Thursday, April 5, 2012

Ortho or Rehab doctor?

     Enjoy your five-day-long weekend for Lent this year. For some, it’s an opportunity to meditate, do some soul-searching, but most intend to go out of town and get some much needed R and R.  I also know that it’s a wonderful time to just stay home, rest and spend some quality time with the kids. Personally, I’m going for the latter because if I go to the beach, I will just see more people than sand. =)

       Now for this post’s topic, I will discuss a question that was asked by a medical classmate before. Recently, a patient came to me, asking the same question. 

      The patient was somewhat apologetic, because he thought he might have come to the wrong doctor.  I greeted him first and introduced myself as an orthopedic doctor.

      “Why?  What is your complaint?” I asked.

     “I have pain in my shoulders and other joints in the body. Sorry doc, should I have come to a rehabilitation doctor instead?” he said.

      So what is the difference is between an orthopedic doctor and a rehab doctor?

      If you feel some pain or discomfort in any part of your extremities and back, will you go to an orthopedic or rehab doctor?

     My honest answer?  To an orthopedic doctor, of course! (obvious bias?)

     But seriously, what is the difference between an orthopedic and a rehabilitation doctor?

      An orthopedic doctor is a doctor who specializes in  treating individuals who have conditions that involve the bones, joints, nerves, ligaments, tendons, and muscles. Also known as an orthopedic surgeon, (orthopedic doctors are surgeons, rehab doctors are not) a person in this field typically works to diagnose and care for patients who have suffered such things as broken bones, torn ligaments and tendons. Essentially, our job is to diagnose patients and uses both medical and surgical techniques in treating disorders and conditions of the parts of the body that allow movement, the musculoskeletal system. 

total knee replacement surgery

      The orthopedic doctor is also the person to order a range of tests, such as x-rays, MRIs, CT scans if deemed necessary, and other types of imaging procedures since we, ourselves, can interpret them.

severe knee arthritis xrays

      An orthopedic surgeon typically is the right doctor to go to during emergency situations that involve the extremities and spine.  When you have broken bones, suffer compartment syndrome or have septic arthritis requiring surgery, don’t go to the emergency room looking for a rehabilitation doctor.

     While we, orthopedic doctors, may be best known for helping people with broken bones, some of us may choose to focus on correcting deformities, such as deformed hands or feet, straighten spine or on injures that stem from participation in sports. There are some who specialize in treating disabled and injured children while others may focus on treating tumors, infections, and degenerative diseases or hips and knees, such as I.

     Aside from that, we orthopedic doctors are trained to do a lot more. Doctors in this field also do casting and splinting procedures, injection procedures, provide treatment for cartilage regeneration and application of platelet-rich plasma.

      Rehabilitation doctors, also known as physiatrists, on the other hand, are trained in the rehabilitation of orthopedic and neurologic disorders, and in the long-term management of patients with disabling conditions, such as stroke. Physiatrists provide leadership to multidisciplinary teams composed of therapists, to provide maximal restoration of physical, psychological, social, occupational and vocational functions in persons whose abilities have been limited by disease, trauma, congenital disorders or pain to enable patients to achieve their maximum functional abilities.



     It is true that some patients have overlapping conditions that require the care of both orthopedic and rehab doctor. We, orthopedic and rehab doctors, work hand in hand to provide maximum benefit to patients with orthopedic conditions.  While it is the orthopedic surgeon who should initially see the patient especially in emergency situations, it does not really matter who see the patients first, as long as both the orthopedic and rehabilitation doctor know when to appropriately refer the patient for proper management. 

with my post-hip replacement patient


bone said...

agree, 100%!

Doc Ralds said...

Thanks Remo. Regards pre

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