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What would we do without physiatrists
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What would we do without physiatrists - November 14, 2007 10:53:35 AM
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MPT
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From: Syracuse, New York
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Part of the article:
Osteoarthritis (OA) can be a very debilitating disease that often adversely affects multiple aspects of a person's life. Osteoarthritis generally causes pain and discomfort in affected joints and therefore can lead to analgesic use, decreased mobility, and function and can have psychologic implications such as depression.[1] To help increase overall quality of life, a therapeutic exercise program should be incorporated into a patient's management plan.
The use of therapeutic exercise as a nonpharmacologic treatment modality is generally accepted as efficacious.[2] Incorporation of the therapeutic exercise program can be conceptualized as occurring in several phases. The primary care physician (PCP) should strongly consider consulting a physical medicine and rehabilitation physician (physiatrist) to write the initial physical therapy (PT) orders (phase I), monitor the patient's progress during enrollment in PT (phase II), and transition the patient to a long-term home exercise program (phase III). The PCP can then resume monitoring this aspect of the patient's care once he or she is on a stable long-term home exercise program (phase IV). If circumstances change during the long-term follow-up phase, the physiatrist can then be reconsulted.
http://www.medscape.com/viewarticle/564335?src=mp
< Message edited by MPT -- November 14, 2007 12:06:18 PM >
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RE: What would we do without physiatrists - November 14, 2007 1:51:28 PM
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OAK
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What a waste. I've only had one encounter with a physiatrist. It took the patient 6 months to see him and all he did was tell her to start an exercise program (which we were already doing). What else to these Doctors do?
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RE: What would we do without physiatrists - November 14, 2007 6:20:34 PM
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jlharris
Posts: 478
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From: Nebraska
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In my experience, they are great in the acute rehab setting. I've had a few, in an OP setting, want to dictate treatments including US settings! There's your first clue on NMSK rehab depth of knowledge.
I think the article is just specifically giving a nod to MD as the sole expert in all health care, and not necessarily taking a shot at PT.
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RE: What would we do without physiatrists - November 14, 2007 8:27:53 PM
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FLAOrthoPT
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From: West Palm Beach
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I once worked with a physiatry group who was a pain management group, they did some trigger point injections, and other than that they referred every patient to therapy. They were slightly more knowledgeable about nmsk conditions and more open to learning, I taught them how to screen for SI problems based on Diane Lee's ASLR tets to help determine laxity, etc...and they listened and incorporated it in their eval, how many orthos refer you a patient with a right hypermobile SI?
I think a good idea would be for a PT to hire a physiatrist, and then they can market directly to the consumer as a pain management clinic and have the meds and orders all taken care of.
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RE: What would we do without physiatrists - November 30, 2007 10:59:46 AM
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TMondale
Posts: 131
Joined: January 3, 2005
From: Newton-Wellelsley Hospital
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I've come to this post late, but it fits in with a regular rant of mine. In my opinion Physiatrists and Podiatrists are the most unnecessary practitioners in outpatient neuro-musculoskeletal care. Physiatrists don't do anything usefully that can't be handled by primary care, ortho, and neuro MD's medically, and PT's non-medically. Ortho can do foot surgery and sprain/fracture care, while PT handles the non-surgical care of the foot and ankle.
Sounds harsh I know, but I never get referrals from these people that couldn't have skipped that step.
I do however agree with Jason, physiatry is useful in the acute rehab setting for meds. control.
Tim
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RE: What would we do without physiatrists - December 1, 2007 2:21:00 PM
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jma
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From: NY
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I've worked with a few of them in the hospital. When they are not around or availabe, the patients go to the orthopedists. Most of the referral are from them.
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