News Archives - Michigan Head & Spine Institute Blog


Postponing non-emergent surgeries due to the COVID-19 Pandemic reduced Michigan Head & Spine Institute (MHSI) neurosurgery procedures by 95%.  The impact on patients, employees and the neurosurgeons were many, and meeting the challenge to continue to treat patients was achieved with these swift actions:

  1. Neurosurgeon partners and administrators took a 45% pay cut. This ensured that employees will continue to be paid at various levels and those working with patients in clinics will receive a 25% premium.
  2. Telehealth was immediately implemented and within 7 days more than 80% of patient consultations were conducted virtually.
  3. Neurosurgeons continue to support their local hospitals through on-call in the Emergency Departments for trauma and urgent cases.

“We are extremely proud of our employees.  They are committed, creative and flexible every day in meeting the challenges caused by this pandemic,” said Robert Johnson, MD, president of MHSI.  “As a designated critical infrastructure service, MHSI employees are committed to patient care.  Every member of MHSI is screened daily when they arrive to work.  The financial decision to support our employees was the right thing to do for the]m and our patients.”

Dr. Johnson explains, “We didn’t want our patients to be concerned about their medical treatment or feel abandoned by their doctors. At the same time, reducing exposure to the COVID-19 virus among our patients, employees and our physicians was a critical factor in moving to Telehealth. We believe the actions taken will better protect everyone as MHSI continues to take every precaution possible through this crisis.”

Richard Fessler, MD, MHSI neurosurgeon and practice partner says, “We had planned for years to gradually enable telemedicine and the current pandemic coincided with our initial roll-out.  MHSI is the largest multi-disciplinary neurosurgical practice in the United States to employ virtual visits on a platform of this scale. Telehealth allows us to provide new patients and our existing patients with access to care during the Covid-19 pandemic and in the future.”

Dr. Fessler explains, “We are grateful to our patients and staff for their support during this unprecedented time.”

MHSI uses which offered a HIPAA compliant product.

If you are patient with a brain, neck, back or spine problem, find out if it can be addressed by a virtual visit:



COVID-19 Header Graphic

As a community, we face the challenge of preventing the spread of the Coronavirus (COVID-19). We want to assure you that our teams at MHSI and Premier MRI | CT | X-Ray continue to be committed to maintaining a clean and safe environment – for you and for us. As always, we follow strict protocols for ensuring each patient care and waiting room area is cleaned frequently with the appropriate cleaners by following the Center for Disease Control (CDC) guidelines.

We ask that if you are just not feeling well, or have cold or flu symptoms please cancel your appointment as soon as possible. We will do our very best to reschedule your visit in the coming weeks.

Our staff is also committed to preventing the spread by staying home if they are not feeling well. While we hope our staff maintains their health, we appreciate your understanding if appointments need to be adjusted or answering your call takes a few extra minutes.

To stay healthy, wash your hands with soap and water frequently, cover your mouth when coughing or sneezing, eat healthy, and get adequate sleep.

Together we can stop the spread of COVID-19.

COVID-19 Prevention Graphic

Follow these tips to help avoid exposure to COVID-19:

  1. Wash your hands often with soap
  2. Dispose of any used materials
  3. Avoid touching your eyes, nose & mouth
  4. Stay home if you are sick



Dr. Robert Farhat
Dr. Robert Farhat
Director, Regenerative Medicine Center at MHSI

Michigan Head & Spine Institute (MHSI) is pleased to announce it has added another non-surgical option to improve patient’s ability to function, it’s called Regenerative Medicine.

Dr. Robert Farhat, one of our physiatrists, has been named director of new Center for Regenerative Medicine at MHSI.

Regenerative Medicine or as you may have also heard it called, Orthobiologics, provides patients another option to relieve discomfort instead of using corticosteroids or opioids. The process uses one’s own bone marrow or blood, which is called autologous, because we believe it to be the safest method. The bone marrow or blood is then spun down and becomes a concentrate.

Bone marrow aspirate concentrate (BMAC) or platelet rich plasma (PRP) helps the body heal itself at the cellular level to restore mobility and function from unresolved musculoskeletal symptoms including neck, back, shoulder, hip and knee pain.  Adding concentrations of either BMAC or PRP is like bringing in the army of healing properties to give the body the boost it needs to heal and repair itself quicker than it can without the help of Regenerative Medicine.  Dr. Farhat describes the process and how to get started [click here].

