Originally posted by Betrayed:
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For example, I know of several physiatrists (including one at a U.S. News top-ranked rehab hospital) who have neglected to restart diuretics on their patients resulting in flash pulmonary edema.
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Betrayed - Hmmm....you've actually completed an internship and residency? I have a hard time believing that after reading someone of your statements, especially the one above. Since you are a FULLY trained Physiatrist, you should already know that since PM&R is a specialty, we need to complete either a year in Internal Medicine, Surgery, or a Transitional Year. In fact, most programs require a year in Internal Medicine. Programs like John Hopkins, Northwestern, and UCI have integrated programs where you spend the first year as part of the Internal Medicine team. I've heard of <a href="http://dailynews.yahoo.com/h/ap/20011205/hl/wrong_surgeries_1.html" target="_blank">Orthopods who have operated on the wrong leg.</a> What does that say about the field of Orthopedic Surgery in general? Does it say that all Orthopods are incompetent? No! If you've spent any time in medicine, surgery, or any other field for that matter, you'd know that patients are sometimes not on the medication that they are supposed to be. Nurses, patients, interns, residents, med students, consults, etc. are all part of the process of gathering the list of medications. Even after all that is done, sometimes they still get left off a W-10, they are accidentally left off the transfer orders, or the nurse just simply forgot to give the patient the medication that you ordered. The point is that there could be several reasons as to why a patient was not restarted on a diuretic.
Physiatry is a specialty an it is called Physiatry and not Internal Medicine for a reason. They have different roles and often patients with complicated medical problems will have medicine consults. This is true of many other specialties as well. GI consults, Pulmonary Consults, ID consults, etc. are things that are commonly ordered on any type of service. No one field can expect to know everything.
Also, I find it amusing that an Internist told you how uncompetitive Physiatry was. It's not like you have to be AOA with 240+ to land an Internal Medicine residency.
Many people choose fields such as PM&R, Radiology, Pathology, and Dermatology because they don't want to deal with the patients that Internists manage. In fact, at Harvard, there are several physicians that chose to do PM&R AFTER Internal Medicine. The point is that the roles are very different and you can't expect Physiatrists to do Internal Medicine as well as an Internist could.
<a href="http://www.hmcnet.harvard.edu/pmr/faculty.html" target="_blank">http://www.hmcnet.harvard.edu/pmr/faculty.html</a>
P.S. Where did you do your internship? Didn't you learn any inpatient skills there? Perhaps all the negative things you hear about your lack of inpatient skills is more indicative of you rather than the field in general.
