How competitive will PM&R be in a few years?

[ToldYouSo]

As an incoming college junior with a budding interest in this field, I'd like some perspective from attendings as to how competitive this specialty will be years from now. Have matches from the past few years up to present shown an increasing interest in this specialty? Thanks in advance.

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[PMR 4 MSK]

As awareness of the field increases, so does the interest. PM&R fits well with many people's ideals of how to approach illness, injury and disease. DO applications to PM&R have picked up considerably in recent years.

PM&R has gained in the area of demand due to recognition of it's potential symbiotic relationship with other fields - notably orthopedics, neurosurgery and sports. Also primary care doctors more and more are recognizing the wide range of services a skilled Physiatrist can offer.

Therefore, it seems logical that over the next decade, there should be increasing demand for our services, especially with a growing and aging population.

That being said, no one knows what the political and financial climates hold for us. 15 - 20 years ago, PM&R came in to demand as hospitals recognized the need for skilled inpt rehab, and more importantly, realized they could make a lot of money on it. 10 years ago, that changed, and they are not as sought after.

 

[ToldYouSo]

As awareness of the field increases, so does the interest. PM&R fits well with many people's ideals of how to approach illness, injury and disease. DO applications to PM&R have picked up considerably in recent years.

PM&R has gained in the area of demand due to recognition of it's potential symbiotic relationship with other fields - notably orthopedics, neurosurgery and sports. Also primary care doctors more and more are recognizing the wide range of services a skilled Physiatrist can offer.

Therefore, it seems logical that over the next decade, there should be increasing demand for our services, especially with a growing and aging population.

That being said, no one knows what the political and financial climates hold for us. 15 - 20 years ago, PM&R came in to demand as hospitals recognized the need for skilled inpt rehab, and more importantly, realized they could make a lot of money on it. 10 years ago, that changed, and they are not as sought after.

Thanks for your reply. What changed 10 years ago that made physiatrists less sought after by hospitals?

 

[bedrock]

Thanks for your reply. What changed 10 years ago that made physiatrists less sought after by hospitals?

Inpatient rehab reimbursement dropped sharply. Outpatient services now pay more.

 

[RUOkie]

Inpatient rehab reimbursement dropped sharply. Outpatient services now pay more.

Also, there are some for profit companies (I will refrain from naming names) that run rehab units that prefer to have internists, or neurologists be their medical directors. In their minds, Physiatrists are too "difficult" (because they actually understand what Rehab is all about) and harder to push around. The interests of the Hospital/Rehab unit do not necessarily coinside with the interests of the physician or the patient.

 

[Jitter Bug]

Also inpatient rehab tends to have alot of medicare/medicaid patients due to our field managing classic problems (stroke SCI, TBI, amputees) of the older or newly disabled.

Medicare has decided nursing homes are much cheaper than 5 weeks of inpatient rehab (which would have been 5 months 10 years ago) and are strangling the will to live out of inpatient docs by burying them in paperwork designed to take more time per patient than patient care per patient.

At least this was how it felt to me.