What Is a Physiatrist?

What is a physiatrist?

A physiatrist is a medical doctor or a doctor of osteopathic medicine who practices physiatry or physical medicine and rehabilitation. Physiatry is a branch of medicine that specializes in the prevention, diagnosis, treatment, as well as rehabilitation of disorders, which cause functional impairment either temporarily or permanently. 

Physiatrists use nonsurgical methods of treatment, such as spinal injections or pain relievers instead of surgery. They specialize in musculoskeletal system treatment including musculoskeletal disorders that impair a person's functioning. The main goal of physiatrists is to help their patients go back to being functional as well as reducing pain to enjoy life as much as possible. 

A physiatrist is also called as a physical medicine and rehabilitation physician or a PM&R physician. 

Training and Specialization

Four years of medical school and a four-year residency training are required to become a physiatrist. During the first year of residency, the focus is on general practice or internal medicine and then specialty training follows for three years of residency. After completing a four-year residency, further training and specialization are available through specific fellowships over a period of 1-2 years. 

To gain additional training in particular forms of treatment, physiatrists may complete one of the specialty training programs:

• Treatment of sciatica, back pain, and other forms of dysfunction or pain from the spine
• Pain management for different types of chronic pain, such as osteoarthritis and lower back pain. Physiatrists require additional specialty training when treating patients using injections for pain. 
• Sports injuries and sports medicine
• Brain injury rehabilitation (stroke)
• Spinal cord injury rehabilitation 
• Pediatric care for patients who are below 18 years old

Physiatry and the Spine

Physiatrists specialize in treating a number of conditions that affect the musculoskeletal system. Below is a list of health conditions that are usually treated by physiatrists:

• Ankylosing spondylitis
• Sciatica or back pain
• Spinal cord injury
• Injuries at work
• Muscle and ligament injuries
• Fibromyalgia
• Myofascial pain syndrome (MPS) 
• Osteoporosis
• Osteoarthritis

Most physiatrists focus on the treatment of back pain since the spine is the area of most of the body's musculoskeletal system. Depending on personal preference and training, some physiatrists specialize in treating spinal problems and utilize injections for pain management along with rehabilitation. 

Physical Medicine and Rehabilitation as a Medical Specialty

Physical medicine and rehabilitation has been around for over six decades. There are many physiatrists who are a part of facilities that provide comprehensive care for different spinal disorders or deformities. Other specialists within the practice include physical therapists, rehabilitation specialists, and spine surgeons, among others. Many physiatrists also coordinate with a multidisciplinary team of doctors that consists of other specialists, such as physical therapists, psychologists, chiropractors, and spine surgeons. 

Diagnostic Approach and Treatment

Physiatrists tend to treat the overall well-being of their patients, and not only specific conditions or injuries. This approach can help improve a patient's overall recovery as well as prevent cases of recurrent back pain and other dysfunctions. 

Treatment goals always involve the restoration of the normal functioning of patients along with improving the quality of life not just physically, but also emotionally and psychosocially. 

Diagnosing musculoskeletal system problems and injuries includes taking the patient's medical history and a complete physical examination. Other helpful diagnostic tests include X-rays, MRI scans, laboratory testing, nerve conduction studies, electromyography, and even psychological testing. 

Physiatry treatments may include one or a combination of the following:

• Assistive devices
• Back braces
• Medications
• Active physical therapy
• Occupational therapy
• Recreational therapy
• Health psychology
• Massage therapy
• Passive physical therapy modalities (heat and cold therapy for pain or ultrasound)

Injections for pain, such as facet joint injections and epidural injections may also be performed by physiatrists. 

Physiatrist Salary

The average salary earned by a physiatrist every year is $202,700. There is also no significant difference between the pay scale of new physiatrists and experienced ones. 

