This is an accepted version of this page
58-493: PMR may refer to: Science and technology [ edit ] Medicine [ edit ] Physical medicine and rehabilitation Polymyalgia rheumatica , inflammatory muscular condition Progressive muscle relaxation , a technique Physics [ edit ] Paraxial marginal ray , in geometric optics Proton magnetic resonance , in spectroscopy Technologies [ edit ] Perpendicular magnetic recording ,
116-505: A specialist , or watchful observation. A follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of " utilization review ", such as prior authorization of tests, may place barriers on accessing expensive services. The medical decision-making (MDM) process includes the analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain
174-407: A combination of all three. Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those who can afford to pay for it, have self-insured it (either directly or as part of an employment contract), or may be covered by care financed directly by the government or tribe. Transparency of information is another factor defining
232-429: A combination of art and science (both basic and applied , under the umbrella of medical science ). For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine, now known as traditional medicine or folk medicine , remain commonly used in
290-500: A decade after medical school. Furthermore, surgical training can be very difficult and time-consuming. Surgical subspecialties include those a physician may specialize in after undergoing general surgery residency training as well as several surgical fields with separate residency training. Surgical subspecialties that one may pursue following general surgery residency training: Other surgical specialties within medicine with their own individual residency training: Internal medicine
348-553: A definitive diagnosis that would explain the patient's problem. On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, lab or imaging results, or specialist consultations . Contemporary medicine is, in general, conducted within health care systems . Legal, credentialing , and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have
406-491: A delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice of patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for its lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and
464-513: A few minutes or a few weeks, depending on the complexity of the issue. The components of the medical interview and encounter are: The physical examination is the examination of the patient for medical signs of disease that are objective and observable, in contrast to symptoms that are volunteered by the patient and are not necessarily objectively observable. The healthcare provider uses sight, hearing, touch, and sometimes smell (e.g., in infection, uremia , diabetic ketoacidosis ). Four actions are
522-422: A pain treatment option. Physiatrists are also trained in nerve conduction studies and electromyography . During the first half of the 20th century, two unofficial specialties, physical medicine and rehabilitation medicine, developed separately, but in practice both treated similar patient populations consisting of those with disabling injuries. Frank H. Krusen was a pioneer of physical medicine, which emphasized
580-448: A patient to investigate or treat a pathological condition such as disease or injury , to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum ). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it
638-473: A period of supervised practice or internship , or residency . This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to
SECTION 10
#1732852270646696-440: A person function optimally within the limitations placed upon them by a disabling impairment or disease process for which there is no known cure. The emphasis is not on the full restoration to the premorbid level of function, but rather the optimization of the quality of life for those not able to achieve full restoration. A team approach to chronic conditions is emphasized to coordinate care of patients. Comprehensive rehabilitation
754-719: A physiatrist. Physical medicine and rehabilitation encompasses a variety of clinical settings and patient populations. In hospital settings, physiatrists commonly treat patients who have had an amputation , spinal cord injury , stroke , traumatic brain injury , and other debilitating injuries or conditions. In treating these patients, physiatrists lead a team of physical, occupational, respiratory, and speech therapists, as well as nurses, psychologists, and social workers. . In outpatient settings, physiatrists treat patients with muscle and joint injuries, pain syndromes, non-healing wounds, and other disabling conditions. Physiatrists are trained to perform injections into joints or muscle as
812-466: A roof where thermal insulation or another material is located above the waterproofing membrane Proto Matrix Rail , a paintball marker Penilaian Menengah Rendah , a public school examination in Malaysia abolished in 2014 Pimp My Ride , a TV show produced by MTV and hosted by rapper Xzibit Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with
870-587: A secondary care setting. Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers , burn treatment centers, advanced neonatology unit services, organ transplants , high-risk pregnancy, radiation oncology , etc. Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means . In low-income countries, modern healthcare
928-547: A significant impact on the way medical care is provided. From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals, and the Catholic Church today remains the largest non-government provider of medical services in the world. Advanced industrial countries (with the exception of the United States ) and many developing countries provide medical services through
986-410: A system of universal health care that aims to guarantee care for all through a single-payer health care system or compulsory private or cooperative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices, state-owned hospitals and clinics, or charities, most commonly
1044-604: A technology for data recording on hard disk PMR446 , a license-free public walkie-talkie protocol in the European Union and the United Kingdom Professional mobile radio or "private mobile radio", VHF & UHF radio networks used by operators such as taxis, utilities and emergency services Biology [ edit ] Plant micro-reserve , a type of small nature reserve Places [ edit ] Pridnestrovian Moldavian Republic , more commonly in
