Talk:Physical medicine and rehabilitation

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Peer reviewers: Cindyshiweinschenk.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 06:37, 17 January 2022 (UTC)

Page Seems Incorrectly Focused

This page seems off to me. It is hard to describe exactly how but let me relate my experience. I or my family members have been seeing physiatrists on-and-off for 15 years. We have seen 3 physiatrists in that time.

An acquaintance of mine has recently been injured and is afraid that they are going straight to the orthopedic surgeon. So I suggested a physiatrist and the response was "A hoos-a-whats-ist?". I explained what a physiatrist was and went to email my acquaintance a link to this article but felt that, while the article might not be incorrect, it would convince her that she should not see the physiatrist because its outdated and are mere gatekeeper: I'm not a doctor and don't feel qualified to update the page Neil Smithline 12:28, 20 June 2007 (UTC)

Neil, Please consult a sub-specialized orthopedic surgeon (many Ortho surgeons are highly subspecialized now, its 2015 !!) and have interdisciplinary practices with the physiotherapists, chiro, occupational etc. You will be much better off, healthwise, and money wise! — Preceding unsigned comment added by 110.159.104.93 (talk) 00:11, 21 August 2015 (UTC) so true.... see the ortho surgeon please and see the physio occupational . Its 2019 !! and a bunch politically driven lowly bred of peculiar doctors are mushrooming across asean region --esp dumb in and around the melayasia — Preceding unsigned comment added by 210.186.226.82 (talk) 08:03, 3 December 2019 (UTC)

Article is flawed

The entire write up is flawed as it in not written with a current, up to date perspective and taking into consideration the surging healthcare cost, the new breed of sub diciplines in medicine, and the redundant, outdated gatekeeper role of the rehabilitation doctor all over the world. Policy should focus on imp[roving the sub-specialisation of Physiotherapists, Occupational therapists, speech pathologists and even nurses and all, to optimize from the shrinking healthcare budget! What wikipedia needs is uptodate writer, living in the 2013, Wikipedia needs to rope in conscientious, economical-savy, and timely writer, preferably with PhD in line with global progress.

Orphan Link

Change "Short-wave diathermy" link to "Diathermy" - Please see the physiotherapists Directly. In developing and underdeveloped countries, the poor consumers are forced by the prevailing traditional and unethical medical model practice, and have to pay taxes to sinful redundant useless GATEKEEPERS before they are allowed to see the physiotherapist.

Orphan Link

Change "Electrotherapy unit" link to "Electrotherapy" - please refer to a Physiotherapy web Rubbish outdated page, promoting an outdated discipline with high cost implications, power crazy controlling freaks, and draining healthcare budget !!

Semi-protected edit request on 14 March 2016

Under "Scope of field," it reads "Common conditions that are treated by rehabilitation therapists include"

Please change therapists to physicians. On of the common complaints among physicians in the field is that we often get confused with physical therapists.

Rehab therapist is the right term--it means trained physiotherapists.  Don't be fooled by a bunch of lowly doc doing physiotherapy 

Sophoskagathos (talk) 01:03, 14 March 2016 (UTC)

Done ThanksDoc James (talk · contribs · email) 06:02, 14 March 2016 (UTC)

Neurological, spinal enthesopathy, site unspecified

Spinal enthesopathy, site unspecified — Preceding unsigned comment added by 2601:483:8003:4990:9122:D445:BDFA:8785 (talk) 17:56, 7 November 2016 (UTC)

Update number of training programs

outdated Jurassic programs !!! hey its 2019 going 2020. the ridiculous discipline of rehab doktur is silly Found on the AAPMR page. — Preceding unsigned comment added by Whit230588 (talk • contribs) 17:12, 16 February 2018 (UTC)

Infobox image

It looks far more like a team therapist giving an athlete a quick stretch before going into action. The photo has none of the characteristics of medical treatment in a clinical environment. Roger (Dodger67) (talk) 17:58, 16 February 2018 (UTC)

