Physician Spotlight Series: Johnathan Cahill, MD

Featured Physician: Jonathan Cahill, MD
Dr. Cahill is an Associate Professor of Neurology at The Warren Alpert Medical School of Brown University and a staff neurologist at the Multiple Sclerosis Center of Rhode Island.

Award: RIMS “Humanism in Medicine” Award
This honor is awarded for Humanism in Medicine in recognition of a career and calling that medicine is at once the most scientific of the humanities and the most humanistic of the sciences.

Dr. Cahill has been honored with the “Humanism in Medicine” award for his deep compassion and unwavering advocacy for patients with multiple sclerosis, and for providing them the highest quality of care. This award also recognizes Dr. Cahill’s enduring commitment to the next generation of neurologists who choose to specialize in the disease. With an acute understanding that multiple sclerosis is a life-changing diagnosis for patients, Dr. Cahill manages patient’s questions and concerns with great sensitivity – providing tremendous guidance and encouragement as they cope with their illness. Dr. Cahill has advocated for patients with MS through the National Multiple Sclerosis Society and the Multiple Sclerosis Dream Center of Rhode Island, and has worked with the Rhode Island Medical Society to give both written and oral testimony on Step Therapy reform at the Rhode Island State House. Dr. Cahill also exemplifies humanism in medicine through his role as an educator to students, residents, fellows, and colleagues. He is known for seeking feedback from these individuals, valuing their opinions, and taking action to make changes for the better. According to his colleagues, Dr. Cahill “prioritizes wellness and patient care above all and embodies the qualities of respect and compassion for others.”

Q&A with Dr. Cahill:

You were nominated for the “Humanism in Medicine” award for your work with and compassion for patients with multiple sclerosis (MS). How would you describe the approach you use in caring for these patients?
With this disease, it’s especially important to take your time and get to know your patients. These aren’t patients you’re going to get to know in one visit or even a couple visits because multiple sclerosis is a brain disease and, in that way, can have a multitude of symptoms that show up over time. So I try to learn a little bit more about each patient, even longstanding ones, every time I see them. In doing so, I can determine the best treatment plan for them at that time. I’m fortunate to work in a very supportive practice environment that gives me the luxury of being able to spend a good amount of time with my patients. This helps me do my best work and, in turn, is beneficial to my patients.

I also offer hope and encouragement. What many people don’t realize is that with current and emerging treatments, people with MS live long lives, have successful careers, and raise families. And since people are diagnosed with MS fairly young – many as young as 19 – it’s important to share the bright side of having this particular disease. Obviously, it’s hard for anyone to be diagnosed with a lifelong disease, but what I tell my patients is that while there is no cure and it affects the brain and neurological functions, we have treatments that are effective in controlling the disease for long periods of time and, therefore, they are going to live a long life.

What work through your focus on MS are you most proud of?
I’m very proud to be a part of the Multiple Sclerosis Center of Rhode Island. My colleague, Dr. Syed Rizvi, started the MS Center, and I then joined the group as his colleague and second physician. We’ve built a strong program here, particularly as it pertains to training fellows. We train a fellow every year and are now in our 8th year. It’s a rewarding experience because now we have eight people that are out in the country practicing and taking care of people with MS. A large part of my career – and this is true not just in MS but my training with the residency program at Brown – has been the teaching and training of other folks to do this kind of work.

I’m also actively involved with a few different nonprofit groups, including the National Multiple Sclerosis Society and the Multiple Sclerosis Dream Center of Rhode Island. They both do important work and I’ve been happy to provide my perspective as a physician to help them move towards their respective  missions.

And the work I’m doing with the Rhode Island Medical Society on Step Therapy Reform is incredibly important and something I’m very proud of. I’ve provided testimony at the state house and have written a number of letters to advocate for its passing. I also very frequently advocate and appeal for individual patients for what I think is the right treatment for them. It would be hugely impactful in the field of MS for Step Therapy Reform to pass because, at its root, Step Therapy wrongfully takes decision-making away from patients and doctors.

While we have the luxury of having effective medications for patients with MS, the cost of those medications has increased exponentially each year over the 20 years of drug development.

What is the greatest challenge in your role? The greatest reward?
The greatest challenge is associated with the fact that every person is different and there are rare, unfortunate cases where patients don’t respond to treatment in the average way. Despite every best effort on their part and ours, some people have disease progression with more and more symptoms and disability. The greatest challenge as a field is to try to figure out how to help those people.

The greatest reward is seeing the majority of people with MS be stable and successful, meaning that they come to visits and have nothing new to talk about because they’re not having any new symptoms, no side effects to their medication, and MRIs that show no change. I tell them, “Boring is good; we like a boring visit!”

At what point in your life did you know you wanted to be a physician?
There was no one moment. It was more of a natural, gradual evolution. I have always been interested in school and in the sciences. Those were always my favorite classes growing up. Also, my Dad is a dentist so there was some natural exposure during my formative years to a health profession and to seeing how he took care of patients through the course of his career. On Saturdays, he would always bring one of us kids to the office with him so we got an early inside look into the way he had a practice and was involved in the community and these patients’ lives. I didn’t fully decide to go to medical school until the second half of college and, at that point, it just seemed like a natural fit for me.

What drew you to neurology and, in particular, multiple sclerosis?
Of the sciences, neuroscience was always the one I found most intriguing. I was a psychology and biology major in college which sort of combines the hard science of neurobiology with what makes people tick and what makes people who they are. Then, when I got  into medical school, the neuroscience rotations were always the ones that clicked with me the most, which led me to a neurology residency. In medical school you have to decide whether you’re going to be a medical person or a surgical person and I was definitely more on the medical side. I like to take my time and think about things. All of this is what led me to the field of MS. It’s a rewarding sub-specialty within neurology because MS is most commonly diagnosed when people are in their twenties and, as such, you have a very important role in their care over the next several decades.

 What key guidance or “words of wisdom” do you try to impart on your medical students interested in this specialty area?
The old fashioned way of practicing medicine still works in almost every scenario. Listening carefully to the patient is probably the most important thing you can do when trying to figure out challenging cases to help people with conditions like MS.

Outside of your demanding job, what do you like to do in your spare time?
My wife and I have young kids so most of my free time is spent with our family. My wife is also a physician – an internist at Rhode Island Hospital – so we relish spending any spare time we have on activities with our 6-year-old and 9-year-old daughters.