Improving Care and Building Communities: An Interview with Nephrologists Fahim and Naeem Rahim

Fahim Rahim, MD, FASN                                  Naeem Rahim, MD

Today Kidney News Online begins a series of interviews with nephrologists who trained in the United States as International Medical Graduates (IMGs). To launch this series, we turned to Fahim Rahim, MD, FASN  and Naeem Rahim, MD, nephrologists who founded the Idaho Kidney Center after training in New York. The Rahim brothers, originally from Peshawar, Pakistan, were interviewed by then ASN President Ronald J. Falk, MD, FASN in 2011 after they received Ellis Island Medals of Honor* for their services to America and contributions to American society.

Fahim and Naeem Rahim completed internal medicine and nephrology training at New York Medical College in Valhalla, NY. In 2005 they moved to Idaho and founded the Idaho Kidney Institute, opening their first clinic in Pocatello, Idaho, and a second one year later in Blackfoot, Idaho. Today the Idaho Kidney Institute includes a clinic in Idaho Falls, and is the largest provider for patients with kidney disease in southeast Idaho, with a catchment area of approximately 250,000.

The Rahim brothers founded the JRM Foundation for Humanity and the Idaho Hometown Heroes Award. They have received a Congressional Recognition award from the US Senate and the Ellis Island Medals of Honor. Both are affiliate faculty at Idaho State University (ISU), responsible for nephrology curriculum for the Physicians Assistant School and Nursing schools, and provide clinical mentoring for residents from ISU’s Family Medicine Residency Program. In addition, they host a weekly medical call in show, House Calls, on the local NPR affiliate.

 

Why did you set up practice in Idaho?

NR:  I met Mark Caputo, who was then CEO of Liberty Dialysis, at an ASN conference -- talking with him helped me focus on running my own practice. I talked with Fahim, who was already working in Florida, and we started researching areas with inadequate renal coverage.

FR: At that time in southeast Idaho, a region that serves approximately 250,000-300,000 people, there was not a single board-certified nephrologist, and very little inpatient nephrology coverage.  We wanted to make a difference in care. Now our practice has four board-certified nephrologists; we hold charts on approximately 10,000 patients, and take care of 300 dialysis patients as well as kidney, heart and pancreas transplant patients.

You have said in other interviews that as soon as you moved to Idaho, you began working with primary care physicians to focus on keeping patients off of dialysis, as well as caring for patients already on dialysis.

NR: Over the years we have worked with a lot of excellent family medicine physicians. And we’ve found that one of the most effective approaches is educating, nurses, PAs and medical students to make sure everyone has a good understanding of the value of earlier referral.

What about identifying AKI in the hospital setting?

NR: This is another area in which it’s critical to engage with nursing students, medical students, PAs and nurses. They become very well versed in understanding the risk signs, looking not just at creatinine but the underlying GFR.

In addition we have conducted a lot of direct community outreach; we believe in empowering patients. We have a number of patients who ask about GFR in the same way people ask about their cholesterol levels, and some patients who self-refer because of community patient education efforts.

You have been engaged in population health right from the beginning. What do you consider ongoing challenges in this arena?

FR: We started a golf tournament right away, to help raise awareness of kidney disease and the risk factors for kidney disease. Empowering the community is essential. The challenges reside with the healthcare infrastructure, creating better and more efficient care systems. This will improve with time and technologies – patient portals are a great example of this.

Why did you start the JRM Foundation?

NR: We’ve been so fortunate to practice in this great community and great country. The concept really started because we wanted to make a difference on a humanitarian level. The Foundation covers a wide range of interests: we raise money for local food pantries and other regional efforts in Idaho, and, for earthquake relief, health services and community projects in Nepal, Pakistan, Panama and Thailand.  

FR: After we received the Ellis Island award, we learned that we were the first people in Idaho to receive that award. We thought so many people were more deserving, that we reached out to the governor’s office and others to start a civic award. This has become the Idaho Hometown Heroes Medal, and there have been nominees from all over the state, people who have touched the lives of others in profound ways. Goodness doesn’t always get great PR.

In what area do you consider the JRM Foundation has had the biggest impact to date?

