Rehabilitation physician

A rehabilitation physician helps people with functional problems in daily life resulting from an illness or accident. These may include learning to walk again, dressing independently, carrying out household tasks without help, and returning to work or sport, possibly with adaptations.

What is a rehabilitation physician?

The aim of a rehabilitation programme is to help people become independent and function as well as possible. This means that some people become completely free of complaints and can do everything again after plenty of practice and training. Others have to learn to cope with their limitations in order to achieve the best possible result, with or without aids.

This usually concerns diseases or serious injuries following an accident that affect the musculoskeletal system. The rehabilitation physician does not primarily treat the disease or injury itself. This is done by other medical specialists, such as the neurologist, orthopaedic surgeon or trauma surgeon. The rehabilitation physician focuses mainly on the functional problems that remain.

Conditions in which a rehabilitation physician specialises include:

• Amputations (a body part has been removed).
• Diseases of the nervous system, such as multiple sclerosis (MS) and brain tumour.
• Organ conditions, such as heart, lung or kidney diseases.
• (Non-)congenital brain injury, such as oxygen deprivation at birth or a cerebral haemorrhage later in life.
• Severe physical injury following an accident.
• Congenital abnormalities, such as scoliosis or club feet.
• Chronic pain.
• Joint conditions, such as rheumatoid arthritis.
• Spinal cord injury following a broken neck or back.

A rehabilitation physician works in a hospital or rehabilitation centre. There, they work closely with medical and paramedical disciplines (fields), such as other doctors, physiotherapists, occupational therapists, speech and language therapists, psychologists and medical device technicians.

What does a rehabilitation physician do?

The rehabilitation physician oversees the rehabilitation programme from beginning to end. They may be the lead or co-treating physician. In the latter case, several doctors work together with the same patient. The ultimate aim is to reduce or prevent functional problems as much as possible.

Some of the rehabilitation physician's duties include:

• Coordinating the rehabilitation programme.
• Analysing walking patterns.
• Setting treatment goals.
• Drawing up a treatment plan.
• Managing the rehabilitation team.
• Regularly monitoring and discussing progress.
• Administering injections, for example containing a painkiller, anti-inflammatory or Botox to reduce muscle tension caused by spasticity.
• Requesting rehabilitation aids, such as orthopaedic shoes, prostheses (artificial arm or leg), splints and wheelchair adaptations.

How do you see a rehabilitation physician?

The help of a rehabilitation physician is called upon when other doctors reach the limits of their field. They may have tried everything, such as medication and/or an operation, but you continue to have problems functioning in daily life. A GP or medical specialist can refer you to a rehabilitation physician.

What is a first appointment with a rehabilitation physician like?

You do not see a rehabilitation physician without good reason. There has usually already been a long hospital admission and/or an extensive course of treatment with other doctors. The rehabilitation physician has all this information, but will still want to hear from you what your specific request for help is.

The aim of the first appointment is to find out what you can do at that moment and what the aim of the rehabilitation programme will be. The rehabilitation physician will ask many questions, carry out a physical examination and may perform further tests. These may include X-rays, a scan (MRI, CT), movement analysis or an ECG.

The rehabilitation physician discusses the treatment options with you and your relative(s). Achievable goals are set for physical, mental and social functioning.

How can you prepare for your first visit to a rehabilitation physician?

• Make a list of questions at home in advance. Also write down complaints affecting physical functioning, your medical history, operations, therapies you have undergone and medication you use. This will ensure that you do not forget anything.
• Think about the treatment goals you want to achieve. Do you want to learn to walk again with a leg prosthesis, or return to work without pain?
• Bring someone close to you. This could be a partner, close friend or adult child. They can listen and remember everything that is said. If you cannot clearly explain what you want and can do yourself, it is essential that someone can speak on your behalf.