Many people are unaware that there is a special branch of medicine specifically dedicated to the diagnosis and treatment of physical Disability. Physiatrists are doctors who are certified as specialists in Rehabilitation medicine by the American Board of Physical Medicine and Rehabilitation.
The area of medicine they practice is called “physiatry.” Physical Medicine and Rehabilitation (PM&R) was born in 1946 in response to the challenge to help disabled citizens reach their maximum potential. What is so special about these specialists? After completing medical school and obtaining an MD or DO degree, they study four more years and take two extra examinations, one written and one oral.
The purpose of this extra training is to make sure that physiatrists are focused on the patient as a whole person. Most physicians deal with illness and possible threats to life. The Physiatrist deals with Functional loss and threats to living fully — the physical and psychological disabilities remaining after initial medical or surgical treatment.
The physiatrist often coordinates a team of other doctors and health professionals in developing and carrying out a comprehensive rehabilitation plan; s/he may specialize in the care of patients with spinal cord injuries (SCI). The coordinated treatment plan extends beyond hospital walls into the patient’s family, community, occupation, friends, and ultimate life style.
This rehabilitation team may include physical, occupational, and/or speech therapies, nurses and doctors from various specialties, including neurology and orthopedics, psychologists, counselors or social workers, rehabilitation engineers and others.
The physiatrist’s success comes through a team effort where the patient is an integral part of the team process. Each improvement in function, however subtle, can significantly improve the quality of life of a person living with SCI.
ED: Adapted with permission from the September, 1987 issue of New World for Persons with Disabilities a publication of California Association of the Physically Handicapped, Inc., “The Pair-A .-Docs of Health” by Julie Madorsky, M.D. & Art Madorsky at Casa Colina Hospital in Pomona, California.
NSCIA revised 01/25/2004
Physiatrists are doctors who are certified as specialists in rehabilitation medicine by the American Board of Physical Medicine and Rehabilitation
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Locate a physiatrist by phone: 1-312-464-9700
A physiatrist performed 3 epidurals last year: cervical, caudal and lumbar. Before the 3rd series, I told him I was having a severe headache. He asked on a scale of 1 to 10 (10 being the worst ), I told him mine was 10+. He then proceeded with the epidurals. After the procedure, I found out May this year in reading the medical records, he then put me to sleep and gave me versed and fentenyl — when calling my name the nurses said I had slept for over an hour, I had stroke symptoms and he refused to keep me at the hospital saying if it was a stroke, there was nothing to be done because of the anesthetics given me. The brain scan June 1 last year showed an intact brain but July 7 emergency room showed I had two strokes, occipital/parietal 4.5 cm approx. and 2.5 cm internal capsule near the brain stem. I begged him not to put me out after the epidurals, but he did it anyway, and I remember him telling the nurses to roll me over and I heard a drill and my head going into a vise. When I chewed him out later for not checking me out before the epidurals, he was surprised I could remember any of it, including him hitting a bone at the cervical area. I looked up the medicines on the computer this year and learned that the drug fentenyl is 40xs more potent than heroine and he gave me a drug to wipe out memory, temporary, but could be permanent. Anybody out there willing to tell me what he did was inappropriate. I had to relearn to type, left side paralyzed and I struggled to regain use, and left with dysarthric speech. He knew my reflexes were hyperreflexic and I had spasticity. After the mess, he referred me to a neurgologist and I was diagnosed with friedreich’s ataxia. He wasn’t sure if it was Lou Gehrig’s, cerebellar ataxia, but that something else was going on before he proceeded. MRI showed congential narrowing of spinal column, and degenerative doral root and DJD and herniated/bulging discs — lumbar shows curve and kyphosis in upper spine. He did spinal manipulation which I never areed to and when he asked 1st of series I refused, but it shows he did it anyway. He told me he would put me out and with manipulation he could straighten it out — I told him all I looked up for degenerative spine that manipulation would aggravate it — and research proves me right. I’m losing strength in upper arms, and was called spastic paraplegic years ago in lower legs. Pes cavus feet, left ventricular hypertrophy, inferior infarction and heart failure, but to satisfy disability board, I proceeded with epidurals to try to minimize pain and none of the series helped — not even 24 hours afterward. What say any of you?