Rehabilitation physician

A rehabilitation physician helps people with functional problems in daily life resulting from an illness or accident. These may include learning to walk again, dressing without help, performing household tasks independently, and returning to adapted work or sport.

What is a rehabilitation physician?

The aim of a rehabilitation programme is to help people become independent and function as well as possible. Some people become completely free of symptoms and regain all their abilities 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 illnesses or severe injuries affecting the musculoskeletal system . The rehabilitation physician does not mainly treat the disease or injury itself; this is done by specialists such as the neurologist, orthopaedic specialist or trauma surgeon. The rehabilitation physician focuses mainly on the remaining functional problems.

Conditions for which a rehabilitation physician may specialise include:

• Amputations (a body part has been removed).
• Nervous system diseases such as multiple sclerosis (MS) and brain tumour.
• Organ diseases, such as heart, lung or kidney diseases.
• (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 centre. They work closely with medical and allied health disciplines, including doctors, physiotherapists, occupational therapists, speech pathologists, psychologists and medical instrument makers.

What does a rehabilitation physician do?

The rehabilitation physician oversees the rehabilitation programme from beginning to end and may be the lead or contributing practitioner. Several doctors may work together with the same patient. The ultimate aim is to reduce or prevent functional problems as much as possible.

Duties include:

• Coordinating the rehabilitation programme.
• Analysing walking patterns.
• Setting treatment goals.
• Developing a treatment plan.
• Managing the rehabilitation team.
• Regularly monitoring and discussing progress.
• Administering injections, such as painkillers, anti-inflammatory medication or Botox to reduce muscle tension in spasticity .
• Requesting rehabilitation aids such as orthopaedic shoes, prostheses (an artificial arm or leg), splints and wheelchair modifications.

How do you see a rehabilitation physician?

A rehabilitation physician becomes involved when other doctors reach the limits of their expertise. Medication and/or surgery may already have been tried, but daily functioning remains difficult. A GP or medical specialist can refer you to a rehabilitation physician.

What is a first appointment with a rehabilitation physician like?

You do not usually see a rehabilitation physician without a long hospital admission and/or treatment by other doctors. The physician has this information but still wants to hear your specific concerns directly from you.

The aim of the first appointment is to determine what you can do at that time and what the goal of rehabilitation should be. The physician asks many questions, performs a physical examination and may arrange further investigations, such as X-rays, MRI or CT scans, movement analysis or an ECG.

The rehabilitation physician discusses treatment options with you and your support person or people. Achievable goals are set for physical, psychological and social functioning.

How can you prepare for your first visit to a rehabilitation physician?

• Prepare a list of questions. Write down your functional complaints, medical history, operations, previous therapies and medication.
• Think about the treatment goals you want to achieve, such as learning to walk again with a leg prosthesis or returning to work without pain.
• Bring someone close to you, such as a partner, close friend or adult child. They can listen and remember what is said, and speak for you if you cannot clearly explain what you want or can do.