By Patricia Houlihan, courtesy of Chicago Booth

When Joanne Smith joined the Rehabilitation Institute of Chicago in 1992 as an attending physician, she didn’t plan on getting an MBA.

But while on assignment at the University of Chicago Medical Center, she saw the marketing implications of how doctors made decisions about disabled patients. That experience led her to Chicago Booth’s Evening MBA program in 2000.

Six years later, Smith was named president and the first female CEO of RIC, where she bridges medicine with the business of health care at the nation’s No. 1 physical medicine and clinical rehabilitation facility. Chicago magazine recently named her to its list of top doctors, and she also earned Chicago Booth’s 2008 Distinguished Public Service/Public Sector Alumni Award.

She finds RIC to be a very hopeful place. “We harness the powerful spirit of each patient as they work toward recovery and ability. RIC is an incredibly uplifting place.”

It was the same experience Smith had at an amputee clinic for children as a medical student. “The waiting room was filled with kids who had obvious, significant disabilities, but they were all playing and laughing. It was like a kid’s birthday party in there,” she says. “I followed a few patients through their medical evaluations that same day and was very moved by this particular field.”

Injured Veteran Looks to RIC

Months after she was appointed CEO, the family of Sgt. Eric Edmundson arrived at RIC with him in the back of their minivan, looking for help.

In the fall of 2005, Sgt. Edmundson had sustained serious blast injuries in Iraq in the fall of 2005: shrapnel wounds to his right leg and abdomen, two fractured vertebrae, and a traumatic brain injury. At a hospital in Bagdad, he suffered a heart attack, losing oxygen to his brain for 30 minutes. Transported to a hospital in Germany and stabilized, he then went to Walter Reed Army Medical Center, where he spent six weeks before being sent to a polytrauma center run by the Department of Veterans Affairs.

But Edmundson‘s rehabilitation regimen there was inconsistent, and the VA hospital was full of elderly veterans, his father, Edgar Edmundson told the New York Times. When Sgt. Edmundson, unable to walk or talk, was discharged and assigned to a nursing home, the family took their 22-year-old son—the married father of a 2-year-old—to RIC.

“Within the first month at RIC, he was responding, waking up. He was mobile,” Smith says. Because Sgt. Edmondson remained on active duty status with the Army, the Department of Defense rather than the VA provided his military insurance policy, which gave the family the option of civilian medical centers.

Dr. Smith Goes to Washington

To Smith, it was a natural fit. RIC had been treating complex brain injuries for years, while the VA hospitals had focused on chronic medical care for aging veterans. She traveled to Washington, D.C. and met with Illinois Sen. Dick Durbin to explain what she had learned through Edmundson‘s case—and to offer to help.

Durbin introduced her to senior Pentagon officials, whom Smith found highly receptive. “I said, instead of trying to start up and learn how to deliver rehabilitation for catastrophic injury; the DoD ought to rely on the best in the world for this care. And frankly, we can help immediately.”

Within 24 hours, RIC had a contract with TRICARE, the health care program of the Defense Department’s Military Health System. Smith and her staff also worked with Durbin’s office on a bill, and within three months, legislation was introduced to extend civilian health care to severely injured soldiers. Three months later, the bill passed.

Publicity surrounding the new law brought more military patients to RIC, but hardly a flood, despite the growing number of soldiers suffering traumatic brain injuries. The culture of the military is unique, and many families are unaware that they can seek care at a civilian facility, Smith says. “But because of Sen. Durbin’s legislation, they now have a choice. The families who do their homework end up here.”

At RIC, Edmundson learned to walk and to communicate with the help of an electronic device. He was discharged in June 2007.

“Here‘s a young man who was going to be relegated to a nursing home for the next 60 years or so, the remainder of his life,” Smith says. “Instead, he went home from RIC and walked into the arms of his wife, while his 2-year-old daughter gleefully ran around his legs.”

Originally published on April 27, 2009.