If a physiatrist has less than five years of experience, then based on 59 salaries provided by anonymous users, he or she can earn an average of $206,000. The total includes overtime pay, tips, and bonuses. A physiatrist who has an experience of 5-10 years may earn an average of $208,000, and a physiatrist who has 10-20 years of experience may have an average earning of $225,000 annually.

A physiatrist who has more than 20 years of experience, may approximately earn an average of $215,000. A salary of a physiatrist tends to vary since it considerably depends on the procedure, geography, and mixed practice. In the United States, the salaries earned typically ranges from $109,262 to $381,989. This pay scale also includes bonuses. Generally, the basic annual salary is at $100,671 to $318,082.  

According to PayScale’s data, if only the yearly bonus is calculated, it can go up to $51,064. Those who are on the upper end of the pay scale report earnings of $255,000 and those on the lower end report $167,000. However, once they have gained experience, the pay scale can go as high as $313,000.

Salary Range

The salary range of physiatrists is from $144,000 to $216,000. However, a variety of factors also determine their yearly income. Work experience is one key factor. According to PayScale, the annual earnings of physiatrists is within the range of $152,283 to $280,284.

Typically, the annual earnings of those who are certified by the American Board of Physical Medicine and Rehabilitation range from $152,605 and $250,000. Generally, the salary of physiatrists who specialize in pain management per year is in the range of $51,064 to $318,082. According to PayScale, the annual income of physiatrists who have an MD degree (Doctor of Medicine) ranges from $102,129 to $411,060.  

Starting Salary

In the first year of the job, physiatrists earn an average annual salary of $120,000 to $200,000. 

Salary by State

For physical medicine, Minnesota is the top paying state. Physiatrists in this state have an annual income of $218,180. It is followed by Indiana, wherein physiatrists earn an average of $212,000. In Georgia, the average income for physiatrists in a year is $209,380. Other states with corresponding average annual salaries:

• Nevada - $295,410

• New Hampshire - $206,680

• South Dakota - $201,140

• Florida - $190,600 

• California - $187,240

• Texas - $168,010

• New York - $151,750

• Illinois - $151,080

• Delaware - $150,600

• Maryland - $150,490 (median yearly salary)

• Nebraska - $141,250

• Rhode Island - $126,380 (lowest salary)

Benefits

Based on the salary statistics that was reported by Salary.com, it was estimated that the benefit packages are more than $66,000. This benefit package consists of disability insurance, social security, healthcare, time off, and pension plans.

Sometimes, the annual earning can be reflected in the benefits package. The salary of those who have malpractices and liability insurance, earn around $102,129 to $318,082.

Job Description

Physiatrists instruct physical therapists on the kind of treatment a patient should receive. Physiatrists treat people who are recovering from surgery or patients with physical disorders or ailments. 

Physiatrists are specialists who diagnose and treat musculoskeletal injuries. They treat patients using a number of methods, such as magnetic field therapy, exercise, and diathermy. They also observe the development of patients and make changes accordingly.  

Factors that Influence the Salary of Physiatrists

The sets of skills possessed by physiatrists will differ whether it is the one working with the military, sports, in geriatrics, or forensic. Below are some of the factors that influence a physiatrist's salary: 

• Geographical Area - This is one of the most important factors that affect a professional's earning. Salaries are expected to be higher in larger cities compared to rural areas. 

• Experience - The salary of a physiatrist can be doubled by a great amount of experience. When compared to other healthcare specialists, the starting salary is very close to the average.

• Industry - A significant wage can be guaranteed by the industry, where physiatrists decide to practice their profession.

• Work Hours - Most of their time is spent with their patients. Many of these people are outpatient while some are seen in clinics, hospitals, residential programs, and community. Working hours may vary depending on what kind of setting they work. Some may have their own schedule while some follow a schedule given by the hospital or clinic.

Job Outlook

Even though physiatrists have to go through many years of studies, the job outlook is highly optimistic in most countries. In the coming years, it is expected that the number of physiatrists will grow even more.