What the heck is a "rehab doc?" Part 2
- continuation of previous post -
What does a PM&R doc do?
The foundational principle upon which rehabilitation medicine is based, is this: physical modalities (exercise, movement, muscle strengthening) are critical components of achieving the highest level of wellness and functionality. The goal of a PM&R specialist is to maximize a person’s functional ability within the constraints of their physical limitations. So that if a person is an amputee, or has had a spinal cord injury, or stroke – the goal is to make them as independent as possible, using prosthetics, orthotics, adaptive equipment, physical training or family assistance.
The rehab physician works tirelessly to enable the disabled. Whether the patient has temporary (such as after a broken bone) or permanent (such as a spinal cord injury) disability, the rehab doctor wants to seamlessly reintegrate the patient into society, into meaningful work, and into a joyful participation in life to the max.
PM&R physicians are the ultimate integrative medicine specialists – they practice a combination of physical and medical healing techniques, while leading a team of specialists to help their patients achieve their goals (nurses, social workers, physical therapists, occupational therapists, cognitive therapists and psychologists, speech & language pathologists, prosthetics & orthotics specialists, and more).
I guess I could sum it up like this: when the proverbial Humpty Dumpty “has a great fall,” the surgeons knit his bones back together, the internists maintain his vital signs, but the rehab doc finds him some crutches, teaches him how to walk again, gets him cognitive therapy and counseling, helps him reintegrate into society, and stimulates his progress towards physical independence and emotional wellness.
Why did I choose this “odd ball specialty?”
Well, truthfully, I didn’t hear much about PM&R during medical school. I happened to meet a group of exceptionally happy residents in the hallway one day, and I asked them why they were smiling. (My only experience with residents was that they were tired, bedraggled, ill-tempered and hen-pecked – and this group defied the stereotype).
They explained to me that they were “rehab residents” and that’s why they were happy. That seemed like a non-sequitur to me, so I investigated the specialty in more detail, and became convinced that there was no higher call than to care for the disabled. I had been a home health aid in college, taking care of young adults with cerebral palsy, and I spent my summers at a camp for disabled adults, sponsored by the March of Dimes, so this was familiar territory and seemed to be a good fit for my nurturing temperament.
As we look at Americans’ current medical needs, we don’t see hundreds of thousands of war amputees (though there is a steady trickle coming from the war in Iraq), or polio victims – but what we do see is a population disabled by obesity and its collateral damage: diabetes (with its amputations), heart disease, stroke, severe arthritis, and various pain syndromes.
I believe that Rehabilitation Medicine, as a specialty, should adapt to serve the needs created by this new obesity epidemic. We have always been the masters of physical exercise for healing – now we should apply those principles to help Americans lose weight and keep it off. I couldn’t agree more with Dr. Jim Hill, who believes that dieting leads to weight loss, but exercise leads to weight loss maintenance (the real key to long term health benefits).
As I have argued in the past, America needs to be rehabilitated. And I hope that my work at Revolution Health will contribute to improving the general wellness of our citizens.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
I have had a fair number of orthopedic problems, most of them of the tendenitis/bursitis variety, with a few joint problems thrown in. I am a very active person, and love the gym, swimming, teach water aerobics, etc. I cannot express enough gratitude to two classes of physicians: physiatrists and sports orthopedists. Both have an attitude that fits my personality–be sensible but get moving and rehab it, find a way to continue doing what you love. I realize that of course this sometimes can’t be done 100%, but so far I have had success, even though it takes a lot of effort even for not terribly serious problems such as rotator cuff tendenitis–perhaps even a couple of years. It’s worth it. I was really saddened recently when a hand orthopedic surgeon told me there is nothing I can do for my hand except a splint which I got from OT and a cortisone shot and surgery. Of course I have been scouring the internet for more active things I can safely do! I wish there were a physiatrist for the hand! Thank you for the wonderful, useful work that you do to keep people active.
Many thanks, Liz! We’ll keep doing our part to keep America on the move!
Here-here on your points about obesity! Thank you, as always, for the education and inspiration.