For some are patients it can be a bridge to relief while waiting for surgery. Or bring relief from injuries or arthritic conditions. Patients suffering with any type of joint, tendon, or ligament pain may be considered candidates if they:

  1. Have experienced short term and/or had no results with physical therapy or corticosteroid injections.
  2. If surgery is in the future, but the injury has not yet required surgery.
  3. Patients with neck, back, spine pain, such as degenerative disc disease.
  4. Patients with knee injuries, like a torn meniscus.
  5. Patients with shoulder injuries.
  6. Patients with arthritic conditions.

To learn more about Regenerative Medicine, Dr. Farhat describes the process and how to get started [click here].

If you would like to be considered for BMAC or PRP, call our Nurse Coordinator for Regenerative Medicine to establish your initial appointment, where additional questions can be answered. Please call 248-331-6038.


Holly S. Gilmer, M.D.Holly S. Gilmer, M.D., is just one of the many highly-talented specialists who work with patients at the Michigan Head & Spine Institute (MHSI). Dr. Gilmer was recently appointed by Michigan Gov. Gretchen Whitmer to represent physicians on the State of Michigan’s Board of Medicine for a term beginning Jan. 1, 2020 and expiring Dec. 31, 2023.

The Michigan Board of Medicine works with the Department of Licensing and Regulatory Affairs to oversee the practice of medical doctors in the state. It is also responsible for the promotion and protection of the public’s health, safety and welfare.

“It is an honor for me to be chosen by Gov. Whitmer as an advocate for my physician colleagues and to represent patients, not only those I assist at the Michigan Head & Spine Institute but across the state,” Dr. Gilmer said.

In addition to her work for MHSI, Dr. Gilmer is an attending neurosurgeon at several hospitals including Ascension St. John Hospital, Ascension Providence Hospital, St. Joseph Mercy-Oakland and others.

Dr. Gilmer received her medical degree from the University of Michigan after graduating cum laude from Harvard University and a residency in neurosurgery at the University of California, Davis Medical Center. She is board-certified by the American Board of Neurological Surgery and the American Board of Pediatric Neurological Surgery. She has been ranked a Top Doc by HOUR magazine 14 times between 2003 and 2019.

Congratulations to Dr. Gilmer on her appointment!

Read more about Dr. Gilmer on MHSI’s website. To receive specialized services at MHSI schedule an appointment online or contact us at 877.784.3667.

Read the announcement online


For most, the idea of paying less for auto insurance is a very appealing notion. But is it still appealing if you are involved in an auto accident and are unable to receive medical treatment and rehabilitation to restore your quality of life or be personally financially responsible for your medical care?

On May 25, 2019, the Michigan Legislature passed sweeping changes to the Michigan No-Fault Insurance Law and the Michigan Insurance Code – known as the SB1. On June 4, 2019, the Michigan House and Senate passed the “trailer bill,” HB 4397 which made revisions and clarifications to SB1.  The bills were signed into law on June 11, 2019, effective immediately.

Personal Injury Protection (PIP) was required coverage of the previous No Fault Insurance Law, regardless who was at fault. PIP offered potentially unlimited lifetime medical benefits. The new law gives those covered by auto insurance the option to choose the level of PIP coverage, or none at all, as a way to reduce costs by 10-45 %. It also removes non-driving factors such as gender, marital status, home ownership, education, occupation, zip codes and credit score into the rate calculations.

What This Means For You & Your Family…

  1. For the patients who are seriously injured in an auto accident, if they have not chosen additional PIP coverage, there will be caps on the amount of money that will be paid for their medical care under PIP.  The new law eliminates life-time medical care, unless you chose to pay for that coverage under PIP.
  2. Without selection of additional PIP coverage, the consumer can be sued and is financially at risk to pay for medical bills when an auto accident occurs, regardless of who was at fault for the accident. PIP covers medical care, rehabilitation, home care and attendants with catastrophic claims being paid by the Michigan Catastrophic Claim Association (MCCA).
  3. If a person/child lives in a home where no one has auto no-fault auto insurance, that person/child — if injured by a car — no longer gets lifetime medical benefits. Instead, the benefits are capped at $250,000 in something called the Assigned Claims Plan. One of these changes, as reported in the Detroit Free Presshas already created a medical financial crisis for one family.

MCCA would continue to be liable for catastrophic injury benefits payable under policies issued or renewed before July 2, 2020 and for policies after July 1, 2020 where drivers have opted to maintain unlimited No-Fault PIP medical benefits. Since the new law gives drivers the option of how much PIP coverage to carry, it’s possible regardless of who caused the accident you could be sued by the other party and become financially responsible for their expenses.

