Having first joined the North American Spine Society (NASS) in 2002, Heidi Prather, department of orthopaedic surgery, Washington University, USA, was appointed President of the association at its most recent Annual Meeting (12–15 November 2014, San Francisco, USA). Having become interested in medicine at school she was advised by her aunt, a nurse, to become a physician. After working as a nursing assistant at a rehabilitation hospital during high school, she decided to specialise in physical medicine and rehabilitation. With this background, she now hopes to bring a multidisciplinary approach to her NASS presidency. Her clinical interests include musculoskeletal and spinal conditions in young adults. She also has extensive experience in sport-related disorders and acts as a consultant for the St Louis Rams NFL and the St Louis Blues NHL teams. She spoke to Spinal News International about her career to date and the goals of her presidential term.
Why did you decide to become a doctor and why, in particular, did you decide to specialise in orthopaedic medicine?
I became interested in medicine as a career in middle school and thought I would be a nurse. My aunt, a nurse herself, encouraged me to instead become a physician. My high school job working as a nursing assistant in a rehabilitation hospital directed me to the specialty of physical medicine and rehabilitation. My parents also supported my drive to do something with an impact.
Who have been your career mentors?
My career mentor, a past-president of NASS, is Joel Press. I continue to rely on his guidance. Our core values mirror each other’s both in and outside of work. He has been essential to my career and personal development.
Of the research you have been involved with, which piece are you proudest of and why?
I am proudest of my current work on the relationships between hip and lumbar spine disorders. I am proud of it because it is descriptive of patients in my practice and is widely applicable to other spine health care providers.
What are your current research interests?
My current research interests include pre-arthritic hip disorders; hip–spine connection and how these relate to pelvic girdle dysfunction and gender differences.
What are the most common sport-related spinal injuries you come across in your work?
Regardless of the level of the athlete (high school, collegiate or professional), the most common injuries I treat are overuse injuries such as stress fractures, intervertebral disc disorders, and movement disorders.
Are there measures that those involved in sport, both players and administrators, can implement to reduce such problems?
Encouraging and enforcing appropriate warm-up and cool down and relative rest—the body needs time to recover.
What are the three questions in spinal medicine that still need an answer?
- What are the diagnostic tools that will best allow us to understand the cause and evolution of axial spine pain?
- How do we prevent chronic spine pain?
- What biologics will improve outcomes for spinal cord and spinal column regeneration?
What do you think will be the next big development in spinal medicine?
A biologic agent used to treat a spinal disorder.
As a physiatrist, are there any trends in spinal rehabilitation that especially excite or interest you?
With the changes in reimbursement and administration of health care in the USA, increasing the evidence for administering spine care outside the operating room has never been more important. Physiatrists’ core training in spinal cord and acute and chronic spine disorders places them in a unique position to contribute to this evidence. Addressing all of the diagnoses (including structural, movement and the biopsychosocial characteristics) that patients present with allows physiatrists to bring a holistic approach to patient care that is missing in a healthcare environment that encourages specialisation.
What are your key goals as the president of NASS?
One goal is to facilitate an environment for the multidisciplinary volunteer members to freely express their perspectives. Embracing our differences in approach to patient care, education, research and health policy will strengthen our work and increase our impact. Another goal is to foster the expansion of educational and health policy products and services to members. Finally, NASS is a global society, so more in-depth educational events are planned for the specific needs of our global members.
How do you think your background as a physiatrist will help you in your presidential role?
Part of the core training of a physical medicine and rehabilitation physician is the role as leader of a multidisciplinary team. I use this training every day in practice and it will serve me well in my leadership role of NASS, an organisation of a wide variety of spine healthcare providers, researchers, and educators.
What were the highlights of the 2014 NASS Annual Meeting?
Highlights from the 2014 NASS annual meeting included the high level of original research presentations (250 podium presentations), expansion of the outreach of clinicians participating in the allied health track, and the growing international speaker presence in the global spine symposium, as well as expert international researchers.
Are you planning on attending many spinal meetings this year? If so, are there any that you are particularly looking forward to? Why?
I recently attended the Chinese Orthopaedic Association meeting in Beijing, China. This was a wonderful experience. Spine education in China has an intensified focus of standardising education in order to improve outreach and access for patients. We are making plans for NASS to play an important role in bringing advanced educational events to China. We are also planning for the exciting 2015 NASS Annual Meeting, which is to be held in Chicago in October. We hope to provide more small group discussions regarding current topics in medicine ranging from patient care to research and policy.
What has been your most memorable case?
I have been fortunate to have had the experience and privilege of people entrusting me with their care, and sharing in their associated major life events. One case in particular comes to mind as being especially memorable. I provided care for a middle-aged woman who presented with a low back pain disorder that had forced her out of her manual labour job and onto disability. She had been advised that her condition was chronic and that there was little to be done. We worked together for five years consistently, during which time she travelled over two hours one way to see me. She went from taking narcotics and relatively little activity to being off her medications and exercising. From there she returned to school where she became a licensed practical nurse and went to work at an Alzheimer’s facility in her rural community. From disability to healthcare provider—powerful.
Outside of medicine, what are your hobbies and interests?
I am the wife of an academic radiation oncologist and mother of two children. My hobbies are supporting them, which includes watching a lot of sports and dance and driving to many places. My outlets include running, reading, travelling and listening to music.
2013–present -Professor, Chief, Section of Physical Medicine and Rehabilitation, Department of Orthopedics, Washington University School of Medicine, St Louis, USA
2013–present -Professor, Department of Neurology, Washington University School of Medicine, St Louis, USA
2006–2013 -Associate Professor, Chief, Section of Physical Medicine and Rehabilitation, Department of Orthopedics, Washington University School of Medicine, St Louis, Missouri, USA
2000–present -Consultant, St Louis Rams (NFL)
2000–present -Consultant, St Louis Blues (NHL)
2000–2006 -Consultant, St Louis Cardinals (NBL)
1983–1987 -Bachelor of Arts, with Honours, Biology and Chemistry, Drury College Springfield, USA
1987–1991 -Doctor of Osteopathic Medicine, University of Health Sciences College of Osteopathic Medicine (UHSCOM), Kansas City, USA
1991–1992 -Internship, Family Practice, Presbyterian/St Luke’s Hospital, Denver, USA
1992–1995 -Residency, Physical Medicine and The Rehabilitation Institute of Chicago, Northwestern University Medical School, Chicago, USA
Boards and committees
2014–present -President, North American Spine Society
2012–2014 Second Vice President, North American Spine Society
2011–present -Chair, Distinction Program committee, North American Spine Society
2006–2007 -President, Physiatric Association for Spine, Sports and Occupational Rehabilitation
2003–present -Board of Governors, North American Spine Society