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

Objective: To 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. Design: Questionnaire survey of PM&R and EM physicians. Participants: Board-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 Measurements: Evaluating 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. Results: A 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). Conclusions: Regardless 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.