The state of physical medicine: Partnering with primary care

Primary care physicians should think of physiatrists as willing and well-suited partners for a broad range of musculoskeletal and rehabilitation needs, not just the obvious cases of hospitalized patients requiring post-injury recovery. Rather than focusing narrowly on whether something can be surgically fixed, physiatrists help patients adapt and function across the full spectrum of conditions, making them often better suited than other specialists to manage the nonoperative cases that primary care physicians routinely encounter. John C. Cianca, M.D., FAAPMR, president of the American Academy of Physical Medicine and Rehabilitation, explains that connection.

Medical Economics: Our main audience is primary care physicians. What would you like to say to them? Or what would you like them to know?

John C. Cianca, M.D., FAAPMR: We're happy to partner with them, I mean, with something that we look at as the entrance to our practices. Primary care, for many, many, many years, has been the gateway, and we have really tried to educate primary care practitioners as to what our capabilities are. I think some of those were obvious when you're dealing with people in the hospital who need rehabilitation — OK, let's get a physiatrist involved. However, in the areas that I'm in, which are a little bit more subtle and historically have been the sort of focus of orthopedics, that's been a slower revelation. For me, it's important that we continue to communicate our capabilities and our expertise to such specialties, primary care, whether it's family practice or internal medicine or pediatrics, that we can do this. And in fact, it's probably that we're better suited to it than most because of the breadth of how we look at a problem, rather than a simple focus on, I can fix this or I can't. We do more than fix; we help people adapt. So that's really where I think the ongoing message to primary care needs to be. It's like, what do you need and who can best provide that? And I think that is what we can do.