Physiatrists: What do they do? How do I find one?

By Rob Ingraham

The specialty of physiatry is defined as “a medical specialty concerned with the prevention, diagnosis, treatment, and management of disabling diseases, disorders, and injuries typically of a musculoskeletal, cardiovascular, neuromuscular, or neurological nature by physical means—as by the use of electromyography (EMG), electrotherapy, therapeutic exercise, or pharmaceutical pain control” (Medline Plus).

The field is sometimes confused with physical therapy, but Dr. Monifa Brooks, staff physiatrist at the Kessler Institute for Rehabilitation in West Orange, New Jersey, explained that, while a physiatrist will often work with a physical therapist, the specialty of physiatry requires significantly more training. “A physiatrist is a medical doctor who has completed a four-year postdoctoral residency, usually at a rehabilitation facility, specializing in physical medicine and rehabilitation. Candidates must also be certified by the American Academy of Physical Medicine and Rehabilitation (AAPM&R) before they are allowed to practice.”

Addressing the Whole Person

The term physiatry is from the Greek words physikos (physical) and iatreia (art of healing). Treatment typically involves the whole person and addresses the physical, emotional, and social needs required to restore the patient’s quality of life.

The field of physical medicine and rehabilitation began in the 1930s to address musculoskeletal and neurological problems, but after World War II it broadened its scope as veterans returned with serious disabilities. The Advisory Board of Medical Specialties granted physical medicine and rehabilitation its approval as a subspecialty in 1947.

Brooks explained that there are also “subspecialties within the subspecialty.” For example, some physiatrists work exclusively with spinal cord injuries, others with stroke victims, others with musculoskeletal disorders, and others with sports-related injuries or geriatric medicine. She explained that a physiatrist is specially trained in electrodiagnostic medicine (EMG) such as, nerve condition studies, and somatosensory evoked potentials, which help the physiatrist diagnose conditions that cause pain, weakness, and numbness. (Somatosensory is sensation relating to the body’s superficial and deep parts, as contrasted to specialized senses such as sight.)

While physiatrists do not perform surgery they may prescribe drugs or assistive devices and may also use such diverse therapies as heat and cold, electrotherapies, massage, biofeedback, traction and therapeutic exercise.

Finding a Physiatrist

Brooks said the best way to locate a physiatrist is to visit the AAPM&R Web site (www.aapmr.org), which not only provides information about the field of physiatry, but offers help in locating a certified physiatrist in your area of the country. When researching physiatrists, Brooks noted, “Look for someone that you’re comfortable with and who you can talk to. Find someone who is a good listener and who will address your particular needs.” She said that the field is expected to grow substantially as the population ages and the “Baby Boom” generation lives longer, requiring more rehabilitative care to remain active

According to the AAPM&R Web site, “Since physiatrists focus on restoring patients to maximum function, the difference they make can be dramatic. In the case of a herniated disc [for example], the physiatrist not only takes care of the acute problem, but also treats the patient until he or she returns to optimal functioning, usually without surgery. The physiatrist also teaches the patient how to prevent the injury in the future.”

Presently, there are over 7,000 physiatrists practicing in the US. To receive a printed list of board- certified physiatrists in your area, contact Adrianne Watson, AAPM&R marketing and sales coordinator at 312-464-9700 or e-mail awatson@aapmr.org. Information on locating a physiatrist can also be obtained through the Association of Academic Physiatrists at www.physiatry.org.

Rob Ingraham is senior editor.