What is Physiatry? Physical Medicine & Rehabilitation

Dr. Ali A. AlMoshaweh, physiatrist R1, PSMMC, Riyadh.

What’s physiatry?

The art of improving quality of life for people with disabilities.

“A true friend knows your weaknesses but shows you your strength, feels your fears but fortifies your faith, sees your anxieties but frees your spirit, recognizes your disabilities but emphasizes your possibilities…” – William Arthur Wards

PM&R, also known as physiatry, is a medical specialty that emphasizes prevention, diagnosis and treatment of patients who experience limitations in function resulting from any disease process, injury or symptom.

Physiatrists use a wide range of treatments, from medications, injections, physical modalities, exercise and education tailored to patient’s needs. Who’s in need for PM&R specialists, though? Generally, patients with neuromuscloskeletal disorders who have acute and chronic disabilities requiring rehabilitation services.

The goal of physiatry is to restore function in patients, in all spheres of life, including the medical, social, emotional and vocational dimensions.

Physiatry has been branded as the “quality of life medical specialty” and has grown in international recognition because of its commitment to meeting the quality of life and nonoperative neuromuscloskeletal needs of aging society, assessing patient’s functional capabilities, evokes patient’s life goals, designs interdisciplinary treatment plans and coordinates rehabilitation interventions to maximize outcomes.

How did PM&R get started?

A major shift in thinking amongst the health care providers began to take place in the middle of the 20th century. A holistic, comprehensive, team-oriented care for people with disabilities began to be recognized as an important societal obligation.

The year 1936 was a banner year for physiatry. Dr. Frank Krusen introduced the first residency training program at the Mayo Clinic. During World War II, there was an urgent need for such a specialty, in which many lives have been saved and many disabilities have been rehabilitated.

Pioneer physicians in this field helped to plant the seeds of an exciting new specialty that cared for the whole person not just the disease.

When did PM&R become recognized as a specialty?

Although the American Academy of Physical Medicine & Rehabilitation traces its origin to 1938, the American Board of PM&R was established in 1947.

What medical conditions are treated by physiatrists?

Comprehensive care for persons with diverse medical conditions and disabilities have gained a fundamental background for the field. Common conditions that are treated by physiatrists include amputations, arthritis, brain injuries, burn, cancer, cardiopulmonary diseases, spinal cord injuries, strokes, fibromyalgia, industrial injuries, pain disorders, multiple sclerosis, neuromuscular diseases, sport injuries, neuropathies, orthopedic injuries, pediatric disorders like cerebral palsy and traumas.

What subspecialties can I go for in PM&R?

For those who want to specialize in specific areas, subspecialty fellowships accredited by ABPM&R are currently available in Spinal cord injury medicine, Pain, Pediatrics, Sport medicine, Hospice and Palliative medicine, Neuromuscular medicine and Brain injury medicine.

I’m a physiatrist. Why did I choose physiatry?

I initially explored PM&R during my fourth year in medical school because I always had an interest in musculoskeletal system, neuroanatomy and pathologies occurring to them, like sport injuries. And I knew that physiatrists took care of patients with stroke, traumatic brain injury, spinal cord injury, and other disorders of the nervous and musculoskeletal systems. During my first rotation in PM&R was when I learned that physiatrists primary focus in helping their patients is by improving function. This focus on function is ultimately what attracted me to PM&R, because enabling patients with different abilities to function can substantially affect quality of life. Another aspect of PM&R that attracted me to the specialty was working with a multidisciplinary team to provide care. Where the team consists of, physiatrists, physical therapists, occupational therapists, speech therapists, prosthesis and orthosis specialists, clinical neuropsychologists, social workers, nurses, recreational therapists and others.

The family meetings that we conduct for each patient to keep him/her oriented and updated about every single detail regarding his/her condition was one of the many great things that attracted me to PM&R.

The recreational and social activities for the patients to keep them feel like home or even better.

PM&R feels just like home…