1. Dismiss Notice
  2. Download free Tapatalk for iPhone or Tapatalk for Android for your phone and follow the SDN forums with push notifications.
    Dismiss Notice

PM&R revisited

Discussion in 'PM&R' started by Imhotep, Aug 6, 2002.

  1. Imhotep

    Imhotep Attending
    7+ Year Member

    Joined:
    Aug 6, 2002
    Messages:
    135
    Likes Received:
    0
    Hi all:
    I am a pgy1 in fp, strongly considering switching to PM&R. Several questions and concerns seem to linger, however. Bust first, I must thank all those who have posted informative messages on this forum, they've really helped me understand the "world" of physiatry.
    Anyway, I was at this party over the weekend, chatting with an opthalmologist, and mentioned something about Physiatry...the guy turned, and asked.."what exactly is PM&R?" I couldnt believe it !!!
    Have any of you had similar experiences? If so, how did you handle them? I was enraged, but managed to blurt out a diplomatic answer.
    Secondly, although this next question is rather vague, but what do you guys perceive the future of physiatry to be like? From what I hear, it is rapidly gaining popularity amongst med students....
    Thirdly, I've heard that many physiatrists affiliated c orthopods do very well financially, provided they offer interventional pain mgmt....true?
    How are physiatrists regarded by others in the medical community? With respect (hopefully), disdain? or overlooked?
    Thanks...this should do it for now...
    Cheers
     
  2. Note: SDN Members do not see this ad.

  3. Imhotep

    Imhotep Attending
    7+ Year Member

    Joined:
    Aug 6, 2002
    Messages:
    135
    Likes Received:
    0
    any comments from the previous posters like stinky tofu, ligament, drusso, etc would be appreciated. thanks
     
  4. 1. Have any of you had similar experiences?

    Yes, there are many people out there who do not know what Physiatrists do. I'm not really upset or offended, I just see it as an opportunity to educate them. However, I think that a lot of people are beginning to learn about the service that we can and do provide. Even in the Harvard system, our department is growing rapidly. We have our own hospital and have added an Interventional Pain clinic (with flouro suites). We also have plans to expand the hospital by adding two more buildings. There are strong ties to the Anesthesia department. Their pain fellows spend a good portion of their training in our hospital or with our Physiatrists in outpatient clinics.

    2. Secondly, although this next question is rather vague, but what do you guys perceive the future of physiatry to be like?

    It's hard to predict what things will be like in medicine with any degree of certainty. However, I think Physiatry has a good future. I think there is a growing understanding of our role in medicine both by the medical and non-medical community. Also, with the aging population, there will be a greater need for both physical medicine services and inpatient rehabilitation. In this age group, there is also more of a reluctance to pursue surgical procedures for orthopedic problems. We get consults all the time from Harvard's Department of Aging before they decide to get an Ortho consult. In fact, often they let us decide whether it is a surgical case or not.

    3. Thirdly, I've heard that many physiatrists affiliated c orthopods do very well financially, provided they offer interventional pain mgmt....true?

    Yes, those that I know in such groups often make 200-400K+. However, many Interventional Physiatrists that I know now want to form their own groups. There are pros and cons to such a partnerships, but that's a different discussion.

    4. How are physiatrists regarded by others in the medical community? With respect (hopefully), disdain? or overlooked?

    I think the answer to that really depends on who you ask and in what setting. Last year, I felt that many people did not know what Physiatrists do. This is probably in part due to the fact that there are no PM&R programs at Yale or UConn. Many surgical and medicine residents would often joke about what an easy lifestyle I would have and that's all they would know about my profession. However, since I arrived in Boston, it seems like their is a greater appreciation and understanding for what my residency entails. In private practice, I think that their is a growing respect for what we do as well. There are many things that we can add to an Ortho, Neurosurg, Pain (even non-fellowship trained), or Primary care groups. I think many residency programs are starting to shift towards an emphasis on Physical Medicine and I personally think this bodes well for the future of PM&R.
     
  5. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 21, 1998
    Messages:
    6,946
    Likes Received:
    2,092
    Status:
    Attending Physician
    I think that Stink hit the nail on the head. When I explain physiatry to lay people or other physicians I usually explain it as a blend of non-operative orthopedics and peripheral neurology. Although not perfect, I found that this usually helps people understand the kinds of patients and conditions that physiatrists deal with on a daily basis.

    It's important to understand that PM&R really evolved in two separate directions simultaneously: Physical Medicine and Rehabilitation Medicine. The field came together in the 1960's, but has not done a good job marketing itself to the medical community. Interestingly though, the field was very prominent in the 1940's and 1950's and was pivotal in the evolution of the VA heatlh care system. I've found that if you speak with older physicians about physiatry that they have a great deal of respect for the field as it was physiatrists who took care of the polio patients, war veterans, amputees, multiple sclerosis patients and other various and sundry "cripples." Although I believe that traditional inpatient medical rehabilitation is very important, I avoid using the term "rehabilitation medicine" to describe the field as it inevitably leads to confusion with chemical dependency treatment.

    I think that field is experiencing a resurgence in interest for a few reasons: Aging population, waning interest in primary care, lifestyle considerations, and the option to subspecialize in a variety of areas (pain medicine, brain injury and stroke, spinal cord medicine, neurodegenerative disease and MS, sports and spine rehabilitation, occ med, electrodiagnosis, and cancer rehab to name a few). I also think that people like PM&R because it's sort of a "touchy-feely" specialty. Rehab hospitals are very hopeful places for the most part because patients have gotten over their acute issues and are focusing on putting their lives back together again. You'll find this specially true if you work with kids---pediatric rehab can be a lot of fun! If you can arrange for a rotation at a Shriner's hospital you'll see what I mean.

    There is a lot of interest in multi-specialty groups involving ortho and neurosugeons, neurologists, and physiatrists. There are pluses and minuses to these arrangements. When constructed appropriately, they can be a real boost to patient care.

    Hope that helps!
     
  6. Imhotep

    Imhotep Attending
    7+ Year Member

    Joined:
    Aug 6, 2002
    Messages:
    135
    Likes Received:
    0
    Dear Drusso and Stinky tofu:
    Thank you for your encouraging and succint replies. I hope to work with people like you as colleagues in the near future !!!!
    I had gone to med school with an initial intent of practicing primary care medicine. After being exposed to it in the wards, and now residency, I find that it doesnt provide the intellectual stimulation that I thought it would. Especially outpatient primary care. Of course, its only my opinion....that being said, primary care is a wonderful field, and one in need of competent and compassionate physicians.
    I just emailed the program director of the program that I am looking into. Hopefully, things will work out :)
    In any case, thanks once again.
    Best of luck in your future career plans.
     

Share This Page