Member May 2026: Working Outside the Model: Pearls for SCI Practice Outside of the Model System (On-Demand)-Session Recording

Video Transcription

Video Summary

The session opened with housekeeping notes about professionalism, recording, muting, and Q&A procedures. Dr. Christopher Bowe then presented on spinal cord injury (SCI) care outside of model systems, focusing on the challenges and practical solutions he has encountered as a relatively new SCI physiatrist in San Diego.<br /><br />He explained what SCI model systems are, their history, and how they have shaped modern SCI care through research, specialized interdisciplinary teams, and standardized resources. However, he emphasized that model systems reach only a small percentage of SCI patients, leaving many people to receive care in fragmented, non-specialized settings.<br /><br />Using several cases, Dr. Bowe illustrated common failures in community SCI care: a patient with undiagnosed bladder stones causing recurrent autonomic dysreflexia, an incarcerated patient whose dehydration was relieved only after a makeshift adaptive drinking device was created, and a young woman with chronic paraplegia who had never received proper SCI rehabilitation and developed a severe pressure injury. These cases highlighted gaps in acute care, rehab access, equipment, education, and follow-up.<br /><br />He described strategies to improve care locally, including education for staff, specialized bladder supplies and wheelchairs, outpatient SCI clinics, and collaboration with nonprofit organizations. Andrew Skinner of Triumph Foundation joined to describe peer mentorship, loaner equipment, home modification support, and adaptive sports programs that help people with SCI thrive. Both speakers stressed the need to partner with advocacy groups to expand access, improve education, and prevent avoidable complications and deaths from SCI-related conditions like autonomic dysreflexia.

Keywords

spinal cord injury

SCI model systems

autonomic dysreflexia

pressure injury

bladder stones

rehabilitation access

adaptive equipment

peer mentorship

community SCI care

advocacy groups