Top Docs Q&A: Mel B. Glenn

This post is part of our Top Docs Q&A series where we ask a physician who was selected as one of our Top Docs questions about their field, life as a doctor, and practicing in the Greater Boston area. 

Name: Mel B. Glenn

Hospital Affiliation: Spaulding Rehabilitation Hospital, Massachusetts General Hospital

Title: Director of Outpatient and Community Brain Injury Rehabilitation

Field: Physical Medicine and Rehabilitation

Specialty: Brain Injury Rehabilitation

Why did you choose to specialize in physical medicine and rehabilitation?

I have always had an affinity for the underdog. I was drawn to the idea of helping those who had become disabled by catastrophic injuries. I was also intrigued by the broad scope of the field and the practical approach to the treatment. It involves treating medical, neurological, and musculoskeletal problems, as well as physiological and social issues. It’s really a form of holistic medicine, with the ultimate goal of maximizing a person’s ability to function at home, in the community, and at work.

What do you like most about the field?

I very much enjoy the team approach. I work with a team of physical and occupational therapist, speech and language pathologist, mental health professionals, nurses, and case managers.

In the time you’ve been practicing, how have you seen the field change?

For one, the lengths of inpatient rehabilitation stays have become dramatically shorter. It used to be common for patients with catastrophic injuries to remain inpatient for three to six months. Now two to four weeks is the norm. Another huge change that I’ve seen is in the competitive nature of the residency training program. When I entered the field, most physicians had never even heard of physical medicine and rehabilitation. Today we get hundreds of applications for just a few available residency positions.

What are the latest advancements in the field?

Although there is progress being made in many areas, to me some of the most exciting advances are being made in research on non-invasive brain stimulation using direct electrical current or magnetic fields. There is emerging evidence that this can help people with strokes and traumatic brain injury to improve the use of weak limbs, to influence the use of impaired language and cognitive skills, and to treat depression.

What is your hope for the future of physical medicine and rehabilitation?

My hope is that recognition of the value of rehabilitation continues to grow such that physical medicine and rehabilitation becomes a valuable resource in the future world of health care systems.

You have worked closely as the project director and now advisor for the Spaulding-Harvard Traumatic Brain Injury Model System. What exactly does this database do?

The mission of the Model System is to contribute to a national database of patients who have had traumatic brain injuries, to do research on traumatic brain injury rehabilitation, some of which involves the use of the database to disseminate the results of the research and other information regarding traumatic brain injury, and to provide a continuum of care for people with traumatic injury from emergency medical care through rehabilitation and long-term follow-up.

Where did the idea for this system come from?

The Model Systems have been in existence for many years. The Department of Education started the Spinal Cord Injury Model System grant in the early 1970s, the later burn Model Systems grants were added, and in 1989, the Traumatic Brain Injury Model Systems were initiated.

You’re a contributing author for a chapter in the book “Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation” that was published this year. What did the chapter talk about?

I wrote a chapter on mild traumatic brain injury and post-concussive symptoms with my co-author Dr. Seth Herman. The treatment of people with persistent post-concussive symptoms such as headache, dizziness, and cognitive impairment is among the most interesting and challenging areas for rehabilitation.

What has been your biggest achievement during your career?

My greatest achievement involved medication interventions for individual patients and advocating for changes in medication treatments in the rehabilitation medical community. I was later asked to edit and write a pharmacology column for the Journal of Head Trauma Rehabilitation in 1985. I continued to edit the pharmacology journal for a total of 28 years now.