Monday, October 27, 2014

What physiatrists do

I had an experience in ortho clinic as a resident that was kind of a metaphor for what being a rehab doctor is all about.

In the new specialty clinic building, all the patient examining rooms had computers with printers. Apparently, all the ortho docs had been trying for months to get these printers to print out patient films, but without success. However, on my one day in the clinic, I got a patient's hip X-ray to print out. Everyone was super impressed.

How did I do it? Instead of printing from the actual radiology program like all the ortho docs were doing, I pressed PrntScrn, then I pasted it into Word and printed the Word doc. A cheap solution, but it worked.

And that's kind of what we're about. In ortho, when a bone is broken, they fix it. Orthopedic surgeons fix things that are broken. Physiatrists take things that are broken and can't be fixed, but find a way to make them work anyway. It's a worthy cause, I think.

FYI: The winner of the humor writing contest will be posted tomorrow in its entirety!


  1. Nice description! I am a medical student interested in PM&R. And I have always had a talent for "Macgyver-ing" things. Sounds like a good fit. On the other hand, I shadowed in outpatient PM&R and found it kind of dull. I suspect I would prefer something like medically complicated or inpatient rehab or maybe SCI and will check that all out. I would love to hear more about your daily life and different practice settings (though it probably is less fodder for comedy).

  2. Wow, that is the best description of physiatry that I have ever heard. I will probably share it with my patients. We treat patients who have [usually incorrectly] been told there is nothing else that can help their problem. I also use the old standby that we treat bones, muscles, and nerves.

    Many patients ask me if I'm a neurologist or orthopedist. Not sure there is any other specialist who could be mistaken as either of those two disparate specialties!

  3. Prediction: Residency spots for PM&R will be in greater demand. Soon, you'll have to be at the top of your class to get one! To Dr. Fizzy and PGYx, you both made a good choice. Pretty gals and smart too. Or, in other words, pretty smart!

    1. +1, Anon! Are you a physiatrist, too?

    2. As I told a hospital administrator who mistook me for a physician, I cannot
      make that claim. I'm a podiatrist, I responded. I graduated podiatry school.
      And then he looked at me and said with a straight face, "What's that?"

    3. Yikes, that's such a great example of administration staff having no idea what actually goes on in a hospital.

      It is my understanding that as a podiatrist, you are a physician and one of my colleagues.

      On a related note, many folks think physiatrists are podiatrists. Or physical therapists. Or psychiatrists. In the rare times people are familiar with physiatry they usually tell me a story about a great experience they or a family member had with a physiatrist. Hope we as a field can continue to happily surprise people with our efforts.

    4. Thank you for your kind words. When people would ask me why I chose podiatry, I would answer: " I felt it was a good fit even though I know the work is beneath me." - Paul

  4. Paul, you sound like a humble person, which I admire. You are by definition a pediatric physician and have earned that title. All the hospital systems in which I've worked have had cultures that appropriately give credit to podiatrists as key members of the medical team.

    Your work makes an important difference in patients' lives. Non-health care providers may not realize that untreated foot problems are at best painful and at worst dangerous (e.g., risk of serious infection, decreased mobility or fall risk).

    And many (most?) other physicians give the feet short shrift because they lack tools to handle issues there. But I wonder if you have any idea how grateful docs are when they can refer to a good podiatrist.

    1. Ack, autocorrect -- should have read "pOdiatric physician!"

    2. Thank you, again, PGYx. I cannot tell you how much your words mean to me. I can only speak for myself, but I often felt like an underling, not
      a colleague. Everyone has their own opinion, and I hold no animosity
      toward those in the medical profession who feel otherwise. By the way,
      the "work was beneath me" was my attempt at humor. - Paul

    3. Hahaha, I just got the joke and laughed out loud. I swear I'm not a humorless robot, I only play one on the internet!

      I wonder if it would be nice to think I'm much better than others. But am pretty sure if could summon more arrogance I'd just end up embarrassed when I fall flat.

      I'm so often amazed and frustrated by how we tend not to give much credit to others for the work they do, even when we could never do it ourselves. Maybe it makes us feel better to think of ourselves as better than others. But giving others credit for their contributions in no way decreases the value of my own and brings plenty of benefit!

    4. That was a very thoughtful response back, PGYx.
      Like Dr. Fizzy, you're pretty special.