HWN Suggests

“You Want to be a Physi-what Doctor?”

Physiatrists focus on function. Everything they do is about restoring/maintaining function in their patients. This can be done in various realms, including sports medicine, pediatric rehab, traumatic brain injury, spinal cord injury, general rehab, prosthetics/orthotics, and even regenerative medicine! Physiatrists aren’t the brilliant diagnosticians of internal medicine, they don’t make life or death decisions like an emergency medicine doctor, and they definitely aren’t regarded as one of the prestigious fields of medicine. But what they are doing, in my mind, is part of the whole foundation of being a physician – working to restore a certain quality of life and daily function in our patients.…

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Featured

 My Story: how do medical students choose their specialties?

Most people go through four years of medical school, and nobody talks to them about people who have disabilities. There’s such a huge need for it. We have all these veterans who return from war with amputations and chronic pain. Even a simple thing like accessibility, we take it for granted. Medical students must be exposed to these types of things. It also gives us an opportunity to recruit the best of the best in this specialty.

 Physiatry rising: on engaging the next generation of physiatrists

The classical clinical rotations include Internal Medicine, Pediatrics, Obstetrics and Gynecology, Surgery, Psychiatry and Neurology. The choice to focus on these core rotations is historical, although this means that 88% of all medical students get through medical school without ever getting any exposure to disability management, the evolution of physical impairments that develop as a result of chronic disease vs. aging, or the associated loss of functionality with major injury or trauma. Yet, it is these very skills coupled with team leadership that future physicians need to succeed in an environment that will place a high premium on value-based outcomes with function at its core. These are the skills that physiatry imbues in a physician. Nonetheless few medical schools require Physiatry aka Physical Medicine & Rehabilitation as a core clerkship.

Articles of Interest

Challenges and Opportunities in Academic Physiatry: An Environmental Scan

Several important international trends have led to a shift in the demographics and characteristics of physiatric patient populations. Globalization has led to increased diversity of communities from the standpoint of culture, race, ethnicity, preferred language, and immigration status. In most World Bank high-income countries, populations are rapidly aging due to improvements in health care and reduced birth rates, resulting in an increasing prevalence of disability. These trends will challenge us to provide culturally competent rehabilitation services that meet the needs of highly diverse populations.

Demonstrating the vital role of physiatry throughout the health care continuum...

The COVID‐19 pandemic has exposed and amplified many of the longstanding barriers, biases, and inequities in health care services for people with disabilities. Physiatrists are well positioned to lead the charge toward a more inclusive, accessible, and equitable system of care. Physiatry's unique approach to patient care presents an opportunity to be leaders in this next charge in the disability rights movement.

History of the Specialty

The American Society of Physical Therapy Physicians, the organization that became the American Academy of Physical Medicine and Rehabilitation (AAPM&R), was founded in 1938. The same year, Dr. Frank Krusen proposed the term “physiatrist” to identify a physician specializing in physical medicine. To avoid confusion with psychiatry, he proposed a pronunciation with emphasis on the third syllable.

Past Experiences, The Current State of PM&R and What The Future May Hold: An Interview with Dr. Bruce Gans, M.D.

There is a big need and opportunity in our field to influence the continuum of care. With the American Medical Rehabilitation Providers Association (AMRPA) I have been pushing things like the continuing care hospital. Together, we have developed a model where we get rehab hospitals, acute care hospitals, nursing homes, LTACs, home health agencies and the payer to come together in advance to do post-acute care in a better way.

Physiatry and Sports: Getting Back in the Game Safely

Physiatrists, or rehabilitation physicians, are experts in diagnosing and treating musculoskeletal and neuromuscular conditions. Unlike other medical specialists, physiatrists adopt a holistic approach to patient care, emphasizing the restoration of function and quality of life. When it comes to sports injuries, physiatrists become instrumental in devising comprehensive rehabilitation plans tailored to individual needs.

So You Want to Be a Physiatrist (PM&R)

PM&R is the jack-of-all-trades specialty focusing on both inpatient and outpatient management of non-operative orthopedics and neuro-rehabilitation. These are the primary physicians for certain nervous system or non-surgical orthopedic disorders, offering both medical and procedural treatment modalities. These are the doctors handling their unique conditions on an ongoing and outpatient basis. Some patients present with spinal cord or traumatic brain injuries, for whom you’ll manage their pain, neuropathy, and bowel and bladder care. Other patients may have other mixed connective tissue or nervous system issues that you’ll treat, such as mallet finger or jersey finger.

Some reflections on the past, present, and future of Physical and Rehabilitation Medicine

I strongly believe that the quantity and the quality of our knowledge base have increased significantly in the last few decades. It has been said that when Charles II of England had a mild stroke, the treatment (and rehabilitation) administered by his personal physicians included bleeding, purgatives, enemas, sneezing powder, and antidotes containing extracts of herbs and animals . Needless to say, today’s protocols for the treatment and rehabilitation of stroke are vastly different. This is due to the considerable amount of new information and knowledge that has resulted from scientific research in rehabilitation.

Understanding Physiatry & Pain Management...

Have you ever heard of physiatry? No, not psychology or physical therapy, but physiatry. That’s pronounced FIZZ-eye-ah-tree. These medical doctors are specially trained to treat ongoing pain of the nerves, muscles, and bones using both surgical and non-surgical techniques. The main focus of physiatry is the patient’s function, independence, and quality of life.

What’s Afoot and What’s Ahead for Physical Medicine and Rehabilitation

One main challenge continues to be that we are not a well-known specialty, despite the fact that the AAPM&R was founded in 1938. Among the general public, and even among some healthcare professionals, there remains a lack of familiarity with the fundamentals of PM&R as a specialty for medical doctors and the fact that physiatrists may be subspecialized in areas such as brain injury, hospice/palliative medicine, spinal cord injury, sports medicine, interventional spine, pain medicine and pediatric rehab.

Resources

Physiatry in Motion

Physiatry in Motion, the RFC-newsletter for highlights of recent innovations and developments in our field.

American Academy of Physical Medicine and Rehabilitation

As the primary medical society for the specialty of physical medicine and rehabilitation (PM&R), your Academy is focused on moving the specialty and you forward. Explore below to learn about the value of your Academy membership and what it supports.

Archives of Physical Medicine and Rehabilitation

The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.

Association of Academic Physiatrists

AAP’s vision is a thriving global academic community leveraging mentorship, leadership, and scholarship to maximize human function. Learn about our history, mission, leadership teams, and more!

International Journal of Physical Medicine & Rehabilitation

International Journal of Physical Medicine & Rehabilitation is an open access journal includes studies on cancer rehabilitation cardiopulmonary rehabilitation cardiovascular disability clinical physical medicine & rehabilitation geriatric rehabilitation hospice and palliative medication inpatient rehabilitation interventional pain mental rehabilitation musculoskeletal pain management neuromuscular medicine orthopaedic rehabilitation pediatric rehabilitation physical medicine and rehabilitation