Dr. Rebecca Clemans graduated from Wayne State University School of Medicine and completed her residency in Anesthesiology at Northwestern Memorial Hospital. She completed a fellowship in Pain Medicine at Northwestern and started work at Beaumont Health in 2004.
For the last 10 years Dr. Clemans has been the medical student director for Anesthesiology and Pain Medicine, and when the Oakland University William Beaumont Medical School started in 2009, her title changed to Clerkship Director for Anesthesiology and Pain Medicine. She works day to day in a variety of environments, which makes for an interesting career. Some days she is in the OR providing anesthesia for a lung resection, or in the Labor and Delivery unit doing epidurals for laboring patients. Other days she is in the pain clinic where she performs interventional procedures for chronic pain such as epidural steroid injections. Yet other days she is in the hospital doing inpatient rounds on patients with acute and chronic pain from a variety of causes (post operative, trauma, chronic pain etc). Dr. Clemans says, “Caring for the inpatient pain patients over the years has revealed the need for more specialists in addiction medicine.”
What motivated you to pursue addiction medicine certification?
I have come to realize that many of the patients we are asked to see in the hospital, for consultation to treat difficult-to-manage pain, really have an underlying SUD. The patients are often trauma patients or patients admitted with infection. Over the years, our inpatient pain service has been asked to assist with these patients because our hospital does not have an addictionologist on staff. Our pain team, the primary team and indeed, the patients, were dissatisfied with the old process which consisted of treating their illness or injury and discharging them as soon as possible with a list of phone numbers for addictionologists in the area. I recognized the problem was getting worse with time, not better. We are seeing more and more patients with OUD, and not having the tools to help continued to frustrate me. I felt I was in a perfect position to make a change.
What ideas do you have that can help build a better community of addiction medicine professionals?
We can build a better community of addiction medicine professionals including Addiction Medicine into our medical school curriculum. Teaching our young medical students and residents that Substance Use Disorder is a biopsychosocial disease that is preventable, diagnosable, and treatable is the solution. When we demystify this disease process for our learners, we help them avoid stigmatizing patients and help them understand how they too can make a difference in these patients’ lives. We can give students the tools to improve the future treatment for this chronic illness. Toward that goal, I have worked with the OUWB medical school curriculum committee which has incorporated education about addiction into the M1-M3 years, and I developed an online M4 Addiction Medicine elective which includes x-waiver training. We hope to have a clinical rotation in the near future.
Thinking back, what has been your most challenging patient case and how did you overcome that challenge?
The most challenging patient cases have not much to do with the patients. Instead, it has to do with the realization that there are often barriers to treatment for patients with SUD that are difficult to overcome. For instance, when we have the opportunity to intervene and a patient is ready to accept treatment, but we find the patient has no state identification. Without state ID, a patient is usually not able to get treatment from a Methadone Clinic or obtain Buprenorphine from a pharmacy. The process to obtain a state ID can be long and arduous for patients who have limited resources and limited support after leaving our care. Bringing some of these barriers to light may guide our legislative policy in the future.
What advice or words of wisdom do you have for physicians on the fence about pursuing addiction medicine as a career?
Treating patients with SUD has been very rewarding to me. Like some other areas in medicine, this specialty brings us close to patients who are desperate for someone to listen and help. Unlike other areas in medicine, there are limited providers who are comfortable treating SUD. It is an amazing experience to see the change in a person’s demeanor when talking with them in a way that is non-judgmental and non-stigmatizing. You can see such a dramatic change when you start the conversation; the patient looking hopelessly down at the floor, just knowing they will not be heard or understood in this problem they are experiencing, only to turn their faces up to make eye contact, open up and appear more hopeful when they learn there are options to help and people who care. Providing hope is powerful. When you see this happen in a single conversation, it reinforces the reason many of us went in to medicine.
Question from our last participant: Given that this group is probably well-represented by Gen Xers and older Millennials, who is the most important musical group of the 1990s?
The most influential musical group of the 1990s would likely be Nirvana but all the boy bands were important too! I quiz my kids to make sure they can recognize Madonna and Prince when we hear them on the radio – such great music in the 90’s!
Finally, let’s have some fun. What is that burning question you have for our next MI CARES participant in the spotlight?
What is the contribution you have made to “be the change that you wish to see in the world?”