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Physiatrist Dr. John Tait had raised six children and spent two decades of his career in Kansas City.

But by late 2006 — with their nest empty and warmer climes calling — he and his wife, Laurel, were ready for a new start in a new state.

Tait responded to a search at Baptist Memorial Hospital-North Mississippi and signed on to run the hospital's acute inpatient rehabilitation unit. He formed Oxford Physical Medicine and Rehabilitation, PLLC in January.

"When we came down and interviewed, we really fell in love with the town — the people and the environment," said Tait, whose arrival marks the introduction of a new specialty at the hospital.

Previously, Baptist North Mississippi had relied upon a semiretired internist to cover the unit. Since Tait arrived, he's been able to take on oversight of the inpatient unit while also beginning to build a new outpatient practice.

A native of southern California, Tait holds a Bachelor of Arts degree from the University of California in Los Angeles and a medical degree from the University of Missouri in Kansas City. He completed an internship at the University of Kansas in Kansas City and a residency at the University of Missouri in Columbia.
He is board-certified in physical medicine and rehabilitation — a relatively young specialty which took off in the years after World War II, when soldiers returned and needed treatment for chronic debilitating conditions.

Tait's practice has centered on diabetes, stroke, amputees, spinal cord injuries and wound care. He also has experience with EMGs and nerve conduction studies. In addition, he has frequently seen patients recovering from hip fractures and knee surgeries, those dealing with debilitating muscular or neurological problems, and others fighting chronic back and neck pain.

At Baptist North Mississippi, Tait's role is to coordinate care for the acute rehabilitation patients — both their medical and surgical issues — and their work with physical therapists, occupational therapists and speech therapists.
Typically, he said, patients in the inpatient acute-rehab unit have multiple medical issues, where the primary challenge is exacerbated by secondary problems or illnesses.

Government regulation effectively requires that this be the case. Such units have been governed by Medicare's "75 percent rule," mandating that they focus the bulk of their care on patients with complicated cases who also have certain medical conditions.

Although efforts are underway in Congress to keep the rule from going fully into effect, there is concern in the rehabilitation field that the hurdle of proving "medical necessity" for each patient is effectively keeping some from getting the care they need.

"The 'golden age' of rehabilitation ran up till the late '80s or early '90s," Tait said. "Then the government restrictions started coming in and kept ratcheting down with more paperwork, more regulations, more scrutiny and more people being denied rehabilitation access."

As in most medical fields, the shift from being able to focus on caregiving to having to fight battles with payers has been the greatest change Tait has witnessed during his career.

"Sometimes it's frustrating from the caregiver's side of the fence," he said, "because they make you walk this razor line of 'the patient's too sick' or 'the patient's not sick enough.'"

As he builds his practice in Oxford, Tait is starting out spending the bulk of his time at the hospital. Eventually, the goal is to divide his time by spending half of it on inpatient work and the other half on outpatient work.

Being able to provide Oxford-area residents with the care they need close to home goes hand-in-hand with building good relationships across the north Mississippi referral area, Tait said.

"The goal is to provide a good-quality rehabilitation unit and get some stability through referrals from the outlying area, so that we can have a higher level of rehabilitative services in this area," he said. "Oxford sits in a good position for being able to care for a growing community that's going to need it down the road."

As he launches the practice, Tait has the rare advantage of being able to rely fully on his new office manager — who also happens to be his wife. Dr. Laurel Tait, a podiatrist, sold her own Kansas City practice when the couple moved to Mississippi and now manages her husband's office full-time.

"Without her, it would be impossible," Tait emphasized. "She's so familiar with the business side of the medical practice, and it's invaluable to have someone you can absolutely trust."

That mutual support was key as the couple balanced their careers with raising six children. Now grown and starting families of their own, their children have said they don't recall missing their father at a track meet or soccer game — even though, in his mind, running late at the hospital was a frequent frustration.

"Part of it was having a supportive wife who didn't make a big deal out of it when I couldn't make it on time," Tait said. "If I got there at the end of the meet, I was there."

On the flip side of his family's understanding were his own expectations for what his "downtime" held in store.

"I didn't expect to go home and sit in a Jacuzzi," he said. "We usually had soccer games instead, and you just did what had to be done."

With those dates on the sidelines now in the past, Tait's off-hours today are often spent watching sports and working out. As the couple settles into their new home, he's looking forward to getting back into gardening and also perhaps finding a local outlet for another favorite hobby — model railroading.

In Kansas City, where the historic Union Station celebrates the rail era in grand style, Tait volunteered with the local model railroad club. His own collection occupied a basement room in his previous home, but he hasn't found a place to set it up yet, as he is still settling into his new environment.

"Right now," he said, "I've just got a storage unit full of my stuff."

May 2007

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