Kritis Dasgupta, MD, MBA, MSc is the Chair of Physical Medicine and Rehabilitation at MedStar Good Samaritan Hospital. He also serves as the Associate Medical Director for the MedStar National Rehabilitation Network, Baltimore region. Dr. Dasgupta was at MedStar National Rehabilitation Hospital (NRH) for nearly 10 years and served as the Medical Director of the Brain Injury Program and Medical Director for Quality and Safety. He obtained his undergraduate degree in English from Princeton and his medical degree from the University of Maryland. He holds an MBA from Johns Hopkins and an MSc in Evidence-Based Health Care from Oxford.
Originally interviewed by Dr. Mike Farrell in November, 2016
How did you become interested in medicine, and specifically, what attracted you to the field of Physical Medicine and Rehabilitation (PM&R)?
I enjoyed science and problem-solving, and also enjoyed interacting with people. I was an English major in college but did not think becoming an English professor was the right path for me. Medicine seemed to have the right balance of human interaction and technical knowledge.
As a freshman in medical school I read that PM&R physicians are among the happiest with their choice of specialty. I did two PM&R rotations as a fourth-year medical student and enjoyed them very much, specifically the intimate relationship with patients and the collaboration of working with a rehabilitation team. I liked the rehabilitation environment of positive encouragement and kindness. I also had a longtime passion for the martial arts, which fit well with PM&R’s holistic and exercise-centered approach.
Could you tell us about your work in Traumatic Brain Injury (TBI), and what kinds of medical problems and conditions you address in practice?
As an inpatient brain injury physician I work closely on a team with physical, occupational, speech and recreation therapists, social workers and psychologists. The patients I encounter have had traumatic brain injury from falls and accidents, non-traumatic intracranial bleeds, brain tumors and even conversion disorder with neurological-appearing symptoms.
Chronic Traumatic Encephalopathy or CTE has been receiving a lot of press in recent years, for current and future clinicians, what are some important take away points you could share?
Societal awareness of concussion and of the longterm sequelae of repeated concussions, including CTE, has been an important step forward. There is much more we need to learn about CTE and we will do so through research as we are better able to correlate clinical findings with brain biopsy studies. The takeaway points for now are that we should (1) prevent concussions whenever possible through safety measures (protective helmets, changes in sports rules, etc) and (2) make sure patients are fully symptom-free from one concussion before resuming activity that could put them at risk for another.
I have found that many students are surprised to see the level of recovery some TBI patients experience following an inpatient rehabilitation stay, do you have any experiences that stand out in your mind over the course of your career?
We cannot always predict how patients will recover, but I am always amazed and gratified when patients make a dramatic recovery after TBI. Not long ago we treated a young man who sustained a severe TBI from an all-terrain vehicle accident. He was initially assessed to be at too low of a functional level even to undergo inpatient rehabilitation. Within a few days he woke up in the acute care hospital, went through our inpatient rehabilitation, and left essentially independent.
Another patient had a severe TBI from a motor vehicle crash and was admitted in a very confused and agitated state. She made excellent progress both as an inpatient and afterward. It has been a few years since her injury and she is now in France teaching at one of the most prestigious universities in the world.
PM&R continues to grow, what goals do you have for the specialty? Is there a particular direction you hope this specialty takes in the years ahead, or a role that you think it could serve particularly well in the 21st century healthcare system?
I see a lot of exciting opportunities for the field of PM&R. The shift to value-based reimbursement in healthcare will give PM&R an opportunity to demonstrate that rehabilitation can lead to better outcomes. Evidence-based research studies in this area become even more vital. PM&R’s mission to preserve function and quality of life fits beautifully with the needs of the growing older population. Because of advances in trauma and surgical care we now save patients who would not have survived before, which makes rehabilitation all the more important.
What parting advice would you give medical students who are thinking about or currently pursuing PM&R as a career? How about specific advice for other healthcare professionals?
Realize that PM&R is a very broad field, and try to get exposure to its different aspects to see if it is right for you. For example, outpatient back pain and inpatient spinal cord injury are two very different areas within the speciality.
Healthcare providers have hard work, stress and long hours. Exercise and meditation are two practices that are essential to stay physically healthy and mentally balanced, in my opinion.
You will be just as busy after medical training as during training, so the time to start making these practices a habit is today; even a little bit works wonders.
PM&R physicians have to motivate others and we can set the example by being physically fit, positive-minded and cheerful. Think of your duties in healthcare as “service” rather than “work.” With this simple idea you will automatically do an excellent job and be full of energy and enthusiasm.