Physiatrists of meddit, tell us about about your day to day life and what you think of your specialty!

Well, I use to make another parallelism here: what is the difference between a doctor and a nurse? Between ophthalmologists and optometrists? Between psychiatrists and psychologist?

We are all health professionals, some (us) have received medical training, but wouldn't it be a little presumptuous to think that, as doctors, we can work without support of anyone else? Could a surgeon do exactly the same without instrumentalist, anesthesiologist, radiologist? Could we do everything without nursing? The theory may say so, but if we had to do the work of each one of those professionals, who would do ours? And now, in the field of patients with great disability, there must be someone versed in the medical issues of the patient (pain, spasticity, pressure ulcers, dysphagia, ataxia, aphasia, cognitive impairment, musculoskeletal, paresia, incontinence...) who is able coordinate work of the rest of towards specific and complementary targets.

Next question is: why a physiatrist? After all we know there are neurologists carrying neurorrehabilitation, cardiologists doing cardiac rehabilitation and psychiatrists making cognitive rehabilitation, don't we? Clear, but what happens when a patient has disability from different areas of function other than what their respective specialists know? From the "physiatric" point of view, how would a neurologist manage a patient with a stroke, a lower limb external fixation and a rheumatoid arthritis? How would he decide what to do, the order of priorities, calculate the possible consequences to minimize sequels, and prepare a rehab program with the deployment of the more efficient means? Maybe from a "save life- save organ" point of view he could get ahead (in the end of us are doctors), but I doubt he would do well quantifying correctly patient needs on the ground of the technical aids, orthoses, ergonomics, the adjustments at home, prescribing a type or other material for a given instrumental aid...

Ok, now let's think: wouldn't it be easier and far more efficient if there was a medical professional specifically trained to diagnose, quantify an treat the functional impact of any disease (whether neurological, musculoskeletal, cardiorespiratory, surgical, oncological, age- related, etc.)? Wouldn't it be logical that a single medical professional knew about tools to manage any disability (non-ionizing physical agents, occupational and orthopaedic methods, physical activity and biomechanics, prosthetics, neurophysiology, cognitive retraining, non pharmacological analgesic methods, bio-feedback, minimally invasive pain procedures, ...) and prescribe them with the same accuracy and control over side effects as if it were drugs or surgery? Well, if you answer is YES, they you have physiatrists.

One last thought: I think medical specialities, as other new fields of knowledge, are not born by the personal whim of anyone, but because a certain need pushes them into existence. In the case of PMR it has been particularly true whenever a new epidemic disease of war have led people to severe impairments and disabilities.

Thank you all for reading. Hope this means, at least, a little bit better understanding of our specialty.

/r/medicine Thread