Fully agree with you. Needs to be changed. OwalalBro (talk) 17:29, 23 January 2024 (UTC)

Lack of references

Adding reference to Scope of Field and history sections — Preceding unsigned comment added by Whit230588 (talk • contribs) 19:03, 20 February 2018 (UTC)

History chronological order

Adjusting the chronological order of the history would improve the flow — Preceding unsigned comment added by Whit230588 (talk • contribs) 19:13, 20 February 2018 (UTC)

Semi-protected edit request on 3 December 2019

RUbbish garbage disciplines...……..... — Preceding unsigned comment added by 210.186.226.82 (talk) 07:59, 3 December 2019 (UTC)

Page Needs Updating.

PM&R is becoming a popular and mainstream field of medicine, especially due to the sheer variety of fellowships available. More information needs to be written about the specialty and its expanding scope. Patients are unsure about what PM&R entails or when to visit a PM&R specialist. The wikipedia photo needs to be updated as well as the physician can be confused as a physical therapist, a common misconception among patients. 2600:4040:2B8B:F00:556B:8A35:59F1:A272 (talk) 07:22, 27 November 2023 (UTC)

Semi-protected edit request on 27 November 2023

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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Please change the wikipedia photo for the Physical Medicine & Rehabilitation page. The profession is often confused with physical therapists and the photo only perpetuates this misconception among patients. Please reference a photo that has a more clinical environment or is a depiction of the specialty, similar to the cardiology wikipedia page. Thanks for your consideration. 2600:4040:2B8B:F00:556B:8A35:59F1:A272 (talk) 07:28, 27 November 2023 (UTC)

 Not done: Please make your request for a new image to be uploaded to Files For Upload. Once the file has been properly uploaded, feel free to reactivate this request to have the new image used. Pinchme123 (talk) 05:37, 30 November 2023 (UTC)

A new uploaded image: https://commons.wikimedia.org/wiki/File:Physical_MedicineandRehabilitationPhysician.jpg <a title="pch.vector, Attribution, via Wikimedia Commons" href="https://commons.wikimedia.org/wiki/File:Physical_MedicineandRehabilitationPhysician.jpg"><img width="512" alt="Physical MedicineandRehabilitationPhysician" src="https://upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Physical_MedicineandRehabilitationPhysician.jpg/512px-Physical_MedicineandRehabilitationPhysician.jpg"></a> 2600:1700:2F47:1560:594:D72:DA5D:16 (talk) 01:02, 27 December 2023 (UTC)

 Not done: Physical therapy is not a standardized term, so any confusion is because the term itself is problematic, not because of any images the article is using.  Spintendo  23:14, 27 December 2023 (UTC)

Physical therapy is a modality of treatment performed by Doctors of Physical Therapy (DPT) whereas a Physical Medicine & Rehabilitation physician is a medical specialist requiring an MD or DO degree. PM&R encompasses a variety of nonoperative procedures and is often a clinic or hospital-based specialty consisting of both inpatient and outpatient environments. The picture representing this article more closely resembles a physical therapy stretch or manipulation of a patient which is not typically performed by a physiatrist, but is rather performed by a member of the allied healthcare team. Physical therapy is a absolutely a standardized therapeutic treatment modality not performed by physiatrists, which is where misconception and patient misinformation stems from regarding this picture. Wikipedia, a common online source referenced by patients, should depict a more accurate version of the specialty and the wide breadth of the field. 2600:1700:2F47:1560:4D0F:97C0:1483:D980 (talk) 18:48, 28 December 2023 (UTC)

 Question: The profession is often confused with physical therapists and the photo only perpetuates this misconception among patients. So you're saying the person in the photo is not a doctor? Or there is something that is occurring in the photo which a doctor would not do? I'm not sure where your confusion is coming from with that photograph. You want to replace it with an illustrated icon, but no concrete reasons have been provided for why the photo is inappropriate.  Spintendo  18:59, 28 December 2023 (UTC)