FR: It’s hard to say, but we’re very proud to have built a lot of bridges in a relatively sheltered, homogenous community. These days you see a lot of rhetoric about divisions in America, but we think there is an untold story, not covered by the media, centered on the citizens of mainstream America who often exhibit profound understanding of and empathy for each other. As just one example, when the JRM Foundation began working in Nepal to provide relief after the earthquake, we raised more than $300,000 just from this part of Idaho.

You all host a very popular radio call-in show, House Calls, on KISU, an NPR affiliate. How did that start?

FR: When Ron Falk interviewed us after we received the Ellis Island Award, he said he thought we should host a talk show. The next day we called several radio stations, and the NPR affiliate at Idaho State University suggested we send in a proposal within 3 months. We called back the next week and said “We don’t need to write a proposal; just put us on the air.” The show is now in its sixth year, and each week about 6,000-7,000 people listen on Thursday mornings, and then more listen online or by podcast. The show is very wide-ranging, not just about nephrology. We often focus on certain themes, such as childhood bullying, but we do get a lot of calls during the show, and have learned to just roll with the flow.

For readers who have not listened to the earlier podcast, could you tell us what it meant to receive the Ellis Island Award?

NR:  I always tend to remember the day I came to the United States. We landed in Newark – this was pre- 9/11, so the pilot flew around to give everyone a view of the Statue of Liberty. I’ve never forgotten that – it embodies free speech, freedom from oppression, freedom of expression and for me it embodied a new life. Of course Ellis Island represents the same concept, so being nominated for an award under the name of Ellis Island – that feeling cannot be matched. It brought me great joy, but also a great sense of responsibility.

FR: The US is a nation that has evolved relatively quickly. I find real beauty in the wide diversity of colors and religions in this country. The Ellis Island Award reflects what America is really about: people from different backgrounds and cultures come to America, maintain their individuality but also become part of the unique oneness that is America. I agree that the award brought a sense of responsibility – looking at “being American” as a verb -- standing for truth and justice, and leaving this place better than we found it.

* Ellis Island Medals of Honor embody the spirit of America in their celebration of patriotism, tolerance, brotherhood and diversity. They recognize individuals who have made it their mission to share with those less fortunate their wealth of knowledge, indomitable courage, boundless compassion, unique talents and selfless generosity; all while maintaining the traditions of their ethnic heritage as they uphold the ideals and spirit of America.  

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Fahim Rahim, MD, FASN                                  Naeem Rahim, MD

Today Kidney News Online begins a series of interviews with nephrologists who trained in the United States as International Medical Graduates (IMGs). To launch this series, we turned to Fahim Rahim, MD, FASN  and Naeem Rahim, MD, nephrologists who founded the Idaho Kidney Center after training in New York. The Rahim brothers, originally from Peshawar, Pakistan, were interviewed by then ASN President Ronald J. Falk, MD, FASN in 2011 after they received Ellis Island Medals of Honor* for their services to America and contributions to American society.

Fahim and Naeem Rahim completed internal medicine and nephrology training at New York Medical College in Valhalla, NY. In 2005 they moved to Idaho and founded the Idaho Kidney Institute, opening their first clinic in Pocatello, Idaho, and a second one year later in Blackfoot, Idaho. Today the Idaho Kidney Institute includes a clinic in Idaho Falls, and is the largest provider for patients with kidney disease in southeast Idaho, with a catchment area of approximately 250,000.

The Rahim brothers founded the JRM Foundation for Humanity and the Idaho Hometown Heroes Award. They have received a Congressional Recognition award from the US Senate and the Ellis Island Medals of Honor. Both are affiliate faculty at Idaho State University (ISU), responsible for nephrology curriculum for the Physicians Assistant School and Nursing schools, and provide clinical mentoring for residents from ISU’s Family Medicine Residency Program. In addition, they host a weekly medical call in show, House Calls, on the local NPR affiliate.

 

Why did you set up practice in Idaho?

NR:  I met Mark Caputo, who was then CEO of Liberty Dialysis, at an ASN conference -- talking with him helped me focus on running my own practice. I talked with Fahim, who was already working in Florida, and we started researching areas with inadequate renal coverage.

FR: At that time in southeast Idaho, a region that serves approximately 250,000-300,000 people, there was not a single board-certified nephrologist, and very little inpatient nephrology coverage.  We wanted to make a difference in care. Now our practice has four board-certified nephrologists; we hold charts on approximately 10,000 patients, and take care of 300 dialysis patients as well as kidney, heart and pancreas transplant patients.

