What is Rehabilitation Medicine?
Rehabilitation Medicine is also known as Physical Medicine & Rehabilitation (PM&R), Physical Rehabilitation and Medicine (PRM) or Physiatry (fizz-ee-AHT-ree, or fee-SIGH-ah-tree; from the Greek physio = of nature or physical, iatrea = act of healing or doctor). As you can see, this medical specialty has some sort of an identity crisis… which does not help much when you’re trying to explain what you do. Physicians who have specialty training in Rehabilitation Medicine are called Physiatrists.
Rehabilitation Medicine is usually difficult to explain because our specialty does not focus on a body part or body system, but rather on function. “Function” itself is rather vague, but it’s something you deal with everyday: the ability to get out of bed, dress and bathe yourself, move through your house, go to work or school, participate in your hobbies. I like to say we’re the specialty that helps you (the patient) get up and moving in the best way you can after an illness, while accounting for the limitations due to illness. We help translate your condition into how you will navigate the real world, give you tools to help with navigation, and in doing so hope to enhance your quality of life. Physiatrist Dr. Lindsey Migliore knows the difficulty in explaining to patients what we do, and discusses it in this video.
Those looking for a more formal definition can quote the American Academy of Physical Medicine & Rehabilitation: the specialty “aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons… Unlike other medical specialties that focus on a medical ‘cure,’ the goals of the physiatrist are to maximize patients’ independence in activities of daily living and improve quality of life.” Read more about physiatrists on their website, aapmr.org. The Philippine Academy of Rehabilitation Medicine has a webpage with examples of conditions physiatrists treat, as well as short cases showing how physiatrists can help patients.
Physiatrists are trained to treat patients of all ages, although most doctors limit their practice to one age group (children vs. adults) or class of conditions (for example, neurorehabilitation, sports medicine or pain medicine). While physiatrists can set up shop and start specialty practice right after finishing residency, some of us go on to sub-specialize by doing a fellowship. For example, I underwent a one-year (clinical) fellowship in Spinal Cord Injury to gain more experience. Other people have done fellowships in fields such as Traumatic Brain Injury, Sports Medicine, Cancer Rehabilitation. The Association of Academic Physiatrists (AAP) has a Fellowship Directory on their website. I wrote a little bit more about training here in this blog post.
We work with a team of other healthcare professionals such as nurses, physical therapists, occupational therapists, speech-language pathologists (speech therapists), prosthetists/orthotists (the people who make artificial limbs and braces) social workers and psychologists. I like to say the physiatrist is like an orchestra conductor or the quarterback in American football. As the head of the rehabilitation team, the physiatrist has to know a little bit of each of the team members’ jobs so we are able to coordinate care, but each team member is an expert in their respective field. We all work together to make the patient better.
