Mary Ann Littell
Having three "top docs" in one department,
at one medical school, is a remarkable achievement. Bragging
rights go to the Department of Physical Medicine and Rehabilitation
(PM&R) at UMDNJNew Jersey Medical School.
(Left to right) Joel DeLisa, MD, MS,
professor and chair of physical medicine and rehabilitation
at UMDNJ-New Jersey Medical School and chief of service of
that same department at UMDNJ-University Hospital, with three
"top docs" from his department: Steven Kirshblum, MD, John
Bach, MD, and Kathleen Francis, MD.
three physicians from the department who are featured in the
2004 edition of "America's Top Docs" are Kathleen Francis,
John Bach and Steven Kirshblum. Francis attributes the department's
success in part to "our chair, Joel DeLisa, an outstanding
physician and administrator who has built a truly world-class
department - one of the best, if not the best, in the country."
returns the compliment, saying, "Dr. Francis is a very caring,
compassionate physician who has been willing to develop comprehensive
rehabilitation programs for patients whose disabilities are
often progressive and for whom no cure is in sight."
is nationally recognized for her work in treating lymphedema,
the swelling of soft tissues, usually in an arm or leg, that
is related to impairment of the lymphatic system. The result
is an enlarged, sometimes very firm limb which can be painful
and immobile. The most common causes in the U.S. are cancer-related.
The name elephantiasis, conjuring up images of grotesquely
swollen extremities, is given to the severest cases.
are so few doctors treating lymphedema that I've become the
local expert," Francis says modestly, adding that she is aware
of only one other physician in New Jersey specializing in
it. "But the number of cancer patients alone who have it is
huge - some 20 to 25 percent."
arrived at her medical career late in life, after having three
children. A graduate of Montclair State University, she says
there were three career options open to women at that time:
nurse, teacher and secretary. She opted for teaching.
job took the family to Scotland for a few years. When they
returned, she and her husband took turns going to graduate
school. He went for business, she went for medicine. "I let
him go first, because I was so busy with the kids," she jokes.
Jersey native (she hails from Cedar Grove and still lives
nearby) stayed near home for medical school, enrolling at
NJMS in 1985. "I had always loved biology and life sciences,"
she continues. "I thought being a doctor would be a way to
make a positive, useful contribution." She graduated in 1989
and did her residency at Kessler Institute of Rehabilitation,
a UMDNJ affiliate.
her residency, she remained at Kessler, where she began to
see patients with lymphedema who had been referred there for
physical therapy. She became very interested in its complexities.
"The more I read about it, the more I wanted to learn," she
says. "What I didn't learn from books, I learned from hands-on
experience, since more and more patients were being referred
says, "She has been the clinical leader in cancer rehabilitation,
and from this has developed the comprehensive treatment program
patients are devastated when they develop the condition, says
Francis: "They tell me, 'I've been through a lot, but this
is the worst.' They survived cancer, but now have a lifetime
reminder of it."
While lymphedema can't be cured, it can be
managed, with great improvement in quality of life. The "gold
standard" - the treatment Francis specializes in - is complete
decongestive therapy, or CDT. It was developed in Europe and
is not widely used in the U.S. It has four components: manual
lymph drainage; compression bandaging or elastic compression
garments; meticulous skin care; and exercises.
Francis took a big step: She left Kessler to establish a private
practice. She is now medical director of a lymphedema treatment
center based at St. Barnabas Ambulatory Care Center in Livingston.
"I had been an employed physician for years, and felt the
time was right to do this," she says. "St. Barnabas has a
strong cancer program with plenty of patients who will benefit
from our services."
a tennis player, is very fit and moves with the grace of a
natural athlete. So it's not surprising that she was drawn
to rehabilitation as a specialty. "We're improving people's
lives in a functional sense," she explains. "They come in
with pain or movement issues, which can trigger a whole host
of other problems, including anxiety and depression. By working
with them to improve mobility, their quality of life improves."
top docs in the NJMS Department of Physical Medicine and Rehabilitation
are as noteworthy as Francis. Bach is professor and vice chair
of physical medicine and rehabilitation at NJMS. Rehabilitating
patients with neuromuscular disease by improving breathing
and coughing function has been his primary focus. As medical
director of the Center for Noninvasive Mechanical Ventilation
Alternatives and Pulmonary Rehabilitation at UMDNJUniversity
Hospital in Newark, he is internationally recognized for his
innovative work in noninvasive (nonsurgical) mechanical ventilation.
is associate professor of physical medicine and rehabilitation
at NJMS and associate medical director and director of the
spinal cord injury program of the Kessler Institute. An expert
on spinal cord injury and rehabilitation, he is the primary
investigator on several spinal cord injury grants, and serves
as project co-director of the Northern New Jersey Spinal Cord
Injury Model System Program. He is the author of numerous
articles and textbook chapters and the editor of Spinal Cord
Injury Medicine (Lippincott/Williams and Wilkins, 2002).