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Defining Medical Specialities - An Overview

June 15, 2016

PHYSIATRIST

Physical medicine and rehabilitation, physiatrist or rehabilitation medicine is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a physiatrist or rehab medicine specialist. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (Such as stroke patients).

Physical medicine and rehabilitation involved the management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, physical training with therapeutic exercise, movement and activities modification, adaptive equipment and assistive device, orthotics (Braces), prosthesis, and experiential training approaches.

Physician Medicine & Rehabilitation physician may also perform electro diagnostics, which are used to provide nervous system functional information for diagnosis and prognosis for various neuromuscular disorders. The common electro diagnostic tests performed by physiatrists are nerve conduction studies (NCS) and needle electromyographies (EMG).

Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, musculoskeletal pain syndromes such as low back pain, fibromyalgia, and traumatic brain injury.

ORTHOPAEDIC SURGEON

Orthopaedic surgery is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopaedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumours, and congenital disorders.

The American academy of Orthopaedic Surgeons defines the field as “a medical speciality that focuses on the diagnosis, care, and treatment of patients with disorders if the bones, joints, muscles, ligaments, tendons, nerves, and skin". Surgeons merge the use of preventive treatment, research and surgery to help patients. Orthopaedic surgeons are one of the first doctors sought when there is a problem with the muscles, joints or skeletal areas.

NEUROLOGIST

A neurologist is a physician who specialized in neurology, and is trained to investigate, or diagnose and treat neurological disorders.

Neurology is the medical speciality related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist physician who treats patients suffering from neurological disease is called a neurologist. Related yet distinct fields of medicine include: Psychiatry, neurosurgery and their subspecialties.

Neurologists examine patients who have been referred to them by other physician in both the inpatient and outpatient settings. A neurologist will begin their interaction with a patient by taking a comprehensive medical history, and then perform physician examination focusing on evaluating the nervous system. Components of the neurological examination include assessment of the patient’s cognitive function, cranial nerves, motor strength, sensations, reflexes, coordination, and gait.

In some instances, neurologists may order additional diagnostic tests as part of the evaluation. Commonly employed tests in neurology include imaging studies such as CAT scans, MRI, and ultrasound of major blood vessel of the head and neck. Neuropsychological studies, including electroencephalography (EEG), electromyography (EMG), and evoked potentials are also commonly ordered. Neurologists frequently perform lumbar punctures in order to assess characteristics of a patient’s cerebrospinal fluid.

Some of the commonly encountered conditions treated by neurologists include headaches, radiculopathy, neuropathy, stoke, dementia, seizures and epilepsy, Parkinson’s disease, multiple sclerosis, head trauma, sleep disorders, neuromuscular diseases, and various infections and tumors of the nervous system.

Treatment options vary depending on the neurological problem. They can include everything from referring the patient to a physiotherapist, to prescribing medications, to recommending a surgical procedure.

PSYCHOLOGIST

Psychologist is a professional or academic title used by individuals who are either:

  • Clinical professionals who work with patients in a variety of therapeutic contexts (Contrast with psychiatrists, who are physician specialists).
  • Scientists conducting psychological research or teaching psychology in a college or university;
  • Academic professionals who apply psychological research, theories and techniques to “real-world” problems, questions and issues in business, industry, or government.

There are many different types of psychologists, as is reflected by the 56 different divisions of the American Psychological Association (APA). Psychologists are generally described as being either ‘applied; or ‘research-oriented’. The common terms used to describe this central division in psychology are ‘scientists’ or ‘scholars’ (those who conduct research) and ‘practitioners’ or ‘professionals’ (those who apply psychological knowledge). The training models endorsed by the APA require that applied psychologists by trained as both researchers and practitioners, and that they possess advanced degrees.

Most typically, people encounter psychologists and think of the discipline as involving the work of clinical psychologists or counselling psychologists. While counseling and psychotherapy are common activities for psychologists, these applied fields are just one branch in the larger domain of psychology. Research and teaching comprise a major role among psychologists.

PSYCHIATRIST

Psychiatrist is a physician who specialized in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy. As part of their evaluation of the patient, among the mental health professionals only psychiatrists are authorized to prescribe psychiatric medication, conduct physical examinations, order and interpret laboratory tests, and may order brain imaging studies such as (CT/CAT Scan), (MRI),  and positron emission tomography scanning.

Some psychiatric practitioners specialise in helping certain age groups. Child and adolescent psychiatrists work with children and teenagers in addressing psychological problems. Those who work with the elderly are called geriatric psychiatrists or geropsychiatrists. Those who practice psychiatry in the workplace are called organizational occupational psychiatrists in the U.S (occupational psychology is the name used for most similar disciple in the UK). Psychiatrists working in the courtroom and reporting to the judge and jury, in both criminal and civil court cases, are called forensic psychiatrists, who also treat mentally disordered offenders and other patients whose condition is such that they have to be treated in secure units.

