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  • Writer's pictureAssociation of Academic Physiatrists

A Call to Action: Defining Physiatry

By: Amber Clark, MD, Resident Physician at the University of Alabama at Birmingham and Former Advancement Representative for the AAP’s Resident/ Fellow Council

“But they’re not real doctors.” I was flabbergasted that this bold statement, coupled with disdain, had escaped the physical therapist’s mouth! As I walked away from one of my first introductions into opinions on physiatry, an important question persisted. How do we define ourselves and communicate this identity to others?

This question is not one that is easily answered, due to the broad scope of our specialty. Unlike some of our colleagues, our specialty cannot be summated by phrases such as “heart doctor,” “lung doctor” or “kidney doctor.” This is by no means meant as a slight to other specialties, it just means that we have to be more creative.

Associated searches related to physiatry include: the difference between physical therapists and physiatrists, are physiatrists real doctors, what does a physical medicine and rehabilitation doctor do, etc. While most of us are not surprised by these questions, it is clear that there still remains work to be done regarding the awareness and understanding of our specialty. So, here we are, poised to make an even greater difference in the lives of patients we treat, can treat and will treat. What do we do with this opportunity?

First, let’s take a look at the facts. According to the CDC, 26% (61 million) of the nation’s adult population identify as having a disability. Of this 26%, 13.7% report deficits with mobility and 3.7% report deficits with self-care and a great need for care. Over the past four years, there has been a great awakening within our specialty as evidenced by an increase of more than 10% and 10 positions in the NRMP. Rehabilitation research continues to make progress and the role of rehabilitation medicine in the healthcare system has increased. Simply put: We. Are. Here.

While these facts are very encouraging, there remains hurdles with the introduction, explanation and understanding of our specialty. Personally, I was the first person in ten years to match into PM&R from my medical school. There was a dearth of resources and knowledge. Essentially, I found myself piece milling together opportunities that ultimately benefited me and those that came behind me. My story is not unique. Many of us found, or rather were found by, PM&R by happenstance.

However, we must continue to change this paradigm. We cannot rely on others to define who we are and we must be our own advocates. It is not enough to promote what we do and who we are amongst ourselves, we must also share it within our patient communities and institutions. We are more than a “is this patient appropriate for IPR?” specialty.

I would therefore like to offer some practical tips to get started.

Amber Clark, MD at dinner with her state medical society at the interim AMA meeting in November 2019.

Community Engagement

  • Participate in local health fairs

  • Patient testimonials

  • Partnering with local Greek organizations during health initiatives

  • Speaking at churches

  • Volunteering at school sporting games

  • Consider partnering with other physiatrists to host a “Get to Know Us” event

Institutional Engagement

  • Present during grand rounds and didactic sessions (especially of specialties such as NSGY, neurology, IM, ortho, etc.)

  • Educate colleagues during consults on other parts of our specialty that they may find helpful

  • Create handouts specific to your institutions that clearly list the services offered

State & National Engagement

  • Get involved in both state and national medical societies

  • Learn who your representatives are so you can educate them on issues specific to rehabilitation and the populations in which we treat

  • Become more involved in health policy by either participating in a fellowship or getting further graduate training

As physiatrists and physiatrists in training, we have a coveted and unique skillset to look at the entire picture that ultimately leads to improved quality of life and hope. Let us translate these skills across other arenas and take greater charge of our narrative.

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Nov 12, 2020

Thank you for sharing your perspective! This is really incredible. I'm a current MD/PhD student at the University of Pittsburgh. I came into med school certain I would become an ortho surgeon but have found myself being drawn to PM&R more as my time in school has gone on. I am trained as a chemical engineer, and when I think of PM&R, I think of the "engineer of doctors". Engineers take scientific knowledge from all sorts of facets and apply it to a problem set. At the end of the day though, the engineer's bottom line is practicality: is this sustainable, and is this profitable? I view physiatrist similar to this: the bottom line is patient functionality, and physiatrists pull…

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