Rehabilitation physician

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

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 symptom-free after extensive practice and training. Others learn to manage their limitations and achieve the best possible result with or without aids.

This usually concerns illnesses or serious injuries affecting the musculoskeletal system. The rehabilitation physician does not primarily treat the illness or injury itself; this is done by specialists such as the neurologist, orthopaedic surgeon or trauma surgeon. The rehabilitation physician focuses mainly on the remaining functional problems.

Conditions treated include:

• Amputations (a body part has been removed).
• Nervous system diseases such as multiple sclerosis (MS) and brain tumours.
• Organ conditions such as heart, lung or kidney disease.
• (Congenital or acquired) 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, closely with medical and allied health disciplines such as doctors, physiotherapists, occupational therapists, speech therapists, psychologists and medical device technicians.

What does a rehabilitation physician do?

The rehabilitation physician oversees the rehabilitation programme from start to finish and may be the lead or contributing doctor. The ultimate aim is to reduce or prevent functional problems as much as possible.

Duties include:

• Coordinating the rehabilitation programme.
• Analysing gait patterns.
• Setting treatment goals.
• Preparing a treatment plan.
• Leading the rehabilitation team.
• Monitoring and discussing progress regularly.
• Administering injections, for example painkillers, anti-inflammatory medication or Botox to reduce muscle tension in spasticity.
• Arranging rehabilitation aids such as orthopaedic shoes, prostheses (artificial arm or leg), splints and wheelchair adaptations.

How do you see a rehabilitation physician?

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

What is a first appointment like?

You do not usually see a rehabilitation physician without prior treatment. There has often been a lengthy hospital admission and/or treatment by other doctors. Although the physician has this information, they also want to hear your specific request for help.

The aim is to establish what you can do at that point and what the rehabilitation programme should achieve. The physician asks many questions, performs a physical examination and may arrange further tests, such as X-rays, MRI or CT scans, gait analysis or an ECG.

The physician discusses treatment options with you and your family or support person, setting achievable goals for physical, psychological and social functioning.

How can you prepare for your first visit?

• Prepare questions and write down your functional complaints, medical history, operations, therapies and medication.
• Think about your treatment goals, such as relearning to walk with a prosthetic leg or returning to work without pain.
• Bring someone close to you, such as a partner, friend or adult child, to listen and remember what is said. If you cannot clearly explain what you want or can do, they can speak on your behalf.