October 17, 2017
I am very excited and proud to congratulate Dr. Gerard Francisco, chair of our Department of Physical Medicine and Rehabilitation and chief medical officer of TIRR Memorial Hermann Hospital, on his election to membership in the 2017 class of the National Academy of Medicine (NAM). Established in 1970 as the Institute of Medicine of the National Academy of Sciences, the academy is an independent organization of highly regarded professionals from diverse fields, including medicine, engineering, nursing, behavioral sciences, public health/epidemiology, and administration who work to address important issues in medicine, health, and public policy. NAM elects 70 regular and 10 international members each year. Membership in the academy is one of the highest honors in medicine, recognizing individuals who have demonstrated outstanding professional achievement and commitment to service.
Dr. Francisco has been a respected member of our medical school faculty for 20 years. He is an outstanding clinician and teacher, an innovative investigator, and an excellent leader.
I am delighted to share the incredible story about his journey to the medical school and what inspires him and keeps him excited about our school.
You grew up in the Philippines – when did you know you wanted to become a physician?
I didn’t know what I wanted to do after high school. I applied to five universities in the United States in five different areas of study, and I figured wherever I was accepted, must be where I was meant to be. The areas included the Humanities, English, Chemistry, Biology, and Political Science – anything that does not involve a lot of math! As fate would have it, I was accepted to all five and had chosen to attend the University of Pennsylvania – but my dad wanted me to apply to the to the inaugural 7-year Integrated Arts and Medicine (INTARMED) program at the University of the Philippines College of Medicine. I guess he figured out that bribing me with a brand-new car would be less expensive than the tuition at UPenn. So straight out of high school I entered the medical school, and I will never forget our very first day. It wasn’t in a classroom – instead we went to the hospital’s emergency room, and our assignment was to talk to patients and get to know them. That stressed upon me that medicine is about people, not just diseases.
How did you become interested in physical medicine and rehabilitation?
At the end of medical school, I was interested in pursuing hematology oncology—an exciting field with new drugs and therapies. So I decided to go to Chicago where I completed my internship in internal medicine at the Michael Reese Hospital, then an affiliate of the University of Chicago. While I was in training in the general medical wards, I was frustrated that I couldn’t talk to my very ill patients, and it felt as if I were treating numbers in the chart rather than a person. Also, the utilization review nurses were looking over my shoulder, questioning every order and pressuring us to discharge the patients. To get them off my back, I would refer patients not fit to return home to either nursing homes or to the rehabilitation unit next door to our hospital. I made the consult rehab resident quite busy and when it became clear that I was referring patients indiscriminately, she sat me down and educated me on how rehab works. She asked me to spend an afternoon with her in the rehabilitation pavilion. It was so refreshing to see patients up and about, busy with their therapies. I finally got to spend time with some former patients and listen to their hopes and concerns. I realized that PM&R would allow me to develop relationships with patients and make an impact by helping them reach their potential to get back on their feet. That same resident helped me apply to various PM&R residency programs, and I was so fortunate to have been able to transfer to the Kessler Institute in New Jersey. At that time, brain injury rehab was an up and coming field, and I found that so exciting as it would not restrict me to just implementing established protocols, but would allow me to develop my own treatment protocols. Back then there were only 4 or 5 brain injury fellowships in the country and only two of us applying. Now it is an ABMS subspecialty with about 500 diplomates. I decided to come to Houston to train in brain injury medicine at TIRR because of its reputation. And when I interviewed here – guess who was the newly appointed fellowship director – it was the same rehab resident from Chicago. After my postdoctoral fellowship here, I returned to New Jersey to serve as the director of the Brain Injury Program at Kessler Institute for Rehabilitation. My first day on the job, I got a phone call from TIRR. One of the brain injury attendings had announced his resignation, and they asked me to come back to Houston. In a year and a half, I was back and have been here for almost 21 years now.
Why did you come back to Houston?
The palpable energy of the Texas Medical Center attracted me. I interviewed for my faculty position at the peak of the summer, and I reminded myself that one reason I left the Philippines was the year-round heat and humidity. However, the energy and growth potential within TIRR and the medical center were enough to convince me to come back to Houston.
What has changed in the 20 years you have been here?
The exponential growth of PM&R. Our department had just 5 or 6 faculty back then, and now we have more than 20 faculty. We have a forged a synergistic and symbiotic partnership with TIRR Memorial Hermann, which has been the envy of many of my colleagues. TIRR is a top-notch rehab hospital that has been ranked #2 in the nation by US News and World Report for the last two years. This year our department is ranked among the top PM&R departments for NIH funding in the country. Not a small feat considering that only about 8 years ago we hardly had any federal research funding.
What inspires you?
Frequently I have “inspiration overload” from different sources. The successes of my faculty continue to inspire me. Our clinical faculty have helped TIRR become what it is today. Our research faculty is very innovative, asking research questions that are patient-centered. My patients and their families inspire me, too. The clinical and functional challenges they pose are my opportunities to think creatively of ways to further their recovery. I am so fortunate to have been touched by their optimism and tenacity. When I asked one of my patients what he wanted to get out of rehab he said, “I wanna be more better.” It’s that spirit of never giving up that drives me.
Thank you, Dr. Francisco, for your inspirational career and leadership.
Please join me in congratulating Dr. Francisco for this wonderful and well-deserved honor.