20 Questions: Ross D. Zafonte, DO, Physical Medicine and Rehabilitation

Ross D. Zafonte, DO, is Earle P. and Ida S. Charlton professor and chairman of the Department of Physical Medicine and Rehabilitation at Harvard Medical School. He also serves as chief of physical medicine and rehabilitation at Massachusetts General Hospital, as well as vice president of medical affairs research and education at Spaulding Rehabilitation Network. Zafonte received his bachelor’s degree in psychology and biochemistry from University of Georgia (1981) and his DO from Nova Southeastern University College of Osteopathic Medicine (1985). He completed a one-year internship at Henry Ford Bi-County Hospital, followed by a residency in rehabilitation medicine at Mount Sinai School of Medicine, where he was also chief resident. Dr. Zafonte was a program fellow in research enrichment at the National Institute on Disability and Rehabilitation.
Dr. Zafonte has been on faculty at Thomas Jefferson University, University of Missouri, Wayne State University, and University of Pittsburgh. He has published extensively, authoring more than 250 peer review journal articles, abstracts and book chapters. His work can be found in Brain Imaging and Behavior, Critical Care Medicine, Journal of Burn Care & Research, Journal of the American Medical Association, PM&R, Archives of Physical Medicine & Rehabilitation, and Movement Disorders. Dr. Zafonte serves on the Board of Governors for the International Brain Injury Association, as well as the American Congress of Rehabilitation Medicine.

When did you first decide to become a doctor? Why?
I think I always wanted to be a physician, however my desire to focus on helping others recover and the importance of the medical profession was driven home when my grandfather had a stroke.
How and why did chose the medical school you attended?
I went to Nova Southeastern University. I was intrigued by the focus on interdisciplinary care and the importance of addressing the whole person that was emphasized at that school.
What surprised you most about your medical school studies?
I think the most surprising element came early on, when I began to understand that medicine was a lifelong learning process, and medical school simply prepares us with fundamentals to integrate further information.
Why did you decide to specialize?
I became very interested in issues related to recovery and how we might enhance the lives of those with injuries and disabilities.
If you would has to do it all over again, would you still specialize in your field?
I certainly would. Physical medicine and rehabilitation has a broad, exciting focus and has allowed me to explore ways to participate in the recovery for patients as well as see how well they have done overtime. The science of physical medicine and rehabilitation is the biology of recovering. It is fascinating and lends important aspects to the musculoskeletal and neurorehabilitation portions of our field.
Has being a specialist in your field met your expectations? Why?
In general, it has exceeded my expectation, it has provided me with the diverse opportunity of seeing and getting to know patients who have a wide array problems, and I have been able to help improve their quality of life and function.
What you like most about being a specialist in your field?
I like the tremendous diversity in physical medicine and rehabilitation from musculoskeletal patients to those with spinal cord injury, amputation or traumatic brain injury. In specific, my field of interest is traumatic brain injury and concussion, a growing area of clinical exploration and research.
What you like at least about being a specialist in your field?
I think I like all aspects of the specialty and find it fascinating as well as gratifying. Like all areas of medicine, one of the recent concerns has been the increasing burden of regulations that may be hampering the care of those with disability.
How did you career path lead you to where you are now?
I was fortunate to have outstanding mentors in residency and afterwards who assisted me in focusing on my desire to remain in academic medicine. In specific, focusing me on clinical care teaching and research for those with traumatic brain injury.
Describe a typical day at work.
I don’t think I have a typical day. I’m fortunate enough to do clinical care, administrative, educational and research work virtually every day, and the diversity of that experience keeps me interested. My day starts extremely early and ends quite late. Each day, however, is quite fulfilling in the fact that I have touched a number of different areas of practice almost every day and had an impact in some way on our department, on my patients and on trying to develop new biotechnologies for recovery.
On average how many hours do you work a week? How many hours of sleep do you get each night? How many weeks of vacation do you take annually?
I work between 80 and 100 hours per week and sleep around four hours per night. I typically take two weeks of vacation a year.
Do you feel that you are adequately compensated?
I think that for me the important element of what I do is really the ability to contribute back and much less about [my] compensation.
If you took at educational loans was paying them back a financial strain?
I was fortunate that my grandparents helped me with my medical school cost, so my loans were minimal and paid off over a relatively short of period of time.
In your position now, knowing what to do, would you have said yourself when you were beginning you medical career?
I would say pick an area of medicine that you have a great passion to practice and participate in. Despite any burdens that may occur in the future, you will always be excited each day to return to your place of practice.
What information or advice do wish you had when you were beginning your medical studies?
I wish I would have known to obtain a stronger background very early on in the business of medicine, understanding the economic issues and being able to understand their implementation in a dynamic environment.
From your perspective, what is the biggest problem in health care today?
Total medical expenses are growing at an exponential rate. We need to look at not only the medical sources of that rise in cost but also the regulatory burdens. As a society, we need to understand what contributes to improve the patient outcome and what simply contributes to cost. It is atypical for us to examine these types of issues, but clearly in the future we will need to eliminate things that don’t provide added value for patients.
Where do you see your specialty in five to 10 years?
I think physical medicine and rehabilitation will have tremendous growth, because of the aging of the population not only in the U.S. but in the western world. Physical medicine and rehabilitation will develop and enhanced recognition because of its focus on interdisciplinary care and the ability to improve patients’ function.
What types of outreach/volunteer work do you do, if any?
I focus a great deal on contributing back to the community. I have been involved in local community activities, but my greatest source of pride is being involved in the Home Base Program, a program with Mass General and the Red Sox Foundation that gives back to our nation heroes who have served in Iraq and Afghanistan with post traumatic stress or traumatic brain injury.
Do you have family? If so, do you have enough time to spend with them? How do you balance work and life outside of work?
It’s often difficult. I feel I don’t spend enough time with my family, especially my son, but I do make a special emphasis to try to get to activities that are important for him, such as sports or specific academic activities at his school. I think one needs to prioritize those key events that have high value to family and make every effort to be present for them.
What is your final piece of advice for students interested in pursuing your field as a career?
I think physical medicine and rehabilitation is a great opportunity for the future. I encourage those who have academic questions about recovery, those who enjoy spending a longitudinal time with patients and those who see an opportunity in helping individuals recover pursue this field. It carries great promise.