Questions about Physiatry

[Tiz]

For those who have experienced PM&R medicine:

 

-To what degree are the physiatrists involved in rehab (ie do they just coordinate rehab with the physiotherapists/other health professionals and follow up with pts or do they do any hands-on work with pts?)

-How treatable are the conditions seen in Physiatry (i realize its broad)? Is there much progress made in stroke, brain injury, or MSK diseases? What time frame are we looking at for results?

-Does physiatry allow the development of patient relationships- long term or short term? Do patients know their physiatrists and appreciate their work etc?

-What is the lifestyle like? I've heard you don't have to do call if you don't want to. What branches of physiatry necessitate call and which do not?

-What is it that physiatrists love about their work? What do they not like?

 

Thanks in advance.

[Psiborg]

Ill try to answer your questions as best I can im a physiatry keener who has spent some time with physiatrists so if anyone wants to correct me go ahead.

 

1) The best analogy of a Physiatrist in rehab is like a Quarterback. They do a lot of assessments and planning for patients (ie. This patient is now a candidate for bracing etc) Little hands on actual hands on thearapy (thats the relm of the PT/OT/SLP). They meet as a group and make goals and care managment. In an oupatient setting they do more hands on stuff (injections etc)

 

2) Depends on what you mean by 'treatable'. On one side much of what PM&R deals with are conditions that wont go away. But the flip side is that there is so much you can do to improve the quality and function of people with things such as stroke. Its really amazing to see the progress sombody can make. As for time frame its variable. From the patient who a month after your steroid injection is pain free to the patient with ALS who you are slowly adapting their life to their progressive limitiation.

 

3) Yes! Definately PM&R has both short and long term. But i think there is a lot of the longer followup as patients who see a physiatrist generally have issues that are chronic and therefore always need some fine tuning.

 

4) Rehab emergency is a bit of an oxymoron. The lifestyle is great with good pace with paients. Its one of the pros of the specialty.

 

5) For this I will only be able to speak for myself.

a)The variablitiy - the speicalty is HUGE no two physiatrists do the same thing. From Neuro to MSK to pain managment to amputee clinic.

b)Lifestyle - Its good to see your family and friends

c)The patient population - I have seen more 'cool cases' in my time with Physiatriy than anywhere else. You generaly work with people who are ammenable to rehab, that you can see improvment in their lives.

 

Cons

a) Renumeration - All doctors are paid well, Physiatrists less so. So its a matter of perspective. There are some more lucrative sides to the specialty perhaps (from what I hear EMG/Medicolegal)

b)Respect - "Physiatrist.....you mean PT?" Haha its definately an underrecognized specialty

 

Its a specialty worth checking out nevertheless.

 

If I could summarize in one sentence:

 

Medicine gives years to life, Physiatry gives life to years.

 

Hope this helps

 

Psiborg

[thebouque]

 

 

Medicine gives years to life, Physiatry gives life to years.

 

 

That sentence is pretty awesome, and very true. Thanks for your input, physiatry is a very underrated and under recognized specialty. I guess that without an elective, no one can really appreciate what it's really about.

[future_doc]

And you have the possibility to do Workmen's Compensation work.

[Tiz]

I've heard that a lot of docs aren't too excited about medico-legal stuff. Why is that? What is it that they do exactly, or does it vary? I heard something about companies paying docs to assess patients who are currently receiving benefits for the purpose of cutting them off from benefits. How do they get payed (is it the same if they don't give the answer the insurance company is hoping for)?

[Psiborg]

Haha, its not my quote. Its the reply I received when I asked somebody why physiatry.

 

As for medicolegal. Ask any of your classmates if they want to do medicolegal and most of them will say no, its that simple really. Otherwise it can also be time consuming to go to court when you could be doing 'real medicine'. So few people do it. A good number of phyisatrists do it though.

 

As for the pay it can be through Workers Comp or insurance companies or lawyers i think. I am not super familiar with that side of the fence. Haha I am sure they are paid the same despite their assessment or it wouldn't hold in court. In order to get true answer to those question you have to ask somebody doing it.

 

Psiborg

[Oenak138]

I (my lawyers) retained a Physiatrist recently to provide an expert report outlining my current and future limitations in all aspects of my life.

 

Her rate? $700/hr for a 2 hour assessment and another 4 hours to prepare the report.

 

I believe a select group of Physiatrists play a large role in injury claims. This sounds like a nice way to supplement an already great income.

[FitnessFreak]

I don't know that the physiatrist would have seen the total amount of the $4200 charged for the exam. The assessment centre that s/he works for would likely take a cut from that.