Physiatry as a primary care specialty.

The ongoing changes in health care seek to create an affordable, accessible, and high-quality health care delivery system for all Americans. In response to this, Physical Medicine and Rehabilitation (PM&R) is re-examining its role in the provision of health care to the disabled, particularly the severely affected. We surveyed 100 physiatrists and 100 PM&R residents across the country regarding their opinions on the competence, qualifications, and desire of physiatrists to provide primary care for the disabled. Fifty-five physiatrists and 51 residents responded (55% overall). Thirty-nine percent of all respondents agreed that PM&R should be designated as a primary care specialty, and 53% believed that physiatrists should provide primary care to the severely disabled (e.g., spinal cord and head injury). Overall, 53% felt that physiatrists are competent in general medical care, but 38% are convinced that the current 4-yr PM&R residency training sufficiently prepares physiatrists to assume the role of a primary care provider. Of the patient populations considered, the respondents thought that physiatrists should manage the care of spinal cord injury (60%) and head injury (51%), but only 40% were willing to assume primary care responsibilities.