PM&R, Primary Care, and Residencies

[FitDoc]

Just wondering?

I'm a second year student leaning very heavily toward PM&R due to my background and interests. In researching the various residencies out there for this field, I've seen no indication that Physiatrists have any role in what is considered "primary care". Would anyone care to comment on this position?

Secondly, would an osteopathic rotating internship and a broad-based PM&R residency program adequately prepare one to sit for Family boards if the overall result is to practice in a rural setting, and if so, are there suggestions as to which residencies might provide such training?

Thanks.

BT
OMS-II

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[electra]

Many PM&R physicians work with a disabled population as a primary care type of physician. Perhaps drusso or stinky could comment on whether PM&R residencies would adequately prepare you for actual first-line primary care medicine.
It sounds more like you are interested in FP with a sports fellowship type of program.

 

[drusso]

You need to do a family practice residency to sit for family practice boards. There are combined PM&R/IM residencies if you're a real glutton for punishment.

 

[axm397]

I think there's an article by Joel Delisa about that very topic - being a primary care doc to the disabled population.

But DRUSSO is right - you can't sit for the family medicine boards with a PM&R residency.

 

[Lodoc]

Just wondering?

I'm a second year student leaning very heavily toward PM&R due to my background and interests. In researching the various residencies out there for this field, I've seen no indication that Physiatrists have any role in what is considered "primary care". Would anyone care to comment on this position?

For many disabled patients, as their Physiatrist, you will see them routinely and in many cases even more than their Primary Care Provider. For this reason, some Physiatrists tend to take on a more Primary Care Provider role and manage the other medical problems that will come up, (i.e. uncomplicated Diabetes, HTN, etc.) particularly because other chronic medical conditions will often affect your management. I think this is where the whole idea of the Physiatrist being the "Primary Care Doctor for the Disabled" came into play. There is a risk with this though because if you step up to the plate, you'd better know what you are doing and if you are not active in the Medicine/Family Medicine community and up-to-date with the latest studies/management, you may be practicing "old medicine".
At the very least, I would imagine if one did decide to practice as more of a consultant capacity, you should at least have a good relationship with the PCP so you know what is going on with the patient and can adjust your management accordingly.

 

[paz5559]

I think there's an article by Joel Delisa about that very topic - being a primary care doc to the disabled population.

But DRUSSO is right - you can't sit for the family medicine boards with a PM&R residency.

DeLisa JA.
Primary care for persons with disabilities. The organized specialty medicine perspective.
Am J Phys Med Rehabil. 1997 May-Jun;76(3 Suppl):S30-4. No abstract available.
PMID: 9210865

Buschbacher RM, DeLisa JA, Kevorkian CG.
The physiatrist as primary care physician for the disabled. A commentary.
Am J Phys Med Rehabil. 1997 Mar-Apr;76(2):149-53. No abstract available.
PMID: 9129523

Francisco GE, Chae JC, DeLisa JA.
Physiatry as a primary care specialty.
Am J Phys Med Rehabil. 1995 May-Jun;74(3):186-92.
PMID: 7779328