Q: What was your ‘why’ for becoming a neurologist and for focusing on multiple sclerosis?

A: Right at the beginning of medical school, I became fascinated by the complexity of neurosciences and the interplay between complex pathophysiological mechanisms of certain neurological disorders and an ever-evolving array of therapies that we could use to help our patients. I also became fascinated by learning about multiple sclerosis (MS), a disease that results from immune-mediated damage to the myelin and subsequently the nerve fibers or axons in the central nervous system. Virtually any portion of the central nervous system can be affected by MS, and that explains the multitude of symptoms that our patients have, including optic neuritis, brain stem syndromes, fatigue and spinal cord disease. Our understanding of the underpinning mechanisms of the disease process allowed us to test and develop different therapies that had a significant impact in slowing down, and in some cases, stopping the accumulation of disability.

About halfway through my residency, the armamentarium of therapies for multiple sclerosis really exploded. I was really drawn to the field with such a rich semiology and clinical presentation, along with the prospect of conducting exciting research that aimed to continue the development of highly effective therapies.

Q: What prior leadership roles helped to prepare you to become the section chief of multiple sclerosis at RUSH?

A: I’ve had many opportunities to occupy leadership positions throughout my career. At the University of Colorado, I served as residency program director and later became the vice chair for education for the Department of Neurology. I also took on leadership roles in other areas, which included running a clinic for underserved populations in Aurora, Colorado. I also led a subspecialty team to provide integrated primary care for patients who were uninsured or those who were on Medicaid. And, at the University of Florida, I was the MS division chief, as well as the associate chair for education.

But with any new role, I see an opportunity to revisit one’s leadership skills and adapt them in a new environment. At RUSH, I am very excited to continue the legacy that Dr. Stefoski started so many years ago. It's truly an honor.

Q: What did you know of RUSH prior to becoming the MS section chief?

A: RUSH has always had a great reputation in the way it cared for patients with multiple sclerosis. During my residency training at Loyola, I remember listening to Dr. Stefoski’s talks. He was a pioneer in the use of highly effective infusion therapies for multiple sclerosis. Patients have always had access to state-of-the-art therapies at RUSH, specifically induction therapies, instead of lower-efficacy therapies through a traditional escalation approach. We want to be proactive in the care we provide to patients, which RUSH has been doing for a very long time.

Q: What made the chief’s role at RUSH appealing to you?

A: For several years now, the RUSH MS Center has been working to move away from the traditional fragmented medical model of care and toward an integrated and comprehensive approach. That approach provides excellent medical treatment as necessary, patient-centered education, psychological support, physical and cognitive rehabilitation, exercise and nutrition programs aiming to optimize brain health and long-term outcomes.

My goal is to continue to change the traditional disease-focused and fragmented clinic visit model to a health-focused, integrated and comprehensive approach by incorporating personalized, evidence-based lifestyle interventions into the care of every patient with MS.

I was also excited about collaborating with some amazing colleagues in rehabilitation and physical therapy, occupational therapy, neuropsychology and sleep medicine, to provide a comprehensive, multidisciplinary approach to patient care that takes a truly proactive approach to care.

On a personal note, I love Chicago. I met my wife here and this is where our first son was born. It’s a great town to live in. It’s very meaningful to be back here and be in a position to serve our community’s underserved and vulnerable populations, particularly from ethnic and racial minorities.

Q: Where did your interest in helping underserved populations come from?

A: Growing up in Argentina, everyone had access to basic care, regardless of where you came from. When I came to the U.S., I was amazed by the high level of care provided to patients, as well as the frontline research and innovation happening here. However, I noticed that access to care, and subsequent health care outcomes, are heavily dependent of social and economic factors. Things like social determinants of health, race, ethnicity and income have a huge impact on patient outcomes. I’m interested in contributing to bridging that gap in terms of providing care or conducting research in those underserved populations.

Q: What are your goals as MS chief?

A: First and foremost, I want to continue the legacy left by Dr. Stefoski. I try to follow a common principle in life: Don’t try to fix things that aren’t broken. I also want to be proactive in how we approach care delivery, whether that’s through a multidisciplinary approach as I mentioned, along with the use of nonpharmacologic interventions focused on creating a positive impact on our patients’ brain health. Brain health encompasses many dimensions, all of which are key in the impact of long-term clinical outcomes and quality of life in MS patients. We will have to be strategic in order to build a program that will offer our patients the tools needed to achieve maximal brain health. I am convinced that RUSH offers the tools and resources to meet that goal.

Q: Is there one aspect of your work that you’re excited about bringing to RUSH?

A: My wife and I founded a nonprofit, the Brain Health Center of the Rockies, which provides education on brain health to patients with neurological disorders. Since its founding in 2019, our organization has provided education to over 1,000 patients and communities around the country. One of my goals is to be able to adopt some of our programs to support RUSH patients to help improve health care literacy through personalized patient education. There’s a lot of great information readily available online, but there’s also a lot of misinformation, which is not evidence-based or appropriate for a patient’s particular disease state.