Here is a link to the
AAPM&R's Medical Student Website which gives a pretty good description of my field.
Despite the fact that the field has been around for the past 50 years, we definitely do still have a difficult time explaining what we do. Conceptually, our field is unique in the sense that our field does our "organ" is function. Physical function and quality of life issues are not traditionally taught in medical school which makes understanding what we do difficult.
PM&R is one of those fields that has such a broad scope of practice that it's difficult to describe succinctly. However, my "one-liner" for what I do is "I work with people with medical problems and physical disabilities as a result of acute or chronic musculoskeletal or neurologic diseases."
Our bread and butter diagnoses inpatient diagnoses are stroke, spinal cord injury, traumatic brain injury, pediatric rehabilitation, cancer rehabilitation, multiple sclerosis, amputee, and post-operative joint replacement care.
In the outpatient setting, physiatrists see patients with musculoskeletal problems, chronic pain issues, and perform electromyography/nerve conduction studies. Some physiatrists also perform CT guided spinal epidural injections, facet and caudal injections, to list a few interventional spinal therapeutics. We are also using a lot of ultrasound for musculoskeletal diagnosis and guidance for injection.
In terms of daily care, I guess it depends on what you consider "an issue." There typically aren't
acute issues on a day to to day basis. If they have too many acute issues, then they probably are not ready for the rehabilitative phase of care. However, we still have many problems that we manage on a day-to-day basis. Many of our patients still have common medical problems (i.e. HTN, DM, CHF, coumadin therapy, etc.) in addition to new issues such as pain, bowel/bladder care, pressure sore management, and patient/family education. Some physiatrists do elect or have the option to consult medicine to assist some of these medical problems, if they choose. However, I suspect that the decision to manage is dependent on the provider. I know I typically manage all of these issues.
In my opinion, one of the reasons that medical students, residents, and attendings do not understand the field is that we are not taught rehabilitative medicine and/or management of chronic medical illness. In 4 years, our focus is primarily on diagnosis and acute care management. When a patient comes in to the hospital, the assumption is that once they are medically stable that they should be able to return to their normal day to day function. The reality is that some patients need help regaining their function and develop new medical problems as a result of their new diagnosis i.e. neurogenic bowel/bladder, spasticity, visual and cognitive impairment, paralysis, pressure sores, and pain. All of these factors do affect a patient's ability to go home and care for themselves. This is what rehabilitative medicine is about.
Someone give me a case and I can give you the rehabilitation issues that come up that we help manage. I really LOVE my field and feel that it's the best thing ever! Let me help you understand what it is we do.
