Dr. Gregory W. Stewart on how the U.S. has improved care for veterans
The daily headlines remind us of how countries around the world care or do not care for their military service members. How does the United States hold up with regard to how it cares for its veterans? We know in the past questions have been raised about the VA system, but it seems that a corner has been turned and veterans’ care has improved. How exactly has the VA system been improved? How does the US care for veterans compared to other comparable countries? What exciting new technological or methodological innovations are being used to improve veterans’ health outcomes? To address these questions, we are talking to successful physicians, healthcare workers, veterans, or other VA employees and officials who can share stories and insights from their experience about the state of veterans’ care today and how the US has improved its care for veterans over the last five years.
As a part of this series, I had the pleasure to interview Dr. Gregory W. Stewart.
Dr. Gregory W. Stewart is the Chief of the Section of Physical Medicine and Rehabilitation, and the W. Kennon McWilliams Professor in Sports Medicine at Tulane University. Nationally recognized in the Department of Orthopaedics, Dr. Stewart specializes in disability prevention, rehabilitative medicine, sports medicine, and has a particular interest in sports concussion. He is the director of the Sports Concussion Management Program and team physician at Tulane, and he has served as team physician for professional, collegiate and high school teams for more than 35 years.
Dr. Stewart is active in professional associations in sports medicine and physical medicine and rehabilitation. He was a major contributor to the successful passage of the Louisiana Youth Concussion Act. He received funding from the U.S Department of Education’s National Institute of Disability and Rehabilitation Research to examine the effects of mild traumatic brain injury in high school football athletes
Dr. Stewart earned a Bachelor of Science degree from Houston Baptist University in 1982 and a medical degree from University of Texas Medical Branch School of Medicine in 1986. He completed an internship and residency at Louisiana State University/Charity Hospital. Dr. Stewart is board certified in physical medicine and rehabilitation.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?
I started out being interested in sports medicine. I did this in high school and college. After medical school I went into physical medicine and rehabilitation. This allowed me to continue to do sports medicine. I slowly build a program over time. Approximately 10 years ago started working with the NFL players Association for a 3-day evaluation program for former NFL players. This led to the development of the current program at the Tulane University Center for brain health where we care for military veterans.
Can you share the most interesting story that happened to you since you began your career?
One of the most interesting things that happened to me was getting a phone call about starting the Brain Health program. Most of the other programs I had worked on and applied for. This was the first time where someone came to me to set up a very important program. It was a phone call and email out of the blue that has led me down this path.
Can you please give us your favorite ”Life Lesson Quote”? Can you share how that was relevant to you in your life?
There are actually quite a few. My team sometimes gets tired of my quotes. Actually have Stewart’s rules which is a long list of quotes. After the previous question the most appropriate one is rule #2 which is “the answer is always yes.” They called- asked if I be interested in caring for military veteran- I said yes and then went into figuring out how we would manage the program. Another one that becomes important with this as well is “always act like you belong and walk with a purpose.” If you go to say yes to something you have never done before then you need to be convincing that you can pull it off. And that means acting like you belong and should be doing the things that you are accomplishing.
Are you working on any exciting new projects now? How do you think that will help people?
One of the most exciting projects that we are working on is the development of our Tulane Center for Sport Brain Bank. This started with a former patient’s family member calling and saying that their loved wanted passed away and he wanted us to have his brain. As you can imagine, this was quite an honor. Since then we have started to accept donations for our sport related injury brain bank. Having this brain bank and starting the veterans program has allowed us to expand into looking at what traumatic brain injury looks like in the military population. There is a big difference between traumatic injuries and blast injuries. Understanding the changes that occur in the brain will greatly assist us in understanding how to best treat these problems.
How would you define an “excellent healthcare provider”?
An excellent healthcare provider has to be someone who cares and is passionate about what they do. They have to listen to what the patient is telling them and you have to be able to meet the patient where they are. Treatment is not a one size fits all. You have to very much understand your patient’s specific needs and circumstances in order to be able to appropriately care for them.
Ok, thank you for that. Let’s now jump to the main focus of our interview. Based on your experience can you please share three recent improvements to veterans care that you are really pleased about?
One of the recent improvements is very important- an acknowledgment of the role that burn pits have played in the health issues of military veterans. Another area that still has a lot to be accomplished is prevention of suicide. I think one of the important things is an acknowledgment that some of the mild traumatic brain injury and moral injury can play a role in this. Which leads to the third improvement which is the continued treatment and acknowledgment of mild traumatic brain injury. That has been the entire impetus behind the creation of the Avalon Network. Looking at prevention of suicide by treating a mild traumatic brain injury.
In contrast, can you highlight three areas of veterans care that still need improvement? What would you suggest needs to be done to address those challenges?
One of the areas that still needs improvement is the treatment of individuals who have suffered military sexual trauma. Even as I started caring for military veterans I was not aware of the extent and prevalence of MST. There needs to be a greater degree of acknowledgment of the problem and placing less blame on the victims. The other big area is that access to care is relatively disjointed for military veterans. The quality and high standards of care are not universal for the veterans. All of the organizations providing care to the veterans need to be more concerned about the veteran and the care they provide than the benefits to their own organization.
What exciting new technological or methodological innovations are being used to improve veterans’ health outcomes?
From a technological standpoint some of the exciting things are in neuro imaging. We are probably 3 to 5 years of being able to image her brain and be able to see some of the damage caused by blast injury. This will help in the care of these veterans, and we will be able to follow changes over time. From a methodological standpoint one of the biggest innovations is also very low tech. Using integrative therapies in a multidisciplinary and interdisciplinary team approach is making a lot of difference as we work with mild traumatic brain injury and psychological issues. The integrative therapies include mind-body medicine, meditation, yoga, music, art and other related treatments. While it is low-tech it is very personnel intensive, it is often hard to find individuals who are very good at their crafts in the integrative therapy world.
This is our signature question that we ask in many of our interviews. What are your “5 Things I Wish Someone Told Me When I First Started My Career”?
As I get further into my career there are many life lessons that I wished I had known earlier. One is that if you are doing good work, there are going to be people that are going to try and pull you down for one reason or another. So you can never give up and never let them grind you down. In the same vein and another lesson is that it is never easy. Sometimes you wish it was easier but then you realize that if it was easier everybody would be doing it. You remember you don’t want to be like everyone else- so you except the fact that often things are not going to be easy. I think another important thing to keep in mind is you eat the elephant one bite at a time. On many of my projects they often appear daunting at the outset. You need to always be looking at the grand vision but at the same time realize that you can get there you just have to be methodical about accomplishing the small tasks and not ignoring the small things. I think another important thing is to know that it is important to compromise where you can. You are not going to get or accomplish everything that you want. There are going to be times where you are not able to compromise, in certain areas you should not especially when it comes to quality. And probably the most important thing to keep in mind is that as you go along in life you should always pray as if God will take care of everything but act as if it is all up to you. You must always realize the tools and opportunities that are placed in front of you, and to be ready to take advantage of the things that are given to you.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
For me, it would be the creation of a mild to moderate traumatic brain injury center of excellence. There are not any places to my knowledge that combine clinical care and treatment, research, and education relative to mild to moderate traumatic brain injury. Having this all under a single roof would maximize the impact of the care and be able to study new innovations in a timelier manner. As with anything the biggest barrier to this is financial.
How can our readers further follow your work online?
You can visit tucbh.tulane.edu to learn more about all that we do or reach out to Bonnie McCollough, Director of External Relations, bmccollo@tulane.edu.
This story originally appeared on Medium.com / Authority Magazine