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When Bernard Farrell, M.D., medical director of Pulmonary Rehabilitation and Pulmonary Diagnostics at HCGH, graduated from medical school in Dublin, the field of pulmonary rehabilitation was relatively obscure in Ireland. After finishing a pulmonary fellowship at the University of Maryland, however, he found pulmonary rehab programs almost nonexistent in this area as well. To remedy that situation, over the past 30 years, he has launched a continually expanding program at HCGH and has helped with getting similar programs started in other area facilities.
Vic Broccolino, president and CEO, HCGH; Tina
Milman; Lynda Sloper, RN; Jean Warthen, retired RN,
patient and volunteer, cutting ribbon for the NuStep
she donated to Pulmonary Rehab; Dr. Bernard Farrell,
and Debbie Daskaloff, executive director, Howard
Hospital Foundation, in 1996.
In 1981, Farrell was recruited by HCGH to head up the Pulmonary Medicine section of the department of Medicine, and soon realized that a growing number of patients with lung disease could benefit from rehabilitation. In 1983, with Anna Watring, department coordinator, and RN Deborah Froman, he launched and served as director of the HCGH Pulmonary Rehabilitation program – the first of its kind in Maryland and one of the first on the entire East Coast. Patients were soon coming from Pennsylvania, Virginia and Delaware, some staying at a local hotel in order to receive services at HCGH.
Several years later, Martine (Tina) Milman, respiratory therapist (RT), became department coordinator, and she and Farrell worked diligently to grow the program, shepherding it to its status as the first certified pulmonary rehab program in the state of Maryland. They obtained membership in the American Association of Cardiovascular Pulmonary Rehabilitation and started a chapter in the state of Maryland.
Farrell and Milman also served as mentors to other health facilities that wanted to start programs, speaking at meetings and offering pulmonary staff from those facilities, including Johns Hopkins, the opportunity to observe HCGH’s rehab services. Initially, there was some disagreement by medical insurance providers about whether pulmonary rehabilitation should be covered. The HCGH program was instrumental in gaining wider recognition for pulmonary rehab as a legitimate form of treatment for lung disease and Farrell’s work to document the improved exercise tolerance of patients participating in rehab exercise helped to provide a broader understanding of the field. Eventually, Medicare and other providers agreed to cover these services. “It’s important for patients to understand that pulmonary rehab can’t change lung function,” noted Farrell. “But it can certainly improve their physical conditioning, allowing them to do more with the same function. It’s really about improving their exercise tolerance and quality of life.”
Dr. Bernard Farrell, Pulmonary Rehab medical director,
third from left, With members of the Pulmonary Rehab
team: from left, Nancy Bauknight, RN; Prashoba
George, RN; Lisa Glasgow, RRT; Brittany Neigh, EP;
Preeti Benjamin, manager, Pulmonary Rehab; William
The majority of the patients seen in Pulmonary Rehab have chronic obstructive pulmonary disease (COPD) or interstitial lung disease, which is characterized by inflammation and scarring of the lungs. The department also sees a growing number of lung transplant patients for both pre- and post-surgery therapy. There is a focus on endurance training, and education about exercise, diet and life-style changes. After finishing Phase II rehab, patients can participate in a voluntary, ongoing maintenance program. There are currently 28 patients enrolled in maintenance, some for as long as 15 years.
In its first location in the original hospital, therapists had to walk patients through the hospital’s halls as part of their exercise therapy. The program moved to a larger space on the first floor of the hospital and is now in The Bolduc Family Outpatient Center. In 1983, the department had one bicycle, one treadmill, one therapist, one RN and two patients; today there are 34 state-of-the-art exercise machines, patient showers, a walking track, a staff of ten that includes RNs, RTs, exercise physiologists and a medical director and as many as 20 patients at any given time. “The department always did a great job, but the new location and resources make it possible for pulmonary rehab staff to provide truly excellent care for their patients,” commented Milman.
Asked what he sees as the biggest change in pulmonary rehabilitation over the years, Farrell responded, “There is recognition of the value of pulmonary rehab. Today it is the standard of care for COPD and chronic lung disease, and our program is one of the largest in the state of Maryland. Medicare coverage has made it possible for more people to benefit from this treatment.”
Join us in wishing Dr. Farrell and his team a happy 30th anniversary.