Rehabilitation physician

A rehabilitation physician helps people with functional problems in daily life resulting from illness or an accident. These may include relearning to walk, dressing independently, performing household tasks and returning to work or sports in an adapted way.

What is a rehabilitation physician?

The goal of a rehabilitation program is to help people become independent and function as well as possible. Some people become completely symptom-free after extensive practice and training. Others learn to manage their limitations and achieve the best possible result with or without assistive devices.

This usually concerns diseases or severe injuries after an accident affecting the musculoskeletal system. The rehabilitation physician focuses less on treating the disease or injury itself; that is done by specialists such as a neurologist, orthopedist or trauma surgeon. The rehabilitation physician focuses mainly on the remaining functional problems.

Conditions in which rehabilitation physicians specialize include:

• Amputations (a body part has been removed).
• Nervous system diseases such as multiple sclerosis (MS) and brain tumors.
• Organ diseases, such as heart, lung or kidney disease.
• (Non-)congenital brain injury, such as oxygen deprivation at birth or a stroke later in life.
• Severe physical injury after an accident.
• Congenital abnormalities, such as scoliosis or clubfeet.
• Chronic pain.
• Joint conditions such as rheumatoid arthritis.
• Spinal cord injury after a broken neck or back.

A rehabilitation physician works in a hospital or rehabilitation center and closely collaborates with medical and allied health professionals such as physicians, physical therapists, occupational therapists, speech therapists, psychologists and medical device makers.

What does a rehabilitation physician do?

The rehabilitation physician oversees the rehabilitation program from beginning to end and may be the primary or co-treating physician. The goal is to reduce or prevent functional problems as much as possible.

Duties include:

• Coordinating the rehabilitation program.
• Analyzing gait patterns.
• Setting treatment goals.
• Creating a treatment plan.
• Managing the rehabilitation team.
• Regularly monitoring and discussing progress.
• Administering injections, such as pain medication, an anti-inflammatory or Botox to reduce muscle tension in spasticity.
• Requesting rehabilitation aids such as orthopedic shoes, prostheses (artificial arm or leg), splints and wheelchair adaptations.

How do you see a rehabilitation physician?

A rehabilitation physician becomes involved when other physicians reach the limits of their fields. Medication and/or surgery may have been tried, but daily functioning remains difficult. A primary care physician or medical specialist can refer you.

What is a first appointment like?

You do not usually see a rehabilitation physician without prior treatment. A lengthy hospital stay and/or treatment by other physicians often comes first. Although the rehabilitation physician has this information, they want to hear your specific request for help directly from you.

The purpose of the first appointment is to determine what you can do at that time and what the rehabilitation program should achieve. The physician asks many questions, performs a physical examination and may order additional testing, such as X-rays, MRI or CT scans, movement analysis or an ECG.

The rehabilitation physician discusses treatment options with you and your loved ones and sets achievable goals for physical, psychological and social functioning.

How can you prepare for your first visit?

• Make a list of questions at home. Write down physical limitations, medical history, surgeries, therapies and medications so you do not forget anything.
• Think about the treatment goals you want to achieve, such as relearning to walk with a leg prosthesis or returning to work without pain.
• Bring someone close to you, such as a partner, good friend or adult child. They can listen and remember what was said, and speak for you if you cannot clearly explain what you want or can do.