Other psychiatrists and mental health professionals in the field of psychiatry may also specialize in psychopharmacology, psychiatric genetics, neuroimaging, dementia related disorders as Alzheimer’s disease, sleep medicine, pain medicine, palliative medicine, eating disorders, sexual disorders, women’s health, global mental health, early psychosis intervention, moos disorders and anxiety disorders (including obsessive compulsive disorder and post-traumatic stress disorder).

RHEUMATOLOGIST

Rheumatologists treat arthritis, autoimmune diseases, pain disorders affecting joints, and osteoporosis, there are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, and tendinitis. Some of these are very serious musculoskeletal system sports related soft tissue disorders and the specialty is also interrelated with physiotherapy, physical medicine and rehabilitation of disabled patients. Patient education programs and occupational therapy also go hand in hand with this specialty.

PHYSIOTHERAPIST

Physical therapy (PT) is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/ intervention and rehabilitation. This encompasses physical, psychological, emotional, and social wellbeing.

Physical therapy involved the interaction between physical therapist, patients/ clients, health care professionals, families, care givers, and communities in a process where movement potential is assesses and diagnosed, goals are agreed upon, using knowledge and skills unique to physical therapists. Physical therapy is performed by a physical therapist or physiotherapist, and sometimes services are provided by a physical therapist assistant (PTA) acting under their direction. PTs are healthcare professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health related conditions, illnesses, or injuries that limit their abilities to move and perform functional activities as well as they would like in their daily lives. PTs use an individual’s history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies.

Physical therapy has many specialties including cardiopulmonary, geriatrics, neurologic, orthopaedic and pediatrics. PTs practice in many settings, such as outpatient clinics or offices, inpatient rehabilitation facilities, skilled nursing facilities, extended care facilities, private homes, education and research centres, schools, hospices, industrial and this workplaces or other occupational environments, fitness centres and sports training facilities.

OCCUPATIONAL THERAPIST

An occupational therapist (OT) is trained in the practice of occupational therapy. The role of an occupational therapist is to work with a client to help them achieve a fulfilled and satisfied state in life through the use of purposeful activity interventions designed to achieve functional outcomes which promote health, prevent injury or disability and which develop, improve, sustain or restore the highest possible level of independence

Role

Occupational therapists help people of all ages to improve ability to perform tasks in their daily living and working environments. They work with individuals who have conditions that are mentally, physically, developmentally, socially or emotionally disabling. They also help them develop, recover, or maintain daily living and work skills. Occupational therapists help clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. Occupational therapists assist clients in performing activities of all types, ranging from using a computer to increase strength and dexterity, while other activities may be chosen to improve visual acuity and the ability to discern patterns. For example, a client with short term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decision making, abstract reasoning, problem solving, and perceptual skills, as well as memory, sequencing, and coordination all of which are important for independent living. Occupational therapists are often skilled in psychological strategies such as cognitive behavioural therapy and acceptance and commitment therapy, and may use cognitive therapy especially when introducing people to new strategies for carrying out daily activities such as activity pacing or using effective communication strategies.

Clients with permanent disabilities

Therapists instruct those with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, in the use of adaptive equipment, including wheelchairs, orthotics, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop computer aided adaptive equipment and teach clients with severe limitations how to use that equipment in order to communicate better and control various aspects of their environment.

Work related therapy

Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners arrange employment, evaluate the work environment, plan work activities, and assess the client’s progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the work can be successfully completed.

With children

Occupational therapists may work exclusively with individuals in a particular age group with particular disabilities. In schools, for example, they evaluate children’s abilities, recommend and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities. A therapist may work with children individually, lead small groups in the classroom, consult with a teacher, or serve on a curriculum or other administrative committee. Early intervention therapy services are provided to infants and toddlers who have, or are at the risk of having, promoting skills for listening and following directions, fostering social skills, or teaching dressing and grooming skills.

With the elderly

Occupational therapy is very beneficial to the elderly population. Therapists help the elderly lead more productive, active, and independent lives through ha variety of methods, including the use of adaptive equipment. Occupational therapists work with the elderly in many caries environments, such as in their homes in the community, in hospital, and in residential care facilities to name a few. In the home environment, occupational therapists ma work with the client to assess for hazards and to identify environmental factors that contribute to falls. Occupational therapists are often instrumental in assessing for appropriate wheelchairs for the elderly. In addition, therapists with specialized training in driver rehabilitation assess an individual’s ability to drive using both clinical and on the road tests. The evaluations allow the therapist to make recommendations for adaptive equipment, training to prolong driving independence, and alternative transportation options.

