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| Rebecca Dutton Home After a Stroke |
When I was an OT I did not realize stroke survivors deal with challenges for years after treatment ends. Eleven years after my stroke I am grateful I still have access to a physiatrist (doctor who specializes in rehabilitation medicine). (1) Dr. Terry, a physiatrist, has a deep understanding of my situation. He listened attentively when I expressed concern about the increasing tightness in my hemiplegic (paralyzed) hand. Instead of ignoring my concern he talked about when muscle tightness helps or interferes with function. I did not have to explain why I wanted to go back to OT. A physiatrist is one of the reasons I do not go downhill when a new challenge appears.
Here are five more reasons to see a physiatrist. (2) Regular in-patient meetings mean the staff have to think clearly about my case in order to present it to the physiatrist and to each other. (3) Physiatrists keep up with research on rehab. It was reassuring to hear Dr. Terry talk about EMG guided Botox shots that can target a single muscle. Without reading current rehab research, neurologists feel free to pronounce conclusions about your rehab potential (e.g. "you will never walk again.") (4) Physiatrists know how hard clients work to become independent. Dr. Terry is one of the few doctors who does not try to undress me like I am a child. After he asked to see my hemiplegic foot he hesitated for a moment. This gave me a chance to take off my leg brace. (5) He asks about my personal life because he sees me as more than a paralyzed arm and leg. (6) He knows the buzz words insurance company adjustors are looking for. He has never given my insurance company an excuse to deny coverage for services he has ordered.
Kinoshita compared outcomes for stroke survivors whose care was coordinated by a physiatrist versus other types of physicians (1). The study found that stroke survivors whose care was coordinated by a physiatrist had significantly more frequent regular conferencing (see #2 above), had significantly higher scores on the Functional Independence Measure (p< .005), and were more likely to be discharged to their home (p< .005). This is a huge advantage.
- Kinoshita S, Kakuda W, Momosaki R, Yamada N, Sugawara H, Watanabe S, Abo M. Clinical management provided by board-certified physiatrists in early rehabilitation is a significant determinant of functional improvement in acute stroke patients. Journal of Stroke & Cerebrovascular Diseases. 2015;24(5):1019-1024.
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