Effective July 1, 2020, the No-Fault law gives insurers the authorization to sell various types of no-fault PIP choice policies and opt-outs from PIP coverage that apply to allowable expense benefits. Drivers now will have the choice to select and pay for one of five No-Fault PIP medical benefit coverage levels:

  • $0 personal injury protection (a 100% savings on the PIP coverage but risks having no medical care as a result of an auto accident).
  • $50,000 of personal injury protection, plus $200,000 for immediate trauma care (a 45% savings for those who opt out of PIP).
  • $250,000 of personal injury protection (a 20% savings for those who opt out of PIP).
  • $500,000 of personal injury protection (a 10% savings for those who opt out of PIP).
  • Unlimited personal injury protection. (Insurers would be mandated to offer it.)

We are sharing this information with our patients for four reasons:

  1. There is still time to contact your elected officials to voice your educated opinion, concerns or suggestions. Click for a list of State Senators and State Representatives along with their contact information.
  2. To inform you that the way these bills are written, buying additional health care coverage to offset what was removed from the no-fault coverage is necessary to protect your medical care and financial assets should you or a child be in an auto accident, regardless of who is at fault.
  3. Under this new legislation, you may be sued and held financially liable for medical expenses, if you are held responsible for the accident and the person (s) involved in the accident should they reach the cap of their medical coverage.
  4. To make you aware it is a mistake to assume that your medical insurance will cover injuries from an auto accident. Be sure to talk with your health insurance company or employer representative about how to coordinate medical benefits with your auto insurance PIP coverage.

The changes to the Michigan No-Fault law are many, very complex to describe in this article and are not clearly understood by legislators or insurance companies. Yet, we believe these changes may severely impact our patients and their families who may be involved in an auto accident.

We are not lawyers and recognize the information presented in this article is subject to change. So, we’ve provided links to those who do practice auto law. Their legal insights may further address questions or guide you into selecting the proper PIP coverage for you and your family. Your insurance agent is able to provide you with costs for the level of coverage you choose, but you must decide the level of risk you can tolerate.

Other sources:

Michigan Auto Law 

Sinas Dramis Law Firm 


Meet Ratnesh Mehra, DO, the newest member of the neurosurgical team at MHSI. Dr. Mehra specializes in minimally invasive, robotic, and endoscopic neurosurgery. He employs the latest techniques to achieve the best results for each patient, including those with severe scoliosis.

Dr. Mehra takes a global approach to every patient to ensure you receive the best treatment possible to improve your quality of life. You can learn more about Dr. Mehra’s background by visiting his webpage and viewing videos that explain who he is and what he does.

If you’ve been putting off dealing with back or neck pain, or arm pain that may be caused by neck problems, Dr. Mehra is accepting new patients. Call (877) 784-3667 or visit


The 10th Annual MINS (Minimally Invasive Neurosurgical Society) Meeting & Cadaver Course: Mastering Minimally Invasive Techniques will be held at the Mayfield Surgical Innovation Center, Cincinnati, Ohio between June 6-8, 2019.

MHSI’s own Mick Perez-Cruet, MD, MS, leads the Society and is joined by neurosurgeons from around the country. Coming together, surgeons to learn from each other, enhance and advance minimally invasive surgical techniques improves the patient’s surgical experience and supports surgeons to expand the scope of their practice.

Michigan Head & Spine Institute neurosurgeons who will teach and present are:

Fernando Diaz, MD, PhD

  • Use of Robotics

Jeffrey Jacob, MD

  • Endoscopic Pituitary Approaches: A Neurosurgeon’s Perspective
  • Endoscopic Posterior Fossa Cranial Approaches

Tejpaul Pannu, MD

  • Posterior Interspinous Process Spacers

Mick Perez-Cruet, MD, MS

  • Posterior Lumbar MIS Approaches
  • Thoracic MIS Approaches


Registration is open until June 1, 2019

The program/agenda is available.

Target Audience: Practicing neurosurgeons, orthopedic spine surgeons, otolaryngologists, fellows, residents and physician assistants.





Congratulations to Ascension St. John Hospital for achieving a two-year certification as a Comprehensive Stroke Center, after successfully completing The Joint Commission Stroke Center survey.  Richard Fessler, M.D., MHSI Neurosurgeon and Chief of Surgery at Ascension St. John Hospital, has long been a leader in stroke care and continues to treat the most complex cases, as well as teach other physicians and residents.

To be commended for their efforts are the Stoke Team In addition to Dr. Fessler, Ascension St. John Hospital’s Stroke Team leaders include: Dr. Paul Cullis, Chief of Neurology, Makenzie Thimm, Nurse Practitioner and Stroke Coordinator, Dr. Robert Dunn, Vice Chief of Emergency Medicine.

The announcement was featured in Ascension St. John Hospital Today magazine.