What is a Physiatrist?
Physiatrist (fizz ee AT trist) are physicians who finished residency training program in Rehabilitation Medicine or Physical Rehabilitation Medicine (PRM).
What kind of training do Physiatrists have?
To become a physiatrist, individuals must successfully complete four years of medical education, one year of postgraduate internship, followed by three additional years of post-doctoral residency training. There are currently four (4) accredited residency programs in Rehabilitation Medicine in the Philippines. Many physiatrists choose to pursue additional advanced degrees (MS, PhD) or complete fellowship training in a specific area of specialty. Fellowships are available for specialized in such areas such as musculoskeletal rehabilitation, pediatric rehabilitation, traumatic brain injury, spinal cord injury, and sports medicine.
To become board certified in Rehabilitation Medicine, physiatrists are required to take both the written and oral examination administered by the Philippine Board of Rehabilitation Medicine (PBRM).
Where do Physiatrists practice?
Physiatrists practice in rehabilitation centers, hospitals, and in private offices. They often have general rehabilitation medicine practice, but some concentrate on one area such as pediatric rehabilitation, sports medicine, geriatric rehabilitation, brain injury, and many other special interests.
What difference do Physiatrists make?
Since physiatrist focus on restoring patients to maximum function, the difference they make can be dramatic. In the case of herniated disc, the physiatrist not only takes care of the acute impairment, but also treats the patient until he or she returns to optimal functioning, usually without surgery. The physiatrist also emphasizes on the patient how to prevent the injury in the future. A broken hip in an elderly patient is another example. Physiatrist can provide aggressive rehabilitation so patient can walk and even exercise again. And because the physiatrist is concerned with the other areas of rehabilitation-social, vocational, and psychological-the quality of life will significantly improve on this patient.
Why Choose a Physiatrist?
Physiatrists are specialists in the evaluation of impairments, disabilities and handicap arising from musculoskeletal, CNS, cardiac, pulmonary, vascular and integumentary disease or impairment. They perform through history taking and physical examination to diagnose and plan a comprehensive medical rehabilitation management. Furthermore, the physiatrist applies the interdisciplinary team approach where professionals from different disciplines work in tandem toward common goals. Team members require the skill of their discipline as well as the ability to contribute to a group effort on behalf of the patient.
Interdisciplinary team management provides a means for patient diagnosis, goal setting, problem solving, and treatment in a coordinated, nonfragmented, cost-effective manner. The treatment program is synergistic producing more than each discipline could accomplish individually. Hence, if the management requires other services, such as those of a physical therapist or occupational therapist or speech therapist or athletic trainer, the physiatrist directs, coordinates and collaborates with the other health care professionals. The result is a specially designed treatment program tailored for the patient. Because physiatrists offer a compleat, non-surgical approach to pain, injury and disability, they are the ideal choice for the rehabilitation treatment of a wide variety of diseases and conditions. Listed below are just some of the conditions that rehabilitation medicine specialists have extensive training in diagnosis and physiatric treatment:
Low back pain
Fibromyalgia / Myofascial Pain / Chronic Pain
Spinal cord injuries
Cancer pain and disabilities
Stroke and Neurological Disorders – Parkinsons
Cardiac Disorders – MI, CABG
Musculoskeletal Disorders / Osteoporosis
Post orthopedic surgery procedures
Pediatric disabilities from CP, polio, GBS, meningitis
Most importantly, physiatrists treat the whole patient, not just the patient’s symptoms. Physiatrists share their medical knowledge to help patients understand their condition and provide the tools and resources to manage it. They employ a variety of treatment methods to reduce or eliminate the problems and to decrease the possibility of a recurrence. This comprehensive approach produces not only cost-effective results, but also gives a high degree of patient satisfaction. Through integrated focused care and comprehensive diagnosis and treatment, physiatrists add quality to the lives of millions of patients each year. The goal: getting you back into the game – not just back on the sidelines.
What are the Physiatrist’s roles in treatment?
A physiatrist may treat patients directly, direct an interdisciplinary team, or provide a consultative service in a special area of expertise to other medical practitioners or to non-physician professional who is caring for a patient under another physician’s referral or prescription. Here are some scenarios that can illustrate the multifaceted roles of a physiatrist:
1. A carpenter is lifting some heavy wood when he feels pain in his lower back and down his led. He sees a physiatrist who does a thorough history and physical examination and performs all the tests needed to make the diagnosis, i.e., a herniated disc. The physiatrist develops and appropriate treatment program, monitors and adjusts it as needed. With this treatment and rehabilitation program, the patient recovers in time and may not need surgery at all.
2. A woman in a diving accident had a spinal cord injury and was paralyzed below the waist. The physiatrist assesses her injury. With the patient and a team of health care professionals, he determines the course of her rehabilitation program. The physiatrist treats the array of medical issues and complications that occur as a result of the spinal cord injury. He also leads the interdisciplinary team to enable the woman to reach the highest functional level possible. The team varies in composition depending on the needs of the patient. In addition to the other medical specialists, the team may include health care professional such as rehabilitation nurses, physical therapist, occupational therapist, psychologist, orthotist, social workers and vocational counselors.
3. A baby is born with cerebral palsy. The physiatrist is called in as the expert who advises on the correct treatment and rehabilitation that can affect the rest of the child’s life. The interdisciplinary team members may include occupational or physical therapist, orthotist or speech therapist.
What kind of treatments do Physiatrists offer?
Physiatrists offer a wide spectrum of treatment options. Physiatrists may choose to prescribe medication or drugs or assistive devices, such as a brace or artificial limb or crutches.
They also use diverse therapeutic approaches such as heat and cold, electrotherapy, massage, biofeedback, traction, and therapeutic exercises. In sports injuries or arthritides, they may opt to do arthrocentesis or intraarticular or intralesional injections. However they do not perform surgery except in the debridement of pressure ulcers.