At the Mount Sinai Morningside Spine Program, the Personal Touch Is Key to Healing

Updated on Mar 5, 2024 | Featured, Mount Sinai Morningside, Your Health

Team members at the Spine Program at Mount Sinai Morningside include, from left, Kiran Ballani, Rachel Newman, PA-C, Patrick Reid, MD, Lauren Mcnoble, PA-C, Divaldo Camara, MD, and Priscilla Garcia

If you are having problems with your back and believe you may need to consult with a surgeon, then Mount Sinai has a program for you.

Mount Sinai Morningside has launched a Spine Program with a uniquely personalized and integrated approach. In addition to its advanced and compassionate clinical providers, the Spine Program is one of the few in New York City to have a care coordinator who focuses on helping patients find the right specialist for their needs.

Priscilla Garcia, a clinical navigator for the Spine Program, is one of the many people who make it work. She helps patients get what they need as soon as possible, prioritizing non-surgical treatments when possible.

“My role is to triage patients,” she says. “Some patients think they need a neurosurgeon right off the bat, but if they’re in pain, I schedule them with one of our pain management specialists first.”

If patients need multiple appointments, she often will try to schedule appointments in the same day for the patient’s convenience. A pain management specialist may order an MRI and notice something that a neurosurgeon should evaluate, so she will try to make that happen on the same day—a more efficient and convenient option for patients.

“It’s great for the patient because they don’t have to go home and come back again in a short timeframe. And the patients feel that we are addressing all their needs in a holistic way” she says.

Patrick Reid, MD, left, and Divaldo Camara, MD. “What sets us apart is how we try to make it easier for patients,” says Dr. Reid. “Some try to do it with computer systems or software, but we are devoting human resources to it.” To make an appointment, call 212-523-8500.

Patrick C. Reid, MD, Director of the Spine Program and Chief of Neurosurgery at Mount Sinai Morningside, makes every effort to help patients get care quickly and easily.

“When people go to the doctor, it can be confusing, especially with something as complex as the spine and surgery. Many times, people are forced to navigate the system themselves and hope for the best,” he says. “But an easy way to improve care is to get the patient in the right room with the right specialist, and that’s what we do in our program.”

Patients with spine issues are often older, and reducing the number of trips to the doctor’s office is beneficial.

“Any patient who sees us needs to have things simplified as much as possible,” says Dr. Reid. “People who have jobs, childcare needs—they all need help coordinating their health care. You don’t want to miss two days of work. That’s the benefit of having a navigator who’s had a lot of experience coordinating these things—it’s invaluable.”

The program at Mount Sinai Morningside has all the advantages of a major academic medical system, including access to the latest equipment and to the most advanced treatment techniques.

“But what sets us apart is how we try to make it easier for patients,” says Dr. Reid. “Some try to do it with computer systems or software, but we are devoting human resources to it.”

Only a small percentage of patients at the Spine Center actually receive surgery.

“There are a full range of treatments we can try before suggesting surgery,” says Dr. Reid. “But if our colleagues are running out of options trying to make a patient feel better, then we start having the discussion about surgery—the risks and benefits and likely outcomes.”

In addition, patients with back or neck pain often have health issues that contribute to their condition, and one of the advantages at Mount Sinai Morningside is ready access to specialists in many other areas throughout the Mount Sinai Health System.

“We see many patients with conditions such as diabetes, hypertension, or heart disease, and we will help them get the any additional treatments as quickly as we can,” Dr. Reid says.

Learn more about the Spine Program at Mount Sinai Morningside

To make an appointment, call 212-523-8500

Mount Sinai Morningside Launches Incidental Lung Nodule Program to Promote Early Diagnosis of Lung Cancer

Mar 31, 2023 | Featured, Mount Sinai Morningside, Your Health

Javier Zulueta, MD, right, is joined by, from left, Rahul Agarwal, MD, and Fernando Carnavali, MD.

Lung cancer is by far the leading cause of cancer deaths in the United States accounting for about one in five cancer deaths. It is difficult to detect because there are often no symptoms in its earliest stages—only 16 percent of lung cancers in the United States are detected at a localized stage.

Lung cancer screening for smokers and former smokers, like the Early Action Lung Cancer Action Program (I-ELCAP), has been found effective in detecting lung cancer at earlier stages. However, as more lung cancers are being detected in non-smokers and many are ineligible for screening under the I-ELCAP guidelines, additional tools are needed to detect lung cancers early and save lives.

The newly launched Incidental Lung Nodule Program (ILNP) at Mount Sinai Morningside opens a new path for early detection guided by methodically identifying the patients with lung nodules at most risk for lung cancer and ensuring they receive timely interventions.

How the Incidental Lung Nodule Program Works

CT scans ordered for other illnesses and injuries are methodically scanned by computerized search—a more equitable and inclusive tool for detecting lung cancer early. All of those scans with a reported and documented incidental lung nodule are reviewed by a team led by a pulmonologist with special expertise in lung nodules.

Research has shown that about 25 percent of individuals who have a CT scan of the chest will have an incidental lung nodule detected, most of which need follow-up. Approximately five percent of the individuals with lung nodules may have lung cancer. With an early diagnosis, lung cancer can be successfully treated in the majority of patients.

All scans with findings are entered into a database for tracking and follow-up. The ILNP team notifies the ordering physician and the patient’s primary care provider, if available, via Epic, phone call, or letter, with a specific follow-up recommendation. If the ordering physician was in the Emergency Department and there is no primary care provider available, the ILNP team will reach out to the patient directly.

How Do Patients Seek Evaluation and Treatment

Javier Zulueta, MD, a lung nodule expert and pulmonologist at Mount Sinai Morningside, leads a multidisciplinary clinic that accepts referrals from physicians and is available directly to patients. Patients who need evaluation by the nodule clinic will be offered an appointment within one week of notification. They will be evaluated by a pulmonary specialist, and a plan will be established according to guidelines, including a wide variety of diagnostic and treatment options depending on the characteristics of the nodule:

• Blood test for cancer biomarkers
• PET scan
• Pulmonary function tests
• Biopsy by robotic bronchoscopy or CT guidance
• Evaluation by Thoracic Surgery

Smoking cessation will be offered to anyone who is a current smoker. All patients will be given a plan for CT scan follow-up within a predetermined period of time—anywhere between three and 12 months.

Patients may require exam and follow-up or diagnostic interventions like image-guided bronchoscopy or percutaneous biopsy. If cancer is diagnosed, the patient will be presented at Mount Sinai Morningside’s weekly multidisciplinary lung cancer and nodule conference. After review of all diagnostic and staging tests, a decision regarding treatment will be made. This can vary depending on the stage but includes thoracic surgery for early stages and oncologic assessment for all.

Patient Follow-Up

Patient not requiring immediate care will be prompted to repeat their CT scan on a recommended schedule and will continue to receive evaluation through the ILNP. The ILNP program navigators will contact the primary care physician, other provider, or the patient directly if patient is not getting the recommended diagnostics.

For more information or to refer a patient to the Lung Nodule Clinic, please call 212-523-3589.