I am saying that the person in the photo may be a doctor, but it also could be a physical therapist. Respectfully, I am suggesting that there are more encompassing pictures of what a physiatrist does that may mitigate confusion among patients who encounter a physical medicine & rehabilitation physician. The illustration I provided depicts a more accurate representation of what the specialty entails including: providing and/or prescribing ambulatory support to an injured patient, discussing musculoskeletal radiographic imaging, and a hospital-based environment where an inpatient physiatrist is often located. I am not suggesting that this is the best photo to represent PM&R, however, I am suggesting that it is more appropriate than the current photo considering that it perpetuates a misconception among patients that PM&R physicians perform physical therapy. See Dodger67's comment above about the InfoBox image.

2600:1700:2F47:1560:4D0F:97C0:1483:D980 (talk) 19:08, 28 December 2023 (UTC)

I don't see a misconception. This isn't a photograph of a man with a lasso on a horse. It isn't a photo of a man in a bishop's miter handing out communion. It isn't a picture of a woman at the controls of a 737 as it glides onto runway 27 at JFK. It's none of those things. If it were, then you and I would immediately be on the same page about what needed to be done here. This picture shows a man performing some sort of human body - type actions which would be consistent with any sort of health-related activities. Unless a reason is given as to what it is, about this photo, which is a misrepresentation, there's not much to do here. Regards,  Spintendo  20:54, 28 December 2023 (UTC)

To be quite frank with you, it seems like you do not have the relevant medical knowledge to add to this discussion. It isn't necessary for you specifically to see a misconception. Patients in the medical system of the United States have misconception of this field. The current image perpetuates this misconception which is easily reconcilable to improve patient awareness. It seems that you do not have any expertise on the subject but have quite strong opinions on what does and what does not fall within the niche scope of PM&R. In fact, the concept that which you referred to as 'human body - type actions' and 'health-related activities' fully depicts your lack of understanding on the subject. This photo is a misrepresentation of the specialty and someone with more poise and understanding of this conversation should refer to this and consider this relevant change. 2600:1700:2F47:1560:F456:7A2D:2567:18D5 (talk) 21:43, 28 December 2023 (UTC)

Making a bunch of personal attacks on the volunteer who reviews your request is not going to help you get it enacted. MrOllie (talk) 22:03, 28 December 2023 (UTC)

I am simply stating facts in this discussion. One editor disagreeing with an improvement request does not negate the truth of the matter. I felt as though I was amicable until he unilaterally decided that his authority as a volunteer editor is enough to close the matter. It isn't. Other editors can consider this request. 2600:1700:2F47:1560:F456:7A2D:2567:18D5 (talk) 22:06, 28 December 2023 (UTC)

In theory other editors can consider this request - I just 'considered' it, but what they're going to see (as I just did) is a bunch of personal attacks and no indication that the proposal has consensus support. MrOllie (talk) 22:11, 28 December 2023 (UTC)

Is it really a personal attack to shed light on a lack of understanding of a niche subject? I feel as though the argument I am making provides improvement to Wikipedia as a reference source. It is undeniably relevant to this discussion that the editor be versed with medical expertise. There isn't consensus as there has not been enough time or appropriate editors referring to this conversation.

2600:1700:2F47:1560:F456:7A2D:2567:18D5 (talk) 22:14, 28 December 2023 (UTC)

Yes, telling people who don't agree with you that they are aren't qualified to comment is 100% a personal attack, which is not permitted by Wikipedia policy. Kindly stop. MrOllie (talk) 22:17, 28 December 2023 (UTC)

 Not done. Multiple editors have commented and now I am. I feel that the current image could be replaced, but the alternative proposed is not an improvement. Because the proposer has resorted to personal attacks and forum shopping, this discussion is effectively over. Propose a better replacement in a new section. ~Anachronist (talk) 22:21, 28 December 2023 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Image change

