Physiatrist: The Ultimate Physician Cross-Trainer
When someone asks me what my specialty is, I can simply say Physical Medicine and Rehabilitation (PM&R) and expect a puzzled, cross-eyed look. Or, I can say that I am a cross between a neurologist, an orthopedist, an internist, an urologist, a rheumatologist, a neurosurgeon, and a physical therapist. “What the heck does that mean?” is usually the reply. Well, I am a physiatrist. “You mean you are a physical therapist?” Well no, I am a medical doctor who knows about rehabilitation and works with therapists. “Oh, Oh, I get it. You are a psychiatrist.” Ugh No, that’s not it either. “Well what the heck are you?” This conversation can go round and round. But when someone needs a physiatrist, he/she will be glad to have found one.
You can find a specialist in Physical Medicine and Rehabilitation in most major trauma centers. Inpatient rehabilitation entails the care of those who are on the long road of recovery from brain injuries, spinal cord injuries, burns and amputations (just to name a few conditions). In the hospital, a patient is admitted to the rehabilitation ward. Once there, the attending physiatrist (a PM&R doctor) is in charge of the medical care and the rehabilitation process until the patient is ready to go home. The goal of inpatient rehabilitation is to make someone as functional and independent as possible.
That same goal found in the hospital is also found in the outpatient clinics. Whether it is in a pain clinic, a rehabilitation clinic or a spine clinic, a physiatrist is always trying to improve function and help someone become as independent as possible. A physiatrist will see all types of disabling conditions from the neuromuscular conditions like muscular dystrophy, ALS, para- and quadriplegia to the musculoskeletal conditions like arthritis, and sports injuries to chronic pain. Thus, PM&R specialists are the ultimate physician cross-trainers because we have to know a great deal about many different specialty areas. Although we work with surgeons, physiatrists are not surgeons. Some are trained to do procedures like epidural steroid injections and nerve blocks. Most are able to do nerve tests called electrodiagnostic studies (neurologists are also trained to perform these tests). In general, conservative care is the realm of rehabilitation and physical medicine. In general, we use medications, therapy prescriptions, durable medical equipment prescriptions, needles, and knowledge to treat disability, pain, and suffering.
So who am I and what is my specialty? My name is Christina Lasich, MD; I am a doctor who can help improve the function of the physical being through a process of rehabilitation; hence, the label: Physical Medicine and Rehabilitation. If you would like the boring description about what a physiatrist is please visit the American Academy of Physical Medicine and Rehabilitation website. Or you can just remember us, physiatrists, as the ultimate cross-trainers in the field of medicine that can put you on the right road. I am here, I am listening, and I can help put you on the right road.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.