Perceived Quality of Life With Spinal Cord Injury: A Comparison Between Emergency Medicine and Physical Medicine and Rehabilitation Physicians

Abstract

ObjectiveTo explore the attitudes of health care providers who treat patients with spinal cord injury (SCI) and examine whether Emergency Medicine (EM) and Physical Medicine and Rehabilitation (PM&R) physicians differ in their judgments about quality of life (QOL) after SCI. DesignQuestionnaire survey of PM&R and EM physicians. ParticipantsBoard-certified PM&R and EM physicians listed in the American Academy of Physical Medicine & Rehabilitation and the American College of Emergency Physicians and/or faculty from academic PM&R and EM departments in the United States and Canada. Main Outcome MeasurementsEvaluating various aspects of perceived QOL if the physician hypothetically sustained an SCI, including impact on leisure activities, social relationships, happiness, meaningful work, satisfying sexual relationships, and overall QOL. ResultsA total of 91 EM physicians and 89 PM&R physicians completed the surveys. PM&R physicians were more likely to agree that they would have a better QOL compared with EM physicians, regardless of the level of injury or aspect of life (P < .01 in all cases). Female physicians, regardless of specialty, were more likely to choose a lower level at which they would choose to die, rather than live, if they sustained an SCI (P = .03). Physicians in both groups were more likely to disagree that they would have a high QOL at a lower level of injury if they disagreed at a higher level of injury (P ≤ .02). ConclusionsRegardless of specialty, PM&R and EM physicians have their own personal perceptions of QOL with SCI. PM&R physicians tend to believe that they would have a higher QOL with an SCI compared with EM physicians and likely have a more optimistic view of SCI. Patient care may be improved by interdisciplinary discussion, as evidenced by the disparity exhibited by practitioners in these 2 specialties who care for the same patient population.