What is the Difference Between Physical Therapy and Physiatry

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The Medical Student's Guide to PM&R

Physiatrists and physical therapists treat patients with the same types of conditions. However, physiatrists are physicians who have completed medical school plus four years of residency training.

A common misconception of physiatrists is that they are the ones who are actually performing the therapies. In general, physical therapists are trained in the clinical features of common musculoskeletal pathology, musculoskeletal examination, developing a treatment plan and exercise regimen, and physical modalities (including heat, cold, TENS). Physiatrists, on the other hand, make and manage medical diagnoses and prescribe the therapies that physical therapists and other therapists will subsequently perform. Despite these differences, both therapists and physiatrists collaborate and communicate to ensure patients are receiving appropriate treatment.

The role of the physiatrist is to manage a patient’s medical issues as they participate through the rehabilitation process. A physiatrist will assess the patient and assure that the patient is medically stable to participate in therapies. Medical issues specific to rehabilitation include pain management, neurogenic bowel and bladder, autonomic dysreflexia, dysphagia, gait and movement disorders, ataxia, spasticity management, energy conservation, and disease education. Furthermore, a physiatrist will manage other co-morbid conditions (e.g., hypertension, diabetes, CAD, COPD, etc.) in order to prevent further medical complications.

In 2017, the Academy announced a BOLD new vision for physiatry defined by you! Within this new vision, are 3 themes which help better define the specialty and its role in the future of medicine.

Physiatrists are the essential medical experts in value-based evaluation, diagnosis, and management of neuromusculoskeletal and disabling conditions.

Physiatrists are indispensable leaders in directing rehabilitation and recovery, and in preventing injury and disease.

Physiatrists are vital in optimizing outcomes and function early and throughout the continuum of patient care.



    Category

    Physical Medicine & Rehabilitation (PM&R)

    Physical Therapy

    Definition

    A medical specialty (physiatry) focused on improving function & quality of life for individuals with physical impairments or disability.

    A branch of rehabilitative healthcare that helps patients improve movement, strength, balance, and overall functional independence through physical methods.

    Qualifications

    4 years of medical school (MD or DO)

    4 years of Residency training. (1 intern year + 3 rehab years)

    Board certification in Physical Medicine & Rehabilitation (Written & Oral exams)

    Doctor of Physical Therapy (DPT) from an accredited program (typically a 3 year post graduate program)

    Passing a state licensure exam.

    Scope

    Medical management including prescribing and managing comorbidities

    Diagnostic evaluations through clinical exam, labs, and imaging

    Perform diagnostic & therapeutic procedures

    Coordinate comprehensive rehabilitation plan

    Focuses on therapeutic exercises and manual techniques

    Develop individualized rehab plans based on assessments

    Provide patient education for recovery and mobility improvement.

    Interventions

    Corticosteroid injections

    Botulinum Toxin injections

    Trigger Point injections

    Nerve blocks

    Radiofrequency Ablations

    Manual therapy techniques

    Physical Modalities such as heat, cold, TENS, and electrical stimulation

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