For years physicians from around the world have referred patients to TIRR Memorial Hermann for rehabilitation. With 5% of inpatients arriving from other countries and an even higher number of outpatients from abroad, the hospital has formalized its international referral process and put together a core team to work with international clients.

“Our referrals have come primarily from the Middle East, Europe, Asia and Africa,” says Jacob Joseph, MD, clinical chief of specialty rehabilitation programs and medical director of international programs at TIRR Memorial Hermann. “Some are years post injury and haven’t received rehabilitative care previously. Others have gone through intensive rehabilitation but wonder if anything else can be done to improve their function. Often we find rehabilitation issues that have not been addressed – perhaps improper wheelchair fitting, positioning or spasticity that led to complications after their initial treatment. Much of the technology I see, especially in the Middle East and Europe, is equal to what we have here in the United States but that doesn’t necessarily translate to the best rehabilitative care. Technology is important, but recovery is also highly dependent on the skill of the therapists.”

Salam Waqialla, MD, who is half Syrian and half Sudanese and grew up in Saudi Arabia, is marketing coordinator for international relations at TIRR Memorial Hermann and Memorial Hermann-Texas Medical Center. “Because I’m a physician and can speak many languages and dialects, I communicate well with doctors and patients from other countries,” he says. “We facilitate the transfer of medical records quickly. After reviewing the record, we schedule appointments and arrange travel and accommodations. We arrange for patients to be greeted at the airport and walked through customs. During their stay we provide translation services and do everything we can to ensure that their cultural, spiritual and emotional needs are met. We provide a very personalized service.”

During their stay we provide translation services and do everything we can to ensure that their cultural, spiritual and emotional needs are met. We provide a very personalized service.

Dr. Joseph, Dr. Waqialla and Sandra Lloyd, director of marketing and business development, traveled to Washington, DC, in February to meet with medical attachés at the embassies of four Middle Eastern countries. “Our goal was to better understand the needs of patients from these countries and address the logistics of international referrals,” says Dr. Joseph, who is an assistant professor in the department of Physical Medicine and Rehabilitation at McGovern Medical School at UTHealth.

TIRR Memorial Hermann continues to expand its international outreach by providing multidisciplinary evaluations in other countries, including a recent trip to Italy by Dr. Joseph and a physical therapist, occupational therapist and speech/language pathologist. The hospital has also extended its international influence to China, where hospital CEO Carl Josehart is consulting on the development of a rehabilitation hospital. In addition, the international rehabilitation team has plans to build relationships with South American countries working through their embassies.

“Our best international referral source is former patients,” Dr. Waqialla says. “When patients experience the services we provide firsthand, many are overwhelmed by the experience. They need care, attention and to be listened to, and they also need to feel it’s genuine. That’s exactly what we provide.”

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Spring 2014 Edition
US News and World Report Best Hospitals Badge

Nationally Ranked Rehabilitation


For the 35th consecutive year, TIRR Memorial Hermann is recognized as the best rehabilitation hospital in Texas and No. 2 in the nation according to U.S. News and World Report's "Best Rehabilitation Hospitals" in America.

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