Physiatry

The specialty of Physical Medicine and Rehabilitation (PM&R) is called Physiatry (pronounced fizz ee at’try), and the doctors who practice in this specialty are called Physiatrists or “Rehab doctors.” They are typically MD’s or DO’s who have had four years of medical school training, a year of internship and three years of specialized training as a resident in the field of PM&R. This type of training is similar to other areas of medical specialties that other doctors received.

Sometimes there is some confusion between physical therapy and rehabilitation medicine. It is important to note that Physical Therapy is not Rehabilitation Medicine (PM & R) but is a discipline of it just as are Occupational or Speech Therapy to name a few. Hence sending a patient for rehabilitation is not the same as sending them for Physical Therapy. PM & R encompasses a wider spectrum of disciplines.

The Working Physiatrist

The Physiatrist often works closely with other health care professionals, such as other MD, DO, DPM, Psychologists, Chiropractors, Nurses, Physical Therapists, Recreational Therapists, Speech Language Pathologists, Social Workers, Orthotists, Pedorthists and others.

Physiatrists may work in freestanding rehabilitation hospitals, general hospitals or private practice. Most physiatrists will have a diverse practice while others will focus on a few selected areas of interest such as strokes, spinal cord injuries, sport medicine, traumatic brain injuries, musculoskeletal injuries, pediatrics and electromyography (Needle EMG, Nerve Conduction Studies, Evoke Potentials) , interventional pain medicine/ spine disorders to name a few. There are fellowships offered in some of these areas.

The Physiatrist Evaluation and Treatment

The Physiatrist takes a non-surgical management approach to pain and injuries. Each patient’s evaluation begins with a complete medical history (including social and functional/home situation) and physical examination. The Physiatrist evaluates and treats patients with a wide range of medical presentations. Some of them are listed in this web site.

The role of the Physiatrist may be consulting, interdisciplinary team leader, in an outpatient setting or inpatient management of patients with any of the above presentations. Treatment goals focus primarily on restoring, improving or maintaining functions enabling the patients to have the best possible functional life. They may require outpatient or inpatient therapy and hospitalization for an appropriate time. Therapy may involve exercises, hot or cold applications, ultrasound, electrical stimulation or acupuncture and others. Patients may also receive medications including injections if warranted. In addition, various assistive devices (e.g. cane, reacher) are available to facilitate the rehabilitation objectives. Laboratory tests, blood tests, X-ray, MRI/CT -scan and EMG are sometimes ordered or performed if determined to be necessary.