Overview of specialty
Overview of specialty
The AFRM’s focus on interdisciplinary training and teamwork makes the rehabilitation medicine physician the best qualified specialist to lead teams of allied health staff, nurses, and other medical practitioners (specialists or general practitioners) in providing coordinated, patient-focused, individualised programs of goal-directed rehabilitative care.
Rehabilitation medicine is a:
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Principal Medical Specialty in Australia and a Vocational Scope of Practice in New Zealand
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Diverse specialty whose members are trained to facilitate the best possible recovery of function over the full range of common and uncommon medical and surgical conditions seen in contemporary practice
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Practice that's collaborative and involves input from a diverse range of health professionals focused on optimising the health and wellbeing of those with short-term or long-term disability
Rehabilitation medicine physicians:
use knowledge and skills – developed through the AFRM training program, equivalent overseas or post-fellowship training – to manage all patient types with medical, musculoskeletal, neurological and neuromuscular disorders, with an emphasis on maximising functional ability and quality of life
diagnose and treat patients from adolescence and young adulthood through to the older people
can manage children in certain circumstances but generally do not provide a full range of rehabilitation services to children – see Paediatric Rehabilitation: Rehabilitation Scope of Practice
treat patients affected by function limiting and/or painful conditions involving the central, peripheral and autonomic nervous systems, the cardiopulmonary and musculoskeletal systems, as well as those who experience disability due to illness or injury affecting other body systems
hold a unique blend of education, training and experience, which makes the rehabilitation medicine physician an ideal treating or consulting physician for patients who have impaired function due to debility and deconditioning, including older patients and those with reduced function as a result of chronic diseases or other complex health conditions
are experts in the assessment, treatment, and management of people with permanent disability as a result of injury or illness
are well placed to manage patients with occupational or sports-related musculoskeletal or neuromuscular injuries
use appropriate laboratory and imaging studies, but are also trained in the clinical interpretation of other diagnostic studies that evaluate musculoskeletal and neuromuscular systems such as CT, bone scan, MRI, and musculoskeletal ultrasound
are specially trained in the use of therapeutic exercise, orthotics, prosthetics, and other rehabilitation equipment and modalities, and can prescribe these precisely to meet patients’ specific needs
may engage in the delivery of health services through new models of care and modalities, such as in-reach rehabilitation, early supported discharge, rehabilitation in the home and other community rehabilitation and integrated care models, reablement and restorative models of care, and ambulatory care services, as well as virtually via telerehabilitation
possess a holistic approach, with experience in integrated care with primary care physicians, and training in leading interdisciplinary teams
are skilled in secondary and tertiary prevention for ambulatory patients in the community, such as in ambulatory care services and interdisciplinary falls prevention services, as well as for patients who have stroke, neurological or musculoskeletal conditions, osteoporotic fractures or fragility, to prevent relapse or recurrence of injury or to improve function or quality of life.
Rehabilitation medicine physicians who have completed rehabilitation medicine specialty training have adequate training in the following areas:
- inpatient and outpatient musculoskeletal and neurological assessment, diagnosis, and rehabilitation
- acute and persistent pain management
- injury prevention, conditioning, fitness, and wellness
- non-surgical spine medicine and rehabilitation
- rehabilitation management of sports and sports injuries
- rehabilitation management of occupational injuries and vocational rehabilitation
- therapeutic and diagnostic injection techniques, such as trigger point, soft tissue, and joint injections
- assessments of function, disability, and impairment
- prosthetic and orthotic prescription
- mobility aid, wheelchair, and seating prescription
- rehabilitation management of patients with (upper and lower) limb amputations or limb deficiency
- rehabilitation management of patients with acquired brain injury
- rehabilitation management of patients with spinal cord impairment through injury or disease
- management of spasticity, dystonia, and hypertonia
- rehabilitation management of rheumatological and other joint diseases and arthroplasty (pre- and post-surgery), and post-fracture rehabilitative care
- tissue disorders such as burns, ulcers, lymphoedema, and wound care
- rehabilitation management of older people, including the management of frailty and geriatric syndromes
- rehabilitation management of pulmonary and cardiac conditions
- rehabilitation management of oncological conditions (pre- and post-treatment, and recovery)
- rehabilitation of patients who are debilitated or deconditioned as a result of multi-system disease, prolonged immobilisation, or prolonged hospitalisation
- rehabilitation and coordination of care and management of individuals with developmental and intellectual disorders such as cerebral palsy, spina bifida, and other congenital disorders
- long-term management of the person with disability, in liaison with the individual, their family, their general practitioner and other health care providers
- chronic diseases management, particularly in secondary and tertiary prevention, to prevent relapse or recurrence of conditions, and to improve function and quality of patients, such as falls prevention and osteoporotic re-fracture prevention
- leadership and clinical and administrative management of rehabilitation medicine services and other related clinical services.
In addition, some rehabilitation physicians can demonstrate qualifications and expertise that qualifies them to practice in other areas:
- interventional diagnostic and therapeutic spinal and peripheral pain management procedures using x-ray and ultrasound guidance
- interventional techniques for spasticity management
- electrodiagnostic medicine
- manual medicine techniques
- assessment of capacity and of permanent impairment, preparation of medical and medicolegal reports, and provision of expert medical opinion in rehabilitation medicine.