PM&R vs Chiropractic and physical therapy

[Vacant]

I've just found out about this specialty and I am thrilled to have found something that fits my perspective and professional aims.

I will be learning more about this wonderful specialty. Meanwhile with my lack of information, I am wondering about the overlap with what Chiropractors and Physical Therapists are doing and possible headache of turf war as seen in other specialties with their midlevels and other professions (DNP, NP, etc).

Your experienced input will be greatly appreciated.

Thank you.
I am finishing second year after taking 6months off.

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[PMR 4 MSK]

We all treat MSK pts, but that's about it. We doctors practice medicine. We do a full H&P, make a diagnosis and recommend treatments. We prescribe medicine, prescribe PT and do injections.

Pt sees pts with a doctor's order (although they are trying to change that). They do education about exercise for the specific condition, modalities like heat and E-stim, and manual mobilization of tissues. They are very valuable members of the allopathic team.

Chiropractors cannot prescibe medicine, cannot inject, can write for PT and do their own brand of manipulation or mobilization. They use vitamins and supplements much more that we do, often convieniently having it available for purchase in their own office.

There are many different types of chiropractors. Some think very much along the lines of PM&R, but many are of the 5-times per week manipulation with multiple modalities throw in every day - good business models, poor medicine.

 

[Vacant]

Is this new move from PT to work independently seen as a possible threat and if so, is any pressure implemented to prevent that from happening? Does it impact PM&R at all?

 

[rehab_sports_dr]

The move for PT to work independently can be seen as a threat, particularly if you are just prescribing "evaluate and treat."

I think it is a golden opportunity for PM&R, though. I work very closely with many of the PTs in my area, and because of this we are a big mutual referral source to one another. I think they appreciate having a physician who thinks like a therapist. So, for example, if they see a patient who they think may need a spine injection, they think of me because they know that I think of spine injections as an adjunct, rather than a substitution, for therapy

Given that there are far more therapists than there are physiatrists, I think physiatrists can be well positioned to be the primary doctor therapists think of when they have patients who are not responding to PT as well as they anticipated.

 

[PMR 4 MSK]

If/when PTs get direct patient acess, it won't be much of a threat. Their diagnostic capabilities do not match that of a physiatrist (though they'll agrue that until the end of time) and their treatment is limited to their very narrow scope of practice. We'll still write for meds and stick needles in people.

Another possibility is that can still work with us rather than against us. We'll still see many of the patients first and still write for PT. Insurance companies may not pay for it w/o a doctor's referral. Plus they may be able to refer pts to us when they are not improving, need further diagnosis, work-up, etc.

 

[Vacant]

I'm sure there is something more Physiatrists as a group can do to safeguard the sanctity and dignity of the field. One main thing attracts me to PM&R is the ability to work directly hand-on with patients in their progress to recovery. I don't want to just prescribe and stick needles.

I am sold to this specialty. The more I learn about it the more I feel it's a perfect match for me. Before learning about this specialty literally 5 days ago, I was aiming for Neurology.

I will be contacting someone in PM&R department in my school when I return in few days.

If there is anything I should do to prepare for this specialty, feel free to throw your advise. I will appreciate it very much.

 

[ostensibly]

One very basic thing you could do to learn more about the field is go to your med school library and flip through a rehab text such as Braddom's or Delisa's. Even just looking at the chapter headings will give you a better clue to the extremely wide breadth of the field. Or look at lists of rehab books for residency on amazon. I think just having a good definition of what is relevant to and what the potential of PM&R is in your mind will give you a big leg up.

 

[DrMarchMadness]

I'm sure there is something more Physiatrists as a group can do to safeguard the sanctity and dignity of the field. One main thing attracts me to PM&R is the ability to work directly hand-on with patients in their progress to recovery. I don't want to just prescribe and stick needles.

I am sold to this specialty. The more I learn about it the more I feel it's a perfect match for me. Before learning about this specialty literally 5 days ago, I was aiming for Neurology.

I will be contacting someone in PM&R department in my school when I return in few days.

If there is anything I should do to prepare for this specialty, feel free to throw your advise. I will appreciate it very much.

How can you be sold? You don't seem to know a whole lot about it yet. I can tell because you ask the most basic of questions. Sorry to be a jerk, but you need to hear it. Look into it more before you make a life altering decision. I was "sold" on anesthesiology too, but then left it. At least do a rotation in it, or shadow a doc before saying you are sold.

 

[bkpa2med]