NeurologyLive® Clinician of the Month Spotlight: Jason J. Sico, MD, MHS

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As part of our monthly clinician spotlight, NeurologyLive® highlighted migraine expert Jason J. Sico, MD, MHS, national director of the Headache Centers of Excellence program within the Veterans Health Administration.

Jason J. Sico, MD, MHS

Jason J. Sico, MD, MHS

Neurologists are highly trained medical professionals who play a critical role in the healthcare system in helping patients of all ages to manage their conditions that can affect every aspect of their lives. Each month, NeurologyLive® shines a spotlight on the work of one neurologist, highlighting contributions to their specific field.

Jason J. Sico, MD, MHS, an attendee at the 2023 American Headache Society (AHS) Annual Meeting, June 15-18, in Austin, Texas, recently sat down in an interview with NeurologyLive® prior to the meeting to discuss his role as a neurologist in the field of migraine. For background context, Sico is a neurologist with additional clinical training in headache, brain injury medicine, and stroke. Also, he is a health services researcher with complementary clinical and research interests in understanding and improving neurological care quality and delivery.

Sico serves as an associate professor of neurology and internal Medicine at the Yale School of Medicine and National Director of the Headache Centers of Excellence (HCoE) program within the Veterans Health Administration (VHA). Additionally, he is the director of the HCoE’s Research, Education, Evaluation, and Engagement Activities Center for Headache (RE3ACH), is the primary investigator on 2 VA Health Services Research and Development (HSR&D)-funded multisite clinical trials, and has published more than 80 peer-reviewed articles and book chapters.

He is also active in the American Academy of Neurology (AAN) and American Headache Society (AHS), serving on the AAN subcommittees of Health Policy and Members Research and AHS committees of Advocacy, Publications, and Scientific Program. In addition, he is a board member of the National Headache Foundation and serves in the NHF veteran’s initiative called “Operation Brainstorm.”

NeurologyLive: What are some of the main responsibilities you have in your role as a neurologist? 

Jason J. Sico, MD, MHS: As a neurologist, I specialize in evaluating and managing conditions that affect various parts of the nervous system, including the brain, spinal cord, nerves, and muscles. I do this through direct patient care, patient and provider education, research, and my role as the National Director of the Veterans Health Administration’s Headache Centers of Excellence (VHA HCoE) Program. Sometimes I see patients living with headache disease in my in-person or telehealth clinics. Working with someone to improve their neurological disease management is a dynamic process and goes beyond making the most accurate diagnosis or diagnoses. It involves getting to know them, their values, their preferences, and how their neurological disease affects their life and the lives of those they are close with. I get at what their goals are and what is most important to them.

Education is a large part of what I do. I educate individuals about their neurological concerns as well as treatment options. I also educate other healthcare professionals by keeping colleagues current on evidence-based medicine and best practices while sharing how they can implement their knowledge within their clinics and medical centers. My research focuses on identifying the best ways in which health services could, and should, be organized to improve the quality and delivery of healthcare to those living with neurological diseases. I integrate my clinical, educational, and research responsibilities into developing and expanding a national program within the VHA to provide the best care possible for Veterans living with headache.

Could you describe a typical day in your work as a neurologist? 

I meet regularly with different teams that have both distinct and overlapping responsibilities, though with one common goal – continuously improving the neurological care we provide. I meet with our interdisciplinary clinic team, which includes other neurologists, nurses, health psychologists, clinical pharmacists, physical and occupational therapists, to review our patients and attend to any concerns. I prepare and give lectures for patients and healthcare professionals.

I am currently working with a large team on an updated version of the Department of Veterans Affairs/Department of Defense Headache Clinical Practice Guidelines, which will be available in the coming months. These guidelines will share the evidence related to both “tried and true” and emerging therapies for migraine, cluster headache, and other types of headaches. I will also meet with our research team to review progress on our clinical trials and other projects. I regularly connect with members of the healthcare teams within our 21 HCoE programs. I regularly talk with Congressional offices about neurological care among Veterans, sharing lessons learned from patients and research. I finish each workday as a neurologist knowing that I have made a difference.

What motivated you to pursue a career in neurology, and when did you make this decision? 

I have always been fascinated by the brain and nervous system and have always had a strong commitment to helping others. Our nervous system allows us to meaningfully engage with others and the world at large. When someone has a neurological condition, they may not be able to experience the world as they are meant to. When people have a migraine attack and sequester themselves into a dark room, they are not doing other things that are personally and professionally meaningful to them. On a more personal note, I have seen how neurological diseases can impact a person as well as their loved ones.

When I was a teenager, my father died from a subarachnoid hemorrhage. He was thirty-five. A few years later, my maternal grandfather, who helped raise me and my brothers, had his first of several strokes. I saw how his strokes left him paralyzed on one side of his body and with speaking and memory difficulties. My paternal grandpa developed headaches after he experienced a traumatic brain injury serving in the Army. I saw how his headaches limited how he was able to engage with us and other family members. Both my grandpas served us and served our country. After seeing and experiencing how neurological diseases can affect someone and their family, I have developed an especially strong commitment to using my understanding of the nervous system to serve and care for others with neurological diseases.

What do you find most rewarding about your work as a neurologist at Cleveland Clinic? 

Serving others. I find it exceptionally rewarding to use my training to help others live their best life possible. I do that through my training as a neurologist and my clinical, educational, and research expertise. When people come to see a neurologist, they typically are coming at a time in need. Knowing that people trust in me, my abilities and those of their entire healthcare team, and my commitment to them as a person is deeply important to me.

What are some of the biggest challenges you face in your role? 

Some days there is just not enough time to do everything and there will always be more to do. I often remind myself that for me to be the best neurologist I can be, I need to prioritize patient care, engage and empower members of our teams. These have helped me keep perspective and mitigate burnout.

Is there something that you wish more patients and clinicians understood about the field of neurology?

Neurology is an amazing field. There is so much we can do for our patients. New therapies are coming out all the time with many more being developed and tested. If past treatments have not worked, there are other newer therapies that have come out that may improve quality of life. Also, while there has been an explosion of pharmacotherapies for different neurological diseases, there are treatments that are not medications that can work well.

In addition to your work as a neurologist, what hobbies or interests do you have outside of the clinic? 

I love spending time with my children. I also enjoy drawing, painting, photography, reading, exercising, meditation, and travel. I have also always enjoyed reading comic books and playing video games.

Transcript edited for clarity.

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