Physiatry - Physical Medicine for Boomers, Vets, Athletes and Others

Physiatrists, physical therapists and others may use a hands on approach to spine care.
Physiatrists, physical therapists and others may use a hands on approach to spine care. Wavebreakmedia

A physiatrist treats many of the same problems as a physical therapist might. The difference is your physiatrist is a licensed medical doctor.  

What is physiatry, you ask? It's a relatively new branch of medicine — also called physical medicine — that  offers soldiers, boomers, athletes and people living with chronic pain the opportunity to extend the life of their physical body.   

Why See a Physiatrist?

It's common knowledge that advances in health and medicine are saving more lives than ever before.

 But this means the aging population is increasingly surviving its health problems. Because of that, more patients are living with disability.

Enter, the physiatrist. Physiatry is a medical sub-specialty that focuses on improving your quality of life by increasing your physical function.

Physiatry — The New Kid on the Block

Physiatry is a rapidly growing medical specialty that can pick up where your family practitioner leaves off. It addresses the physical functioning of seniors, the disabled, people with degenerative diseases, and those with mild to severe injuries.

A physiatrist may treat a stroke patient, an athlete with a back injury, a brain injured soldier returning from war, or may oversee a therapeutic exercise program for a heart patient. Often, it's the physiatrist who coordinates the treatment plan for a chronic pain patient. More and more, people are seeking physiatrists for musculoskeletal problems, including back and neck pain.

Just the same, physiatry is not-well known as a field. According to a survey conducted by the American Board of Physical Medicine and Rehabilitation (ABPM&R), approximately 2/3 of those questioned had health problems that could be treated by a physiatrist; examples include spinal arthritis, work-related back injuries or spinal cord injuries.

Yet only 1% had heard of this medical sub-specialty.

Physiatrists take a Patient As Person Approach

Physiatrists are full-fledged medical doctor who have passed a certifying exam given by the American Board of Physical Medicine and Rehabilitation (ABPM&R). While she has all the credentials necessary to treat patients with (or at least refer them for) invasive procedures, a physiatrist mainly focuses on a non-surgical approach to care. 

In other words, physiatrists tend to prescribe conservative care and medication, exercise, and holistic treatments for their neck and back patients before suggesting that you go the surgical route.

The physiatrist takes a whole-person approach to her patient. Dr. Andre Panagos (physiatrist, and director of the Sports and Spine Medicine of New York) comments, "Surgeons are trained to be meticulous technicians, rather than counselors. By contrast, the physiatrist is the type of doctor who is trained and has time to listen to his patients, to help them sort out options for the direction of their care.

Often the physiatrist leads a multidisciplinary treatment team that may consist of other doctors, physical therapists, occupational therapists, social workers and holistic practitioners. In the age of increasingly complicated treatments, this multidisciplinary approach yields benefits for both the patients and the health care community."

Panagos says that physiatry encompasses many disciplines concerned with pain and function, and borrows techniques from neurology, neurosurgery, rheumatology and orthopedic surgery. The physiatrist, as a quality-of-life doctor, will work with a spine patient; the goal is to take a patient-as-person approach when determining the best course of action, he adds.

A Short History of Physiatry

Physiatry got its start during World War II, when Dr. Howard Rusk, an Army Air Corps medical doctor concerned about the dignity of injured soldiers, began treating them with innovative methods that included psychological, emotional and social aspects of healing. In his career, Dr. Rusk functioned not only as a doctor, but also as an advocate for soldiers with disabilities.

Physiatry has now started to address the effects of sedentary living on the musculoskeletal system. To this day, however, the work with soldiers continues, and physiatrists see patients who have traumatic injury of all kinds, including spinal cord injury and brain injury. Physiatrists also treat stroke patients

With nearly, 7,000 physiatrists practicing in the United States, this medical specialty is a small field and a well-kept secret, Panagos concludes.

Sources:

Rusk, Howard, A. (1901-1989), Papers, 1937-1991 (C3981). Western Historical Manuscript Collection-Columbia. University of Missouri.

Howard A. Rusk, M.D. (1901-1989) Founder. Rusk Institute of Medicine at NYU website.

PM&R Specialty Background. American Academy of Physical Medicine and Rehabilitation website.

Dr. Andre Panagos. Phone and email interviews. 2008.

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