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Published October 26, 2022
Dr. Moghbel: Right after I wrapped up my final fellowship year at Stanford, I went on maternity leave for two months and had my second son. After that, I started back full time at Vituity. I now mainly work from home providing teleneurology and teleneurohospitalist coverage for multiple hospitals.
It’s so gratifying to treat patients who need acute neurology care but live in areas where specialist coverage is scarce. Thanks to telehealth, neurologists like me can respond in minutes to initiate time-limited treatments and promote optimal outcomes.
If you had told me three years ago that this would be possible, I wouldn’t have believed it. Teleneurology has its challenges, but I don’t think any of us ever imagined its possibilities until recently.
Dr. Moghbel: Last year, Vituity started providing IONM services to one of our hospital clients. The timing was ideal for me. I’d focused both my clinical and administrative fellowships on IONM and was keen to continue that work. I took over all intraoperative monitoring cases for that hospital. And then in January 2022, I was promoted to medical director for Vituity’s IONM program.
Dr. Moghbel: Yes, mostly at home. When I’m monitoring a procedure, I’m working with a technologist who’s present in the operating room to place the electrodes and make sure the system is transmitting everything properly. And then I can monitor the signals and provide feedback from anywhere. As Vituity’s program grows, I expect to provide this service for multiple hospitals.
Dr. Moghbel: As a medical director, it's very important to know the business and administrative aspects of medicine. My Vituity Administrative Fellowship helped me to understand billing, contracts, hospital operations, and everything that happens in neurology beyond clinical care. It also provided the critical mentoring and support I needed to imagine myself in this role — not 10 years from now, but soon. And my fellow project — which involved creating IONM and neurodiagnostics webinars for medical directors and hospital administrators — actually positioned me well for this specific opportunity. Overall, I believe the administrative fellowship helped accelerate my path to leadership by several years.
Dr. Moghbel: IONM protects patients through continuous monitoring of the brain, spinal cord, and nerves during surgery. There’s strong evidence that it improves safety and quality. Unfortunately, there’s a shortage of fellowship-trained clinical neurophysiologists to provide IONM. This has led some unqualified people to offer the service — which is not the standard of care and jeopardizes the patient’s well-being.
So I guess you could say I have a personal mission to change that. The goal of my administrative fellowship project was to educate healthcare leaders that this specialty is critical and that the people doing it should be qualified. And now I get to continue that work as medical director for Vituity’s IONM program.
Dr. Moghbel: Over the next few years, I would really like to help grow Vituity’s IONM program. There’s plenty of evidence to support this as the standard of care. This is true not just for brain and spinal cord surgeries but for all high-risk procedures, including some common vascular and orthopedics operations.
However, until recently, IONM simply hasn’t been available outside of tertiary care settings. So I think most hospitals just don’t yet fully appreciate its value. There’s so much unmet need out there right now, and I think Vituity has an opportunity to really turn that perception around.
Dr. Moghbel: I love being involved in the administrative part of the practice. Clinical medicine is rewarding, but I would say administrative medicine is empowering.
If you’re a neurology resident or new attending interested in leadership, there’s no need to wait around for the next decade to get started. Vituity values your potential as a new attending, and their programs can help you advance sooner rather than
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