Jorge E. Garcia-Negron, MD
PM&RS/Pain Service Chief, VISN 8 REC ICC PM&R Lead
WPB VA Healthcare System, VISN 8
Jupiter, Florida, United States
Ramon L. Cuevas-Trisan, MD
ACOS for Education and Research
West Palm Beach VA Healthcare System
West Palm Beach, Florida, United States
Hein Linn Thant, MD
PGY III PM&R Resident
Larkin Community Hospital
West Palm Beach, Florida, United States
To describe the demographics and practice patterns of physiatrists in the Department of Veterans Affairs (VA) that operates the largest integrated healthcare system in the US, employing the largest number of physiatrists in the nation.
Design:
We identified 574 physiatrists in the VA system and conducted an online survey of the physiatry workforce in the VA in July 2024. We obtained responses from 392 (68.3%). The survey included demographic and practice questions.
Results:
The most commonly reported practice type in PM&R was outpatient musculoskeletal medicine, followed by Electrodiagnosis and Brain Injury Medicine.
Physiatrists reported that, at their respective facilities, Electrodiagnostic Medicine is practiced exclusively by PM&R in 30% of the cases while it is shared between PM&R and Neurology in 64% of the cases.
Joint and soft tissue injections top the list of procedures performed by physiatrists, followed by chemodenervation. About 11% of the physiatrists reported performing spinal injections (all under fluoroscopic guidance) and nearly 14% report use of orthobiologics for various indications with growing interest and use platelet rich plasma (PRP). Almost 50% perform viscosupplementation procedures. Anatomical guidance was reported to be the most common method utilized but to the use of ultrasound appears to be on the rise.
Conclusions:
Systemwide, the greatest need was identified as Cancer Rehabilitation, followed by Cardiopulmonary Rehabilitation, and long COVID rehabilitation.
The majority of responders reported that there are no current vacancies for physiatrists at their facilities but existing vacancies were reported by 38% of the respondents.
We believe that this is the largest assessment of the PM&R workforce ever undertaken in the VA system. It provides us with better understanding of the practice patterns, distribution of the workforce, and educational/training needs of the workforce. This will provide the initial blueprint for necessary training and potential standardization of the physiatry practice across the VA.
