What Is A Physiatrist Powerpoint

What is a Physiatrist?
Physiatry: Definition
Physiatry:
From Greek physikos (physical) and iatreia (art of healing)
Known as Physical and Rehabilitation Medicine
Historical Perspective
Physical modalities date back to ancient times
Modern medical specialty began to develop during WW I
Coalesced during and after WW II, and the polio epidemic

Addressing need for rehabilitation of injured veterans
and polio survivors
Physiatry formally recognized as medical specialty in 1947
Today, over 11,000 board-certified physiatrists nationwide
Physiatry: Myths and Truths

Physiatrists are
Physiatrists are NOT
MDs and DOs
in competition with PCPs
able to diagnose and prescribe
physical therapists
(physiotherapists)
located throughout the U.S.

available for in-patient and
out-patient care
integral members of the care
team
chiropractors
psychiatrists
Physiatry: Training
4-year medical school
Residency programs
78* accredited programs listed in the U.S. in 2015
1 year internal medicine prelim, surgical prelim,
or transitional year
3 years PM&R training
Fellowships
Fellowship programs allow for sub-specialization
E.g., spinal cord injury, sports medicine, pain
*AAP Residency Training Program Directory (2015)
Available at: http://www.physiatry.org/?page=program_directors
Subspecialty/Fellowship Training
Subspecialty fellowships accredited by the ACGME for physical
medicine and rehabilitation include:
Hospice and palliative medicine
Neuromuscular medicine
Pain medicine
Pediatric rehabilitation
Spinal cord injury medicine
Sports medicine
Traumatic brain injury
Subspecialty/Fellowship Training
Non-ACGME accredited fellowships available for physical medicine
and rehabilitation include:
Cancer rehabilitation
Multiple sclerosis
Neurorehabilitation
Research
Spine rehabilitation/interventional spine
The Physiatric Approach
Guiding principles:
Patient function and quality of life
Integrated care
Combine pharmacological and non-pharmacological modalities

Non-surgical approach to treatment and rehabilitation
Coordinate interdisciplinary treatment team

Work with PCP, specialists, physical and other therapists
Multispecialty Approach
Residency training is unique in its multispecialty process,
which allows for a very unique patient care approach
Physiatrists receive formal orthopedic, rheumatologic,
musculoskeletal and neurologic training to care for patients
in both in-patient and out-patient settings
Physiatrists perform electromyography, musculoskeletal
ultrasound and advanced spinal/joint injections
Priority is to avoid surgery while maintaining function
Physiatry: Improving Function
Goal is prevention, diagnosis, and treatment of disorders that may

produce temporary or permanent impairment
Restoration of function
Maximize quality of life
Whole-istic approach (the whole patient, not just a body part):

patient-centered care
Practice Settings: Inpatient
Leads an interdisciplinary team (physical, occupational and/or

speech therapist, social worker, psychologist and chaplain)
Oversees the medical component as well prescription of

therapeutic modalities
Typically treats spinal cord injury, brain injury (traumatic and

non-traumatic), stroke, multiple sclerosis, polio, burn care, and
musculoskeletal and pediatric rehabilitation
Practice Settings: Outpatient
Experts at nonsurgical management of conditions including

orthopaedic injuries, spine-related pain and dysfunction,
occupational injuries and overuse symptoms, neurogenic
bowel/bladder, pressure sore management, spasticity management
and chronic pain
Typically practice in multidisciplinary groups with other physiatrists,

orthopaedic surgeons and/or neurosurgeons
Physiatry: Conditions Treated
Musculoskeletal
Trauma and injuries:
Sports- or work-related injuries, repetitive use disorders
(e.g., carpal tunnel syndrome)
Acute and chronic pain syndromes:
Back/neck pain
Diseases
Osteoporosis, arthritis
Other
Rehabilitation following joint reconstruction, amputation
Cardiovascular
Cardiac rehabilitation
Vascular diseases
Pulmonary
COPD
Other respiratory dysfunction
Others include:
Rehabilitation for cancer, HIV, pediatrics, geriatrics
Neurologic
Spinal cord injury, traumatic brain injury
Stroke
Multiple sclerosis
Peripheral neuropathy
Movement disorders: Parkinsons disease, cervical dystonia,
and other focal dystonias
Motor neuron disease
The Physiatric Approach to Care
Examples:
Traumatic brain injury: improve cognitive and social functioning
and return-to-work issues
Acute disc herniation: maximize function and decrease pain
with various injection techniques (including epidurals) and
physical therapy, while avoiding surgical intervention
Post-hip replacement: decrease pain and improve functional
gait/activities
Sprained ankle: strengthen and improve proprioception
The Physiatric Approach to Care
Examples:
Post MI: optimize cardiopulmonary function
Spinal cord injury: manage spasticity and assess need for
appropriate adaptive equipment
Post-stroke: increase mobility and range of motion in patients
with spasticity, use focal treatment with botulinum toxin or phenol
injection in conjunction with physical/occupational therapy

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What are some of the guiding principles of physiatry?

What are some of the guiding principles of physiatry?

What types of conditions do physiatrists treat?

What types of conditions do physiatrists treat?

What is a Physiatrist?

Known as Physical and Rehabilitation Medicine

Physical modalities date back to ancient times

Modern medical specialty began to develop during WW I

Coalesced during and after WW II, and the polio epidemic

Physiatry formally recognized as medical specialty in 1947

Today, over 11,000 board-certified physiatrists nationwide

Physiatry: Myths and Truths

Physiatrists are NOT

MDs and DOs

in competition with PCPs

able to diagnose and prescribe

located throughout the U.S.

The Physiatric Approach

Combine pharmacological and non-pharmacological modalities

Coordinate interdisciplinary treatment team

Physiatry: Improving Function

Goal is prevention, diagnosis, and treatment of disorders that may

Maximize quality of life

Whole-istic approach (the whole patient, not just a body part):

Practice Settings: Inpatient

Leads an interdisciplinary team (physical, occupational and/or

Oversees the medical component as well prescription of

Typically treats spinal cord injury, brain injury (traumatic and

Practice Settings: Outpatient

Experts at nonsurgical management of conditions including

Typically practice in multidisciplinary groups with other physiatrists,

Physiatry: Conditions Treated

Physiatry: Conditions Treated

Physiatry: Conditions Treated

The Physiatric Approach to Care

The Physiatric Approach to Care

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