I hate it when fields overlap

[MSKmonky]

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We had a talk by a geriatrician last week (an IM doc who specialized in Geriatric medicine) and they pretty much described their practice as what a PMR physician would be doing if they didn't specialize in Pain, SCI, or TBI. It was really quite annoying to listen to. I know tha fields are bound to overlap in their specialities, but here is a relatively new fellowship (Geriatrics) paying attention to ADL's, Improving Function, and Physical Therapy and what not. Does PMR have any identity anymore that they can strictly call their own???

 

[PMR 4 MSK]

Inpt rehab - no one else wants to do it.

Otherwise, everything else we do outpt is so much fun, everyone else wants to get in on the action...

 

[SSdoc33]

Inpt rehab - no one else wants to do it.

Otherwise, everything else we do outpt is so much fun, everyone else wants to get in on the action...

agreed. geriatricians, tho, don't know bunk about MSK and spine care. they have to worry about other MEDICAL issues with the aging population, and as specialists, we can focus. so, don't worry about geriatricians......

orthopods, anesthesiologists, chiropractors, neurosurgeons, CRNAs, physical therapists.... thats a different story.....

 

[phoenix0610]

As someone with both a strong interest in geriatrics and rehab, the overlap is sort of what made it the perfect fit--there's too much of IM I don't like for me to be an internist, and I love the other aspects of PM&R that, as was stated above, geritricians don't touch. More specialties are moving towards a more function oriented approach, and I think that's a good thing. PM&R is still its own unique entity though.

 

[ShrikeMD]

agreed. geriatricians, tho, don't know bunk about MSK and spine care. they have to worry about other MEDICAL issues with the aging population, and as specialists, we can focus. so, don't worry about geriatricians......

orthopods, anesthesiologists, chiropractors, neurosurgeons, CRNAs, physical therapists.... thats a different story.....

...don't know enough neurology to fill a thimble. (Most couldn't tell you the difference between a SDH vs an SAH, or why that would matter.) They're generally lost in BI Medicine.

To do BI Medicine well, your neurology skills should be sound, particularly for the non-degenerative disorders (ie TBI/stroke/tumors/anoxia). Many of your major, potentially life-threatening complications are neurological/neurosurgical, sent to you in the form of freshly-injured patients with unresolved problems by (some) neurosurgeons who are ready for their beds to be empty.

Your clinical evaluation skills for behavioral/cognitive issues needs to be strong too.

These are not skill/training/experience sets that come naturally to internists, orthopods, anesthesiologists, chiropractors, neurosurgeons...etc. (Caveat: In the case of these orthopods & neurosurgeons, they don't care and don't need these skill sets, because they were naturally born with them. Yeah, right. Besides, they have access to CT/MRI, what else would they possibly need to know?)

PS: I recognize that I am tarring whole fields based upon many of the weakest members I have met over the years. Lord help me if I am similarly judged as a reflection of the weakest members of physiatry!!! YIKES.

 

[ShrikeMD]

Inpt rehab - no one else wants to do it.

Otherwise, everything else we do outpt is so much fun, everyone else wants to get in on the action...

"No one" is incorrect, and an exaggeration. (There are those of us who enjoy inpt rehab, at least for specific patient populations.)

MOST/overwhelming majority is closer to the mark.

 

[Xardas]

We had a talk by a geriatrician last week (an IM doc who specialized in Geriatric medicine) and they pretty much described their practice as what a PMR physician would be doing if they didn't specialize in Pain, SCI, or TBI. It was really quite annoying to listen to. I know tha fields are bound to overlap in their specialities, but here is a relatively new fellowship (Geriatrics) paying attention to ADL's, Improving Function, and Physical Therapy and what not. Does PMR have any identity anymore that they can strictly call their own???

In the real world, all sorts of physicians do stuff that intersects with other fields. There are family doc's who try to do EMGs.

As a medical student doing an externship in a more rural area, I knew a general surgeon who also handled blood pressure meds.

Focusing on what other physicians claim to do only detracts from what you have to offer. A good reputation trumps all, and the referrals will come if say the orthopod down the street knows you know what the hell you are doing.