Please consider the following image change to this article as a better replacement than the one above. This picture depicts a treatment procedure known as corticosteroid sacroiliac joint injection, which can be performed by PM&R physicians as a form of pain management. It can be performed for sacroiliitis, a common cause of lower back pain. This procedure better reflects the specialty and delineates it from patient misconception of PM&R physicians and physical therapists. 2600:1700:2F47:1560:F456:7A2D:2567:18D5 (talk) 22:54, 28 December 2023 (UTC)

The image could be included in the article with an explanation, but it doesn't seem to be illustrative of the article topic as a whole for the purpose of a lead image in the infobox, and certainly isn't clear how it relates to the topic without an explanation. Therefore, I don't see how it's an improvement over the existing image. ~Anachronist (talk) 05:10, 29 December 2023 (UTC)

I want to begin by thanking you for acknowledging that the current infobox image could be improved. Again, I want to emphasize that this request would likely improve the reliability of this article which many patients reference. Infobox images for medical specialties have generally included procedures, conditions within the scope, illustrations of anatomy, or images of specialty physicians in a clinical environment. For the sake of argument, I will link other specialties on Wikipedia that have demonstrated the same pattern:

Orthopedic Surgery: https://en.wikipedia.org/wiki/Orthopedic_surgery (image of a lower cervical vertebral fracture that is treated by orthopedists)

Vascular Surgery: https://en.wikipedia.org/wiki/Vascular_surgery (image of an abdominal aortic aneurysm treated by vascular surgeons)

Cardiac Surgery: https://en.wikipedia.org/wiki/Cardiac_surgery (image of cardiac surgeons performing coronary bypass artery graft)

Oncology: https://en.wikipedia.org/wiki/Oncology (image of malignant mesothelioma)

I am trying to be productive and recommend a picture that better represents the specialty of PM&R, which originally included an illustration that depicts the scope of PM&R: ambulatory support equipment, musculoskeletal radiographs, and a clinical environment. Next image I attempted represents a procedure that is often performed by PM&R physicians as a form of pain management for chronic lower back pain. Respectfully, I am not entirely sure what you are looking for to encompass the entirety of PM&R as other specialties' Infobox images captured a core element. This image and the other image I provided are improvements to this article as it differentiates PM&R physicians from physical therapists. Manual manipulation and stretching of an athlete is not a representative aspect of physical medicine, but rather physical therapy. What are you looking for as an improvement if not this? 2600:1700:2F47:1560:74F9:4058:C505:605B (talk) 13:29, 29 December 2023 (UTC)

I think both of you have good points. In my opinion, the main image needs to be changed. Would you both consider this image? It shows nerve anatomy of the left upper extremity that is often tested by physiatrists via electromyography to diagnose carpal tunnel syndrome, Saturday Night Palsy, and other peripheral nerve disorders. PM<&R docs test peripheral nerves and MSK anatomy to maintain and restore function.

https://commons.wikimedia.org/wiki/File:Nerves_of_the_left_upper_extremity.gif 192.67.188.24 (talk) 16:44, 29 December 2023 (UTC)

I have changed the current InfoBox image to something that is more representative of PM&R. Let me know what you think. OwalalBro (talk) 18:21, 23 January 2024 (UTC)

The poster is correct. PM&R has been misrepresented in this article. PM&R physicians specialize in medical decision-making regarding musculoskeletal, peripheral nervous system, and bowel and bladder dysfunctions in order to restore function to those affected by brain injury, amputations, spinal cord injuries, among others disabilities. We are not physical therapists as many patients mistake us for. I have taken the liberty of uploading an image that shows a physiologic concept taught to PM&R residents in electrodiagnostic medicine. Please consider changing the image. Enough bickering. Descriptions and caption are provided at the wikimedia link: https://commons.wikimedia.org/wiki/File:Electromyograph_of_muscle_twitch_responses.jpg — Preceding unsigned comment added by OwalalBro (talk • contribs)

Electromyograph of muscle twitch responses