The field of competence of the specialist in physical and rehabilitation medicine (PRM)

Abstract

The Field of Competence (FOC) of specialists in Physical and Rehabilitation Medicine (PRM) in Europe follows uniform basic principles described in the White Book of PRM in Europe. An agreed basis of the field of competence is the European Board curriculum for the PRM-specialist certification. However, due to national traditions, different health systems and other factors, PRM practice varies between regions and countries in Europe. Even within a country the professional practice of the individual doctor may vary because of the specific setting he or she is working in. For that reason this paper aims at a comprehensive description of the FOC in PRM. PRM specialists deal with/intervene in a wide range of diseases and functional deficits. Their interventions include, prevention of diseases and their complications, diagnosis of diseases, functional assessment, information and education of patients, families and professionals, treatments (physical modalities, drugs and other interventions). PRM interventions are often organized within PRM programmes of care. PRM interventions benefit from the involvement of PRM specialists in research. PRM specialists have knowledge of the rehabilitation process, team working, medical and physical treatments, rehabilitation technology, prevention and management of complications and methodology of research in the field. PRM specialists are involved in reducing functional consequences of many health conditions and manage functioning and disability in the respective patients. Diagnostic skills include all dimensions of body functions and structures, activities and participation issues relevant for the rehabilitation process. Additionally relevant contextual factors are assessed. PRM interventions range from medication, physical treatments, psychosocial interventions and rehabilitation technology. As PRM is based on the principles of evidence-based medicine PRM specialist are involved in research too. Quality management programs for PRM interventions are established at national and European levels. PRM specialists are practising in various settings along a continuum of care, including acute settings, post acute and long term rehabilitation programs. The latter include community based activities and intermittent in- or out-patient programs. Within all PRM practice, Continuous Medical Education (CME) and Continuous Professional Development (CPD) are part of the comprehensive educational system.