Geriatrician's Personal-Touch Practice is 'Old School in a Good Way'
By LAWRENCE BUSER
For as long as he can remember, Nidal Rahal, MD, has been interested in caring for elderly people.
Actually, interested is not quite strong enough.
"It's a combination of passion and personality traits," said Rahal, who specializes in geriatrics, family medicine, palliative medicine and hospice care. "I have a genuine compassion and patience for elderly people and their families. Some physicians love to perform surgery, some love to deliver babies, and some love to talk to and care for the elderly. I'm one of the latter. My work fits what I have a passion for."
Rahal of East Memphis Internal Medicine sees patients in the office, in the hospital, in nursing homes, assisted living facilities and in hospice settings.
In a world of corporate medicine, specialization and government regulations, he worries that what has been done in the name of patient care has taken away an important part of being a physician: the continuity of patient care and the personal touch.
"In the current health care system, the direction is to have patients followed up by different doctors with different specialties," said Rahal, whose office partner is Dr. Randy Villanueva. "So, the continuation and consistency of care is basically the key of what we do. It serves the patients much better. You know the patients, you know the families. You follow up with them and you build a relationship instead of having one doctor see them in one spot and then another doctor grabs the paperwork and sees them at another spot.
"We're old school, but in a good way. The families know that if their loved one gets sick, I'll be seeing them in the hospital. If they go to rehab, I'm most likely going to see them there. If they're in assisted living, I'll see them there. That's almost nonexistent in the current healthcare formula."
But, Rahal acknowledges, running an old school medical practice is not easy.
"There are a lot of 80-hour weeks," he said with a laugh. "I'm available for my patients by phone 24/7, and I work most weekends. It seriously takes a lot of effort to maintain that continuity and consistency of care. I am thankful to work alongside a great team.
"What I do is not a job. It's a profession. There's a big difference and that's very important to me. I don't clock in and clock out. I'm not done by 5 or 6 or 7. If there's some need, I'm going to tend to it. I take calls at night whether it's at 9 p.m. or 3 o'clock in the morning. I have put a lot of commitment and endless hours into this model, and I have built one-on-one relationships with most patients and their families."
Rahal is the son of a PhD research chemist. His brother, Dr. Kinan Rahal, is a gastroenterologist in Sarasota, Fla.
"There was a lot of emphasis on education growing up," he recalled. "It wasn't necessarily on medicine, but on education."
Rahal attended medical school at Damascus University Faculty of Medicine in his native country of Syria. He completed his residency in Family Medicine at the University of Tennessee Health Science Center in 2002 and attended fellowship in Geriatrics at UT-Knoxville.
After working for seven years as an emergency room physician at Methodist Germantown Hospital, Rahal received training and certification in palliative medicine and hospice care.
That laid the groundwork for his current practice involving inpatient geriatrics at Methodist Germantown, outpatient clinical office appointments, and rounding at multiple assisted living facilities in Memphis, Germantown, Southaven and Olive Branch.
With his elderly patient population, the onset of COVID-19 pandemic earlier this year had a significant impact on his practice, both personally and professionally.
"There wasn't a day that (patient care) wasn't day to day with us," said Rahal. "The first months were extremely stressful. We kept going more than full speed to keep up. Everybody was locked up at home, so we were at the front line, and that applies to all the other doctors.
"COVID-19 has really impacted us in a negative way. I personally admitted all the infected elderly patients I had at the facilities and attended to them at the hospital. It really hits my patient population hard. We have a much higher mortality rate in my world."
His certification in hospice care and palliative medicine allows Rahal to care for his patients and their families even after there is no longer a medical solution to offer.
"At some point when an elderly patient gets to a point where less is more, where enough is enough, it is my job to talk to the family, sit them down and maybe help them consider that option," Rahal said. "It definitely pours into the heart of what I do.
"If the family has no more desire to push, we sit and probably make a decision together about transitioning to comfort care in hospice, and perhaps end-of-life pain management. So, with my practice focusing on elderly patients, I've been able to combine these aspects together and have one closed circle. I believe this type of practice allows me to provide quality care for my patients. That makes this feel successful."
He says he doesn't mind that the demands of his practice leave little time to pursue hobbies.
"I have two sweet little girls who I adore," he said, "so I do my long hours and go back home to my loving and supportive wife and my kids. I'm a family man."