I've read many threads, but I am still confused. As physiatrists, do you perform the rehab, or do you leave that up to physical therapists? Also in what cases would a patient see a physiatrist instead of a physical therapist? Where I live (SF Bay Area) pretty much no one have heard of a physiatrist, but we've all heard of physical therapists. I've seem a PT for many things, including my foot/ankle, back, knee, elbow. What are the conditions of the patients you see, especially if you deal with outpatient MSK?
many PMR docs can and do perform the rehab, at least initially, as well as take a more global approach to overall patient injuries and issues that results in higher quality care than a quick trip to the ortho send to rehab approach.
When I was a director of a spine and sports center, I trained the PTs myself, who were more inpatient trained towards stroke and spinal cord injury. I also brought in top notch PTs from around the country, as well as other professionals to independently do additional training.
In essence, from a PMR/ortho group, hospital, and academic institutionalism standpoint, PTs are a line item on a budget. Beyond the literal meaning, the point here is that without medical training, there isn't enough of a background in a PT education to handle certain aspects of patient care, and patients could get hurt without proper PT guidance by a trained physician in general--thus the need for a PT prescription in order to treat in most states. Good PTs who are secure and knowledgeable welcome a knowledgeable, essentially overseeing doc. Some PTs have feelings of resistance however - but because of significant reimbursement and annual limits on PT services these days, its all pretty much quickly becoming a moot point.
A good PT is worth their weight in gold, BUT PMR docs allow for a better outcome in many isnatances for a patient by providing knowledgable instruction supervision, colaboration, prescription, and correction as it relates to patient care. Becuase PMR docs tend to be busy folks, its good to have PTs as extenders, but a good PMR doc can get in there and do the PT themselves as far as therapuetic exercise. ideally, a PMR doc will have taken the time to acquire some manual assessment skills and treatment as well, but this is not the case either for PTs or PMR docs in many instances.
Anyway, there ya have it - I think part of what you are getting in this thread is a question of sincerity in your post versus a troll of some sort. basically I don't care, but have no issue clarifying roles for you pertinent to your question for any party.