1102-546: Is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions such as spinal cord injury , brain injury , musculoskeletal injury , stroke , pain and spasticity from muscle , ligament , or nerve damage. PM&R physicians lead rehabilitation teams and are trained in medication management, electrodiagnosis , and targeted injections . A physician having completed training in this field may be referred to as
1160-450: Is classified into primary, secondary, and tertiary care categories. Primary care medical services are provided by physicians , physician assistants , nurse practitioners , or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics , nursing homes , schools, home visits, and other places close to patients. About 90% of medical visits can be treated by
1218-525: Is derived from Latin medicus , meaning "a physician". Medical availability and clinical practice vary across the world due to regional differences in culture and technology . Modern scientific medicine is highly developed in the Western world , while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners. In
SECTION 20
#17328522706461276-595: Is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology , but are not considered surgical sub-specialties per se. Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than
1334-400: Is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain. Separation of prescribing and dispensing is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from
1392-408: Is provided by specialists in this field, who act as facilitators, team leaders, and medical experts for rehabilitation. In rehabilitation, goal setting is often used by the clinical care team to provide the team and the person undergoing rehabilitation for an acquired disability a direction to work towards. Very low quality evidence indicates that goal setting may lead to a higher quality of life for
1450-456: Is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in Commonwealth nations, such specialists are often called physicians . These terms, internist or physician (in
1508-461: The United States : Fellowship training for other unaccredited subspecialties within the field include the following: Medicine Medicine is the science and practice of caring for patients, managing the diagnosis , prognosis , prevention , treatment , palliation of their injury or disease , and promoting their health . Medicine encompasses a variety of health care practices evolved to maintain and restore health by
1566-517: The developed world , evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm. In modern clinical practice, physicians and physician assistants personally assess patients to diagnose , prognose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins with an interaction with an examination of
1624-913: The pharmacist who provides the prescription drug . In the Western world there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs. Working together as an interdisciplinary team , many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses , emergency medical technicians and paramedics , laboratory scientists, pharmacists , podiatrists , physiotherapists , respiratory therapists , speech therapists , occupational therapists , radiographers, dietitians , and bioengineers , medical physicists , surgeons , surgeon's assistant , surgical technologist . The scope and sciences underpinning human medicine overlap many other fields. A patient admitted to
1682-513: The prevention and treatment of illness . Contemporary medicine applies biomedical sciences , biomedical research , genetics , and medical technology to diagnose , treat, and prevent injury and disease, typically through pharmaceuticals or surgery , but also through therapies as diverse as psychotherapy , external splints and traction , medical devices , biologics , and ionizing radiation , amongst others. Medicine has been practiced since prehistoric times , and for most of this time it
1740-459: The Baruch Committee, commissioned by philanthropist Bernard Baruch , defined the specialty as a combination of the two fields and laid the framework for its acceptance as an official medical specialty. The committee also distributed funds to establish training and research programs across the nation. The specialty that came to be known as physical medicine and rehabilitation in the United States
1798-752: The English language known as Transnistria, a breakaway state between the River Dniester and the eastern Moldovan border with Ukraine Palmerston North Airport , which has the IATA airport code PMR Peckham Rye railway station , which has station code PMR Pune Metropolitan Region , the metro area around the twin cities of Pune and Pimpri-Chinchwad in the Indian state of Maharashtra Organizations [ edit ] PMR Ltd , consulting, market research, publications Partidul Muncitoresc Român ( Romanian Workers' Party ),
PMR - Misplaced Pages Continue
1856-467: The UK where all doctors are now required by law to work less than 48 hours per week on average. The following are some major medical specialties that do not directly fit into any of the above-mentioned groups: Some interdisciplinary sub-specialties of medicine include: Medical education and training varies around the world. It typically involves entry level education at a university medical school , followed by
1914-480: The United States, can be searched at http://data.medobjectives.marian.edu/ Archived 4 October 2018 at the Wayback Machine . In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts
1972-473: The United States, must be completed in and delivered from a recognized university. Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education . Medical practitioners upgrade their knowledge in various ways, including medical journals , seminars, conferences, and online programs. A database of objectives covering medical knowledge, as suggested by national societies across
2030-487: The United States, residency training for physical medicine and rehabilitation is four years long, including an intern year of general medical training. There are 83 programs in the United States accredited by the Accreditation Council for Graduate Medical Education , in 28 states. Specifics of training differs from program to program but all residents must obtain the same fundamental skills. Residents are trained in
