer says. “A day never goes by that we don’t work with him, and having his expertise is a tremendous asset.” The Pediatric Neurology division also has close, collaborative relationships with subspecialists in Floating Hospital’s Children’s Cancer Center, Muscular Dystrophy Association Clinic, Neurosurgery and Physical Medicine & Rehabilitation programs.
With new staff in place, the division is an integral part of Floating Hospital’s robust Distributed Academic Medical CenterTM model that makes advanced care more accessible in the community setting. One of Griesemer’s goals is to expand the availability of the hospital’s pediatric EEG epilepsy resources outside Boston.
“We’re now able to see patients at MetroWest Medical Center in Framingham and Lowell General Hospital in North Chelmsford, and will soon be at Lawrence General Hospital,” Griesemer says. “We’re also starting a neurology clinic at the Walker School in Needham, a residential psychiatric facility for children and adolescents, and stand ready to support a community hospital affiliation south of Boston when an appropriate site is identified.”
Access to services at Floating Hospital also has been enhanced with the addition of evening clinic hours and three daily slots on the schedule reserved for urgent appointments.
“If a pediatrician is concerned about getting a patient seen quickly, we can schedule that patient into one of these urgent slots,” Griesemer says. “There’s no reason why important issues should wait.”
While he’s achieved a great deal in the past year, Griesemer is nowhere near finished.
“I came to Floating Hospital not only to expand the Pediatric Neurology clinical service but also to rebuild the training program which had a reputation as one of the best in the country,” he says. “We’d like to introduce and fund a research year as part of the five-year curriculum to train pediatric neurologists, and we plan to do some serious fundraising in order to put that year in place,” he says. “We have a superb group of clinicians and tremendous support from neuroscientists at Tufts University, so we have the opportunity to turn out awesome doctors who will move this field forward,” he adds.
In the meantime, delivering outstanding clinical care and exceptionally responsive service remains the top priority of the entire division (see sidebar for an example of the types of complex cases that the Pediatric Neurology team is equipped to handle). And Griesemer remains as enthusiastic about Floating Hospital’s ability to meet the needs of young patients, their families and their referring physicians as he was when he arrived a year ago.
“The honeymoon isn’t over,” he says. “Everything here has been as good as I initially thought it was. Everyone is as patient-focused and service-oriented, as collegial and cooperative as I’ve seen anywhere. It’s just a wonderful place to work.”