WHAT IS A PHYSIATRIST?
Physiatry (pronounced fiz-ee-at’-tree or fizz-eye’-a-tree) is the practice of physical medicine and rehabilitation (PM&R). It is a medical specialty with a governing board. In order to become a physiatrist, medical (MD) or osteopathic (DO) training must first be completed, after which a one-year internship and a three-year residency program follow.
Physiatrists treat a variety of conditions. We are well-versed in the management of patients with serious disorders resulting in severe functional limitations; patients with strokes, spinal cord injuries, traumatic brain injuries, and disabling neurologic conditions such as multiple sclerosis. We also oversee the post-operative rehabilitation patients who have undergone total hip and knee replacement and those who are debilitated after a major surgery or prolonged illness. In the outpatient setting, physiatrists treat more common, less disabling conditions such as arthritis, tendinitis, neck and back pain, sports injuries, and carpal tunnel syndrome.
Physiatry and neurology are the only two medical specialties involved in the training of physicians to perform electrodiagnostic studies (EMGs). These diagnostic tests are necessary to determine whether nerve or muscle damage has occurred. Most commonly, such tests are used to confirm whether a presumed condition is actually present. Carpal tunnel syndrome and radiculopathy (pinched nerve in the neck or back) are examples of two such conditions.
Physiatry is a broad-based specialty that serves all age groups. In order to pass their specialty boards, physiatrists must be qualified to diagnose and treat a multitude of conditions. After passing the required written and oral tests, a physician becomes "board certified". In most cases a career in general physiatry follows. Typically this is a blend of in-patient rehabilitation, out-patient musculoskeletal medicine, and EMG. Many physiatrists focus on a particular interest. Some even choose to pursue additional formal training. Fellowships in PM&R sub-specialties have been established in order to facilitate a growing demand for this additional training. One of the most popular PM&R fellowships is a one-year program in pain management and/or musculoskeletal medicine. Sub-specialty training serves to better prepare the physician to treat more involved and more complicated problems with greater expertise.
What truly distinguishes physiatry from other medical specialties is that physiatrists rely on a comprehensive, team-oriented approach. We work closely with physical therapists, occupational therapists, psychologists, social workers, prosthetics and orthotics technicians, as well as other physicians. Our job extends beyond the initial diagnosis and treatment. We oversee the coordination of care when a team-oriented approach is essential for optimal functional recovery. For physiatrists this is always the goal -- optimizing function.
For more information about physiatry, contact the American Academy of Physical Medicine and Rehabilitation (AAPM&R, One IMB Plaza, Suite 2500, Chicago, Illinois, 60611-3604, telephone #312-464-9700).