Meet Dr. Robert Promisloff
Dr. Robert Promisloff joined the Drexel Medicine team in July 2015 after 37 years in private practice. He is a pulmonologist who specializes in chronic obstructive pulmonary disease (COPD) and plays an important role in Drexel’s Comprehensive Lung Center. Dr. Promisloff is also a faculty member at Drexel University College of Medicine, where he enjoys working with residents and fellows.
For those of us who simply know you as Dr. Promisloff, can you tell me a little bit about your life before medical school?
I’m a lifelong Philadelphian. I attended Central High School, which is a famous magnet school in the city. My parents are Russian immigrants, and they always stressed the importance of a good education since that’s something they weren’t able to take advantage of.
What made you decide to go to medical school?
Like I said, my parents always wanted their children to get a good education and strive for a better life. When I started to consider my career options, my brother was in medical school and was heading into cardiology. I saw my brother’s pathway, and I wanted to follow him.
After high school, I went to Temple University and then PCOM [Philadelphia College of Osteopathic Medicine]. I did an internship at Philadelphia General Hospital, which no longer exists, but it was a great general hospital. I spent my residency and fellowship at Hahnemann, and, really, I’ve been here ever since—since 1974. I was in private practice for 37 years, but I’ve always been based out of Hahnemann, so when I officially moved over to Drexel, it was something that was familiar.
Unlike your brother, though, you went into pulmonology. What attracted you to that?
When I was in school, there was no critical care specialty. Most of the ICU patients were taken care of by pulmonologists, and I wanted to be in the ICU. If I was on call or at night, no matter what I was assigned to, I always hung out around the ICU. That’s what I found exciting. Pulmonary became the natural way to spend time in the ICU. The critical care specialty came to be around 1987 and it hooked onto pulmonary, so I obtained critical care credentials at that time.
As a pulmonologist, you work in Drexel Medicine’s Comprehensive Lung Center. What role do you play there?
I see several patients with COPD. I treat patients who have been diagnosed with asthma. I also get a lot of patients who come in having shortness of breath and/or cough. Cough is a big one. It’s the most common diagnosis in the western world that sends a patient to a doctor.
We have many fantastic specialists here. We have asthma specialists. We have cystic fibrosis specialists, including one who specializes in adults. We have sleep specialists. We have lung cancer specialists. We just try and put everything together in one place, under one umbrella, where a patient can go and get all their needs taken care of.
There’s a pretty severe lack of awareness when it comes to chronic obstructive pulmonary disease. Why do you think that is, and why is awareness so important?
About 10 years ago or more, I think the whole pulmonary community noticed that although we were paying a lot of attention to asthma—which is important considering 5% of the population has asthma—we were paying very little attention to COPD. It was always viewed as a blame disease—you smoked, so now you have COPD. But it was becoming more and more prevalent with over 100,000 deaths per year in the United States. It’s estimated that COPD will be the third or fourth leading cause of death in the world. So while other diseases, like heart disease and many forms of cancer, saw their mortality rate decrease, COPD showed a steady rise.
Generally speaking, COPD affects people over 60 with smoking history and other comorbidities like high blood pressure, diabetes and obesity. Awareness is important because many patients will notice they’re short of breath and will start by seeing a cardiologist instead of a pulmonologist. Luckily, many cardiologists will send them to us, but with more awareness, there are fewer hoops to jump through to get properly diagnosed.
Smoking cessation is a major health care initiative throughout the country. What are you doing to help patients who want to quit?
We try to present them with a number of tools to help them quit smoking. We explain what nicotine replacement therapy is, and we try to help them get into support groups. Honestly, just spending time with the patient and speaking with them for a few minutes has shown results. Nicotine is tough though. I have patients who have been addicted to drugs, alcohol and tobacco, and they’ll say tobacco is the hardest.
There’s a pretty big trend with vaporizers and other e-cigarettes. Would you recommend those to a patient?
E-cigarettes and vaporizers are interesting. There are no FDA guidelines on these things. There’s no oversight, and there’s no science behind them. I think they could be useful as a nicotine replacement vehicle, just like the nicotine patch, as long as they’re regulated and found to be safe. If a person can go from 20 cigarettes a day to the e-cigarette, and then get off that, that seems like a good thing. However, the other end is that it’s being used to introduce nicotine to kids. The vaporizers and flavored nicotine can also produce addiction.
Legionnaire’s disease seems to be popping up quite often in the news. Can you talk a little bit about what it is and how common it is?
It’s an infection that spreads from water vapor. It’s not spread person to person. It’s a bacteria that breeds in water and is spread through air conditioning, showers and other forms of water spray. This outbreak in the Bronx has been one of the bigger ones we’ve seen. Legionnaire’s disease has never gone away; it’s just sporadic. I maybe see one or two cases a year. Unfortunately, the only way to prevent it is to make sure the water vapor systems are properly taken care of.
What do you like most about working at Drexel?
It’s a very collegial place. It’s a very friendly and patient-oriented place. Most of us have known each other for years. We have each other’s cell phone numbers and communicate with each other immediately and freely. I think the patients get excellent care.
One thing that I really enjoy and I’ve grown to appreciate even more in the later stages of my career is teaching and being in contact with residents and medical students. That’s what I enjoy the most. That’s why I’ve always stayed close to academic medicine. Drexel gives me the opportunity to do that.
Robert Promisloff, DO
Pulmonary disease, COPD, critical care
BA – Temple University
DO – Philadelphia College of Osteopathic Medicine
The Arnold T. Berman, MD Building
219 N. Broad Street, 9th Floor
Philadelphia, PA 19107
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