BrainWaves: March 2016

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This month's podcast focuses on how to see a neurosurgeon at Johns Hopkins.

Transcript

Elizabeth Tracey: Welcome to this month's Brain Waves. I'm Elizabeth Tracey.

John Weingart: Hello, Elizabeth. I'm John Weingart, Professor of Neurosurgery at Johns Hopkins. Today, I thought we'd talk a little bit about if you're told that you have an abnormal MRI scan or a tumor, what do you do? How do you get access to Johns Hopkins? Some of the issues related to access have to do with the anxiety that's associated with being told by your family doctor or your primary care doctor that you have an abnormal MRI scan and you need to see a neurosurgeon. Patients fall into several categories. One is the patient that has symptoms not related to what's on their MRI scan. So they're having an MRI scan for a different reason. Maybe it's from migraine headaches. Maybe they had a car accident and they're ruling out concussion or some other problem. And while doing that MRI scan, something is found. The urgency of evaluation for that patient is different than the other patient who's having active symptoms. from what's found on their MRI scan. That person needs to be evaluated much quicker. For the patient and for their family, regardless of which category you fall in, there's a sense of urgency. There are many questions. People need plans. They need to understand. And so oftentimes, the local doctor will refer them to a neurosurgeon or may say, go to an emergency room, or you just need to be seen, and it's left to the family to identify a treatment location. So here at Hopkins, we've developed variety of different avenues for people to get access to the system. The speed of getting seen by neurosurgery here really is on the order of one day to within a week. The key, however, is to get the information here, and all that involves is usually just making a phone call. There is a number to access the neurosurgery department as a whole. We have a separate number for pediatric neurosurgery, and we have a separate number for people who are out of state. The Hopkins USA number is a route them to do that, but they can also call the neurosurgeon's office directly. We have an imaging uploading system that if somebody has their MRI disk on their home computer, they can upload the images onto a website, and we can do an initial screening to understand, one, the acuity of the problem, and then set up an appointment for the next day or an appropriate time for that person.

Elizabeth Tracey: This is all really great. I'm sure it developed in response to things that were probably going on, barriers for people being able to access the system. It's your standard then in this department that you would see people in a really short period of time.

John Weingart: Right, for someone who has a brain tumor, it's oftentimes the very next day. There's a small group of people that have a newly diagnosed brain tumor that need care immediately. But that's the smallest group of people that present with a mass. Most of the time, there is a period of time of a week to 10 days that is perfectly safe to get evaluated, figure out what questions you need to ask, what you need to understand the problem, and then to get seen and treated. People who have a problem like that are seen and they're usually operated on within a week. So there's always time to get second opinions. It's even possible for people to be transferred from other hospitals directly for more acute problems.

Elizabeth Tracey: One of the advantages, of course, here at Hopkins is that we have a wide range of specialists. And as you've told me before, sometimes brain tumors kind of fall into more than one. one specialty.

John Weingart: Oh, you're so right about that. Many of the things require doctors from different specialties to help take care of that patient. When somebody comes in to be seen in neurosurgery, if they have a problem that requires other services involvement to take care of that person in the best way, then we in neurosurgery arrange the visits, oftentimes on the very same day. One of the nice things about the kind of system that you have at a large academic center is that once you jump on the Plus, it stops where you need to stop.

Elizabeth Tracey: So that this comprehensive approach then extends not just to the consult and to the diagnosis, but also to the procedure and the treatment.

John Weingart: Absolutely, and the follow-up care. There are plenty of patients of mine that have a tumor that required surgery only, and they live two, three hours away. I don't ask them to drive two hours for a 10-minute visit to say your MRI looks great. They can get their MRI locally, they can upload it to the system, I can look at it, and we can have a phone Visit, so to speak, to say, Hey, your MRI looks fine, no problems, you know, how are you doing, any issues? It's more efficient for them, it works well for everybody. The system of being able to access information remotely, so to speak, is so efficient.

Elizabeth Tracey: Why don't we end with a note from you on clinical trials, because clearly in this place, that's a really big deal. And it certainly is an advantage to patients if they're eligible to participate in such a thing.

John Weingart: Yeah, the clinical trial thing is also a very difficult thing to access. And in terms of efficiency, to come for a visit and then say, yeah, you could be eligible for these trials, and you need to see this doctor and that doctor, you have to come back to see those doctors, well, that's not good for the patients. So they really need to come and get that evaluation all at once.

Elizabeth Tracey: Excellent. Would you like to share the phone numbers people can access?

John Weingart: Absolutely. For the general adult neurosurgery access line, the number is 410-955-6406. For the pediatric neurosurgery patients, it's 410-955-7337. And for the out-of-state patients, the number is 410-735-4306. 4872, which is the Hopkins USA number. But the other thing is patients can just call the doctor's office directly. So if someone has a brain tumor, they can look on the Johns Hopkins neurosurgery brain tumor site and you'll see listed all of the members of our faculty that take care of brain tumors. Just call that doctor's office. The doctor's assistant will take that information down and the doctor will get right back to them and they'll be seen immediately. So, you don't have to go through the general system. You can, but you don't have to necessarily go through the general system. You can go directly to the doctor's office, and for this kind of a problem, the person will be seen immediately, and sometimes... at least in my office, I have them ask the patient to upload their images even before the appointment so that I can see it so that if it looks like this is something that needs an operation sooner rather than later, I can be getting all that sort of orchestrated in my mind in terms of timing and getting even a pre-op evaluation, tentatively planned for someone on the same day that they're coming to be seen so all of that can be expedited for that person.

Elizabeth Tracey: Very good news. Thank you so very much.

John Weingart: Thank you.