Mental health

Occupational therapists also work with people who have mental health problems and learning disabilities. In this work, therapists choose activities that help people learn to engage in a cop with daily life. Activities include time management skills, budgeting, shopping, homemaking, and the use of public transportation. Occupational therapists also may work with individuals who are dealing with alcoholism, drug abuse, depressing, eating disorders, or stress related disorders. The ultimate aim would be to help people to engage in a personally satisfying and socially adaptive range of occupations

With terminally ill patients

Occupational therapists work with patients with terminal illness like cancer, muscular dystrophy, etc. All performance areas including work, play and leisure are widely affected in these sets of patients. Occupational therapists provide various means to these patients to restore or maintain their deteriorating performance components by using their residual capacities and capabilities to give them a sense of self-importance and a measure of confidence.

With people with chronic pain

Occupational therapists often work within interdisciplinary or multidisciplinary teams (aka professionals such as nurses, doctors, etc.) to help individuals with chronic pain develop active self-management strategies. An area of specific concern to occupational therapists is the use of time but it is also common for occupational therapists to help people return to work, and to return to leisure and family activities. Occupational therapists may use a variety of interventions including biofeedback, relaxation, goal setting, problem solving, planning, and carry this out within both group and individual settings. Therapists may work within a clinic setting, or in the community including the workplace, school, home and health care centres. Occupational therapists may assess occupational performance before and after intervention, as a measure of effectiveness and reduction in disability.

Assessment

Assessing and recording a client’s activities and progress is an important part of an occupational therapists job. Accurate records are essential for evaluating clients, for billing, and for reporting to physicians and other health care providers.

Thorough and accurate assessment ensures that occupational therapists select appropriate and effective interventions for their clients. Assessment in occupational therapy is complex and multifaceted, and is an essential component of the occupational therapy process. Assessment occurs at the beginning of the process (providing the foundation for effective treatment), at the end (evaluation). Reassessment also occurs throughout intervention.

KINESIOLOGIST

Kinesiology also known as human kinetics is the scientific study of human movement. Kinesiology addresses physiological, mechanical, and psychological mechanisms. Applications of kinesiology to human health include: biomechanics and orthopedics, rehabilitation, such as physical and occupational therapy, as well as sport and exercise. Individuals who have earned degrees in kinesiology can work in research, the fitness industry, clinical settings, and in industrial environments.

The word comes from Greek words kinesis (movement) and kinein (to move).

Kinesiology is the study of human and animal movement, performance, and function by applying the sciences of biomechanics, anatomy, physiology, psychology, and neuroscience. Applications of kinesiology in human health include the rehabilitation professions, such as physical and occupational therapy, as well as applications in the sport and exercise industries kinesiology is a field of scientific study, and doesn’t prepare individuals for clinical practice. A bachelor’s degree in kinesiology can provide strong preparation for graduate study in biomedical research, as well as in professional programs such as allied health and medicine.

Individuals with training in this area can provide consulting services, conduct research and develop policies related to rehabilitation, human motor performance, ergonomics, and occupational health and safety.

In Canada, kinesiology is a professional designation associated with the assessment of movement, performance, and function; and the rehabilitation, prevention, and management of disorders to maintain, rehabilitate, and enhance movement, performance, and function in the areas of sport, recreation, work, exercise, and general activities of daily living.

Health services

  • Health promotion: kinesiologists working in the health promotion industry focus on working with individuals to enhance the health, fitness, and wellbeing of the individual. Kinesiologists can be found working in fitness facilities, personal training/. Corporate wellness facilities, and industry.
  • Clinical/ Rehabilitation: kinesiologists work with individuals with disabling conditions to assist in regaining their optimal physical function. They work with individuals in their home, fitness facilities, rehabilitation clinics, and at the worksite. They also work alongside physiotherapists.
  • Ergonomics: kinesiologists work in industry to assess suitability of design of workstations and provide suggestions for modifications and assistive devices.
  • Health and safety: kinesiologists are involved in consulting with industry to identify hazards and provide recommendations and solutions to optimize the health and safety of workers
  • Disability management/ case coordination: kinesiologists recommend and provide a plan of action to return an injured individual to their optimal function in all aspects of life
  • Management/ research/ administration/ health and safety: kinesiologists frequently fulfill roles in all above areas, perform research, and manage businesses.

CHIROPRACTOR

A chiropractor, according to the Association of chiropractic colleges, “focuses on the relationship between the body’s main structures – the skeleton, the muscles and the nerves – the patients’ health. Chiropractors believe that health can be improved and preserved by making adjustments to these structures, particularly to the spinal column. They do not prescribe drugs or perform surgical procedures, although they do refer patients for these services if they are medically indicated.”

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