You have said in other interviews that as soon as you moved to Idaho, you began working with primary care physicians to focus on keeping patients off of dialysis, as well as caring for patients already on dialysis.

NR: Over the years we have worked with a lot of excellent family medicine physicians. And we’ve found that one of the most effective approaches is educating, nurses, PAs and medical students to make sure everyone has a good understanding of the value of earlier referral.

What about identifying AKI in the hospital setting?

NR: This is another area in which it’s critical to engage with nursing students, medical students, PAs and nurses. They become very well versed in understanding the risk signs, looking not just at creatinine but the underlying GFR.

In addition we have conducted a lot of direct community outreach; we believe in empowering patients. We have a number of patients who ask about GFR in the same way people ask about their cholesterol levels, and some patients who self-refer because of community patient education efforts.

You have been engaged in population health right from the beginning. What do you consider ongoing challenges in this arena?

FR: We started a golf tournament right away, to help raise awareness of kidney disease and the risk factors for kidney disease. Empowering the community is essential. The challenges reside with the healthcare infrastructure, creating better and more efficient care systems. This will improve with time and technologies – patient portals are a great example of this.

Why did you start the JRM Foundation?

NR: We’ve been so fortunate to practice in this great community and great country. The concept really started because we wanted to make a difference on a humanitarian level. The Foundation covers a wide range of interests: we raise money for local food pantries and other regional efforts in Idaho, and, for earthquake relief, health services and community projects in Nepal, Pakistan, Panama and Thailand.  

FR: After we received the Ellis Island award, we learned that we were the first people in Idaho to receive that award. We thought so many people were more deserving, that we reached out to the governor’s office and others to start a civic award. This has become the Idaho Hometown Heroes Medal, and there have been nominees from all over the state, people who have touched the lives of others in profound ways. Goodness doesn’t always get great PR.

In what area do you consider the JRM Foundation has had the biggest impact to date?

FR: It’s hard to say, but we’re very proud to have built a lot of bridges in a relatively sheltered, homogenous community. These days you see a lot of rhetoric about divisions in America, but we think there is an untold story, not covered by the media, centered on the citizens of mainstream America who often exhibit profound understanding of and empathy for each other. As just one example, when the JRM Foundation began working in Nepal to provide relief after the earthquake, we raised more than $300,000 just from this part of Idaho.

You all host a very popular radio call-in show, House Calls, on KISU, an NPR affiliate. How did that start?

FR: When Ron Falk interviewed us after we received the Ellis Island Award, he said he thought we should host a talk show. The next day we called several radio stations, and the NPR affiliate at Idaho State University suggested we send in a proposal within 3 months. We called back the next week and said “We don’t need to write a proposal; just put us on the air.” The show is now in its sixth year, and each week about 6,000-7,000 people listen on Thursday mornings, and then more listen online or by podcast. The show is very wide-ranging, not just about nephrology. We often focus on certain themes, such as childhood bullying, but we do get a lot of calls during the show, and have learned to just roll with the flow.

For readers who have not listened to the earlier podcast, could you tell us what it meant to receive the Ellis Island Award?

NR:  I always tend to remember the day I came to the United States. We landed in Newark – this was pre- 9/11, so the pilot flew around to give everyone a view of the Statue of Liberty. I’ve never forgotten that – it embodies free speech, freedom from oppression, freedom of expression and for me it embodied a new life. Of course Ellis Island represents the same concept, so being nominated for an award under the name of Ellis Island – that feeling cannot be matched. It brought me great joy, but also a great sense of responsibility.

FR: The US is a nation that has evolved relatively quickly. I find real beauty in the wide diversity of colors and religions in this country. The Ellis Island Award reflects what America is really about: people from different backgrounds and cultures come to America, maintain their individuality but also become part of the unique oneness that is America. I agree that the award brought a sense of responsibility – looking at “being American” as a verb -- standing for truth and justice, and leaving this place better than we found it.

* Ellis Island Medals of Honor embody the spirit of America in their celebration of patriotism, tolerance, brotherhood and diversity. They recognize individuals who have made it their mission to share with those less fortunate their wealth of knowledge, indomitable courage, boundless compassion, unique talents and selfless generosity; all while maintaining the traditions of their ethnic heritage as they uphold the ideals and spirit of America.