Jaclyn Barcikowski, DO, is a physiatrist who treats patients in the Drucker Brain Injury Center. Certified in Physical Medicine and Rehabilitation and Brain Injury Medicine, she serves as associate program director of the MossRehab/Einstein Physical Medicine and Rehabilitation Residency Training Program.

What is your background?

Before attending medical school, I earned a master's degree in medical nutrition sciences from Boston University School of Medicine, as I felt most physicians could benefit from more nutrition training. After graduating, I attended the University of New England College of Osteopathic Medicine in Maine and did my intern year at St. Vincent’s Hospital in Western Massachusetts for internal medicine. I also completed a Physical Medicine and Rehabilitation residency and a Traumatic Brain Injury fellowship at the University of Pennsylvania in Philadelphia.

You hold certifications in Physical Medicine and Rehabilitation and Brain Injury Medicine?

I completed a multi-year Physical Medicine and Rehabilitation (PMR) residency that offered training in rehab medicine under doctor supervision for both inpatients and outpatients, and a one-year fellowship in traumatic brain injury that focused on patients with brain injuries and how to manage brain injury. So, I'm double board certified in brain injury and rehab medicine. When first starting my residency, I thought I would specialize in sports medicine because I’m an athlete. During my rotations in rehab medicine, I was drawn to more complicated patients with stroke and brain injuries.

Where do you work within the MossRehab network?

I work as a physiatrist in the Drucker Brain Injury Center in Elkins Park. I came straight to MossRehab after completing my fellowship. Coming here was a huge opportunity for me. MossRehab has a wonderful reputation, particularly for brain injury medicine. I knew Alberto Esquenazi, MD, Chief Medical Officer of MossRehab, because he lectured in our residency program. I also knew of Miriam Segal, MD, attending physiatrist at the Drucker Brain Injury Center, Michael Marino, MD, attending physician at MossRehab specializing in traumatic brain injury rehabilitation and concussions and Thomas Watanabe,, clinical director of the Drucker Brain Injury Center when I was a resident and admired their work. I feel lucky to now have them as leaders and colleagues.

What is the MossRehab/Einstein Physical Medicine and Rehabilitation Residency Training Program?

This new program teaches upcoming physiatrists in physical medicine and rehabilitation. Over four years, residents do clinical rotations within the Drucker Brain Injury Center, treating patients who experienced a stroke, spinal cord injury, or traumatic brain injury. They learn to consult with patients to make recommendations on their care and attend lectures on various topics such as wellbeing, orthotics, brain injury and stroke. I serve as associate program director working with Channarayapatna R. Sridhara, MD, Program Director, and Marlyn Ramos Lamboy, MD, Associate Program Director, in developing the program curriculum. Our first class is this year, which includes seven residents chosen out of hundreds of applicants. I currently have a resident on my team.

Who are your patients?

My patients include those admitted to the hospital who require a high intensity of medical care due to brain injuries. I also work with outpatients discharged from the hospital. They come to my practice to get care and may receive different outpatient therapies such as physical, occupational, and speech.

How do your patients acquire brain injuries?

Some patients have traumatic brain injuries (TBIs) caused by falls, motor vehicle accidents, assaults, or gunshot wounds. Others have non-traumatic brain injuries because of a brain tumor, stroke or surgery, or anoxic brain injuries due to a lack of oxygen, which results in brain cell death caused by cardiac arrest.

What are their challenges?

Patients are challenged with walking, talking, and daily activities like showering, dressing, and feeding themselves. Individuals can have cognitive issues that result in difficulties with memory, attention, or focusing on one or more tasks at a time or switching from one to another. Patients also can have language difficulties with speech and comprehension. They may know what they want to say but can't get the words out. Or, they get a lot of words but it doesn't make sense. Many patients have neurobehavioral deficits including agitation, anxiety, and mood disorders.

What is your approach to patient care?

For a patient admitted to the hospital, I gather information about their acute care stay (patient gets immediate treatment for a serious illness or injury to improve health) and conduct a thorough exam. Communication is critical with the patient and their family. After talking to the patient, I introduce myself to the family, explain what happened, and the care that the patient has received thus far. I ask them to tell me more about the patient. What motivates them? Do they have issues with anxiety, depression or past abuse? What do they like to do – read, garden, travel? This information helps me better understand a patient so I can treat the person and not just the TBI.

Patients have a care team consisting of therapists, nursing, neuropsychologist, social worker, and a physiatrist, like myself. Each week, the team discusses different issues such as medications and treatments, what the patient knows and understands, and updates for families so they can make decisions regarding future care upon patient discharge. We also meet every morning to discuss any overnight issues or medical conditions to address during the day. We work towards goals, such as taking out the catheter so they can go the bathroom on their own or dressing before leaving the hospital.

My outpatients often include those I’ve treated in the hospital, so I continue the course of care. A new patient is more challenging as I need to assess their current treatments, the person’s understanding of their health condition, and how to address some of their biggest symptoms to get them back to a better standard of living. As with outpatients, I work with a care team of clinicians to treat their different issues.

What types of treatments do you use in neurorehabilitation?

It depends on the patient diagnosis. Some individuals may experience spasticity (abnormal muscle stiffness) after a stroke that interferes with range of motion movements and speech. Treatments can include oral medications, bracing, and Botox, which is injected right into the muscle to help with stiffness.

For headaches and neuropathic pain (pain from the nervous system), I may prescribe different therapies, nerve blocks, and medications. Or I may refer them to a headache specialist who understands their brain injury from that perspective. Individuals who experienced concussions may need vision therapy as part of a treatment plan because vision disturbances may prolong their recovery.

I may have a patient undergo neuropsychology testing to evaluate behavior issues. If a person is found to have an attention issue, I guide their treatment in terms of medications like neurostimulators, which can help them think faster and hold their attention. Patients often experience depression and anxiety due to injuries. When medications and therapies aren’t sufficient, I refer them to a specialist such as a traumatic brain injury psychiatrist or anxiety therapist. Treatment is different from patient to patient.

What is an example of a recent patient experience?

I had a patient in his early 60s who was involved in a motorcycle accident and had a severe TBI. He had seizures, confusion, and short-term memory issues where he wouldn’t remember me the next day. Through therapy, he started to walk, talk in longer sentences, and know his care team. His progress enabled his discharge to home while continuing to receive outpatient care from me and speech, occupational, and physical therapists at the Drucker Brain Institute. We worked with him on balance and vestibular (body movement) issues because he had a temporal bone (skull bone containing part of the ear) fracture. He also received neuropsychology counseling (which focuses on a person’s cognition and behavior), which was a huge help to him. It took over a year before he could even think of returning to driving because of his cognitive issues. But, now, he is both driving and working.

What inspires you on the job?

My patients. I meet people when they are at their most vulnerable and I'm here to take care of them and help them get to a better place. The biggest source of inspiration I get is the progress I see my patients making towards improving their function and quality of life, and I love being able to make a difference in their recovery.

What is something that your co-workers might not know about you?

I've run 10 marathons in my life. I’ve participated in the Boston Marathon three times, the New York City Marathon, one in Rhode Island, and a few in California and Philadelphia. The Boston Marathon is the most special to me because I lived in Boston and love the city, and it’s one of the most iconic marathons in the world.

What are your interests outside of work?

Besides running, I like to go hiking with my husband and dog. We’ve also been getting into kayaking and we try to take time to travel and visit extended family whenever we can.

What is your favorite food?

I’m from Southern California, so it has to be tacos, especially with chips and salsa.

What is the last book that you read?

I’m reading Dare to Lead by Brené Brown.