2088-446: The absence of scientific medicine and are thus called alternative medicine . Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery . Medicine ( UK : / ˈ m ɛ d s ɪ n / , US : / ˈ m ɛ d ɪ s ɪ n / ) is the science and practice of the diagnosis , prognosis , treatment , and prevention of disease . The word "medicine"
2146-589: The basis of physical examination: inspection , palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order, although auscultation occurs prior to percussion and palpation for abdominal assessments. The clinical examination involves the study of: It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above. The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to
2204-502: The broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which has its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments);
2262-459: The considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health. In
2320-763: The examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of
2378-417: The expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency departments , intensive care medicine , surgery services, physical therapy , labor and delivery , endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in
PMR - Misplaced Pages Continue
2436-640: The gut and the kidneys. In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of primary care . There are many subspecialities (or subdisciplines) of internal medicine : Training in internal medicine (as opposed to surgical training), varies considerably across
2494-553: The hospital is usually under the care of a specific team based on their main presenting problem, e.g., the cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments. Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in. The main branches of medicine are: In
2552-434: The information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only
2610-678: The inpatient setting to take care of multiple types of rehabilitation including: spinal cord injury, traumatic brain injury, stroke, orthopedic injuries, cancer, cerebral palsy , burn, pediatric rehab, and other disabling injuries. The residents are also trained in the outpatient setting to know how to take care of the chronic conditions patients have following their inpatient stay. During training, residents are instructed on how to properly perform several diagnostic procedures which include electromyography , nerve conduction studies and also procedures such as joint injections and trigger point injections. Seven accredited sub-specializations are recognized in
2668-773: The narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of
2726-496: The new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination. Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery". "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing
2784-477: The patient's medical history and medical record , followed by a medical interview and a physical examination . Basic diagnostic medical devices (e.g., stethoscope , tongue depressor ) are typically used. After examining for signs and interviewing for symptoms , the doctor may order medical tests (e.g., blood tests ), take a biopsy , or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on
2842-547: The person with the disability, and it not clear if goal setting used in this context reduces or increases re-hospitalization or death. Not only must a physiatrist have medical knowledge regarding a patient's condition, but they also need to have practical knowledge regarding it as well. This involves issues such as: what type of wheelchair best suits the patient, what type of prosthetic would fit best, does their current house layout accommodate their handicap well, and other every day complications that their patients might have. In
2900-440: The possible exploitation of information for commercial gain on the other. The health professionals who provide care in medicine comprise multiple professions , such as medics , nurses , physiotherapists , and psychologists . These professions will have their own ethical standards , professional education, and bodies. The medical profession has been conceptualized from a sociological perspective . Provision of medical care
2958-432: The primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes. Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required
SECTION 50
#17328522706463016-631: The ruling party in communist Romania from 1948 to 1965 Parti Mauritanien pour le Renouveau , Mauritanian Party for Renewal , a political party in Mauritania Port Militarization Resistance , an anti-war organization in the United States TV PMR , a public television channel in Transnistria Other [ edit ] Preventive Maintenance Report , for Telecom Maintenance. Protected membrane roof ,
3074-540: The title PMR . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=PMR&oldid=1238466161 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Physical medicine and rehabilitation Physical medicine and rehabilitation (PM&R), also known as physiatry ,
3132-555: The two camps above; for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA). Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on
3190-477: The use of physical agents, such as hydrotherapy and hyperbaric oxygen, at Temple University and then at Mayo Clinic and it was he that coined the term 'physiatry' in 1938. Rehabilitation medicine gained prominence during both World Wars in the treatment of injured soldiers and laborers. Howard A. Rusk , an internal medicine physician from Missouri, became a pioneer of rehabilitation medicine after being appointed to rehabilitate airmen during World War II. In 1944,
3248-418: The world: see the articles on medical education for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in
3306-419: Was an art (an area of creativity and skill), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism . In recent centuries, since the advent of modern science , most medicine has become
3364-461: Was officially established in 1947, when an independent Board of Physical Medicine was established under the authority of the American Board of Medical Specialties. In 1949, at the insistence of Rusk and others, the specialty incorporated rehabilitation medicine and changed its name to Physical Medicine and Rehabilitation. The major goal of physical medicine and rehabilitation treatment is to help
#645354