Victoriya Brener, M.D.
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Dr. Frenkel Obstetrician-Gynecologist  
Physiatry (PM & R)
Physical Medicine and Rehabilitation, physiatry is one of the 24 medical specialties certified by American Board of Medical Specialties. Physiatry provides integrated care in the treatment of all neurologic and musculoskeletal disabilities from traumatic brain injury to lower back pain.
What is a physiatrist?
A physiatrist (pronounced fizz ee at' trist) is a physician specializing in physical medicine and rehabilitation. As the population of America ages, as people survive conditions that once would have been fatal, and as quality of life is an increasing concern, the field of physiatry is moving to the forefront of medicine.
How did the specialty develop?
The field of physical medicine and rehabilitation (PM&R) began in the 1930's to address musculoskeletal and neurological problems, but broadened its scope considerably after World War II. As thousands of veterans came back to the United States with serious disabilities, the task of helping to restore them to productive lives became a new direction for the field. The Advisory Board of Medical Specialties granted PM&R its approval as a specialty of medicine in 1947.
What is the role of the physiatrist?
Physical medicine and rehabilitation is a medical specialty dedicated to restoring optimal function to people with injuries. Physiatrists can treat problems as simple as a sprained back or a pinched nerve in the neck, or as serious as a spinal cord injury. Physiatrists are specialists in diagnosing problems in the musculoskeletal system.

They perform thorough histories and physical examinations to find the source of pain, injury or disability, even when the standard diagnostic tests do not reveal specific problems. Because they offer an aggressive, non-surgical approach to the treatment of pain and injury, physiatrists are the ideal choice for the treatment of low back pain, neck pain, and other musculoskeletal problems.

What is the difference between a physiatrist and a physical therapist?
A physiatrist studies about three times as long as a physical therapist to complete their training. A physiatrist is a diagnostician with clinical skills combining knowledge of neurology and orthopedics. They can read and interpret MRI scans and perform nerve tests (EMG's). A physical therapist cannot make diagnoses nor can they prescribe drugs.
What is the difference between a physiatrist and a chiropractor?
A physiatrist studies about twice as long as a chiropractor to obtain their M.D. and complete their education. A chiropractor earns a D.C. degree in about half the time. A chiropractor cannot prescribe drugs.
What is the difference between a physiatrist and an orthopedist?
An orthopedist reconstructs joints, bones, and tendons in the operating room. A physiatrist spends many years learning how to keep you out of the operating room entirely. A physiatrist may prescribe therapy, drugs, or devices which will allow you to recuperate without costly, painful surgery. If surgery is the only alternative, a physiatrist will be the first person to tell you. Your physiatrist will recommend the very best surgeon for your problem.
What types of conditions does a physiatrist treat?
Physiatrists are physicians who treat a wide range of problems from sore shoulders to spinal cord injuries. The focus of the specialty is on restoring function to people. Physiatrists treat acute and chronic pain and musculoskeletal disorders. They may see a person who lifts a heavy object at work and experiences back pain, a basketball player who sprains an ankel and needs rehabilitation to play again, or a knitter who has carpal tunnel syndrome.
What is the physiatrist's role in treatment?
A physiatrist may treat patients directly, lead an interdisciplinary team, or act as a consultant. Here are some scenarios that illustrate the varied roles of a physiatrist:
A carpenter is lifting some heavy wood when he feels pain in his lower back and down his leg. He sees a physiatrist who does a thorough history and physical examination and performs all the testing needed to make the diagnosis as a herniated disc. The physiatrist develops an appropriate treatment program, monitoring and adjusting it as needed. With this treatment and rehabilitation program, the patient does not need surgery.
A woman in a diving accident has a spinal cord injury and is paralyzed below the waist. The physiatrist assesses her injury and with the patient and a team of health care professionals determines the course of her rehabilitation. The physiatrist treats the array of medical issues that occur as a result of a spinal cord injury, and also leads the interdisciplinary team to enable the woman to reach the highest level of functioning possible. The team varies in composition depending on the needs of the patient. In addition to other physicians, the team may include health care professionals such as nurses, physical therapists, occupational therapists, social wokers, neuropsychologists, and vocational counselors.
A baby is born with cerebral palsy. The physiatrist is called in as the expert who advises on the correct treatment and rehabilitaion that can affect the rest of the child's life.
How do physiatrists diagnose?
Physiatrists diagnostic tools are the same as those used by other physicians, with the addition of special techniques in electrodiagnostic medicine like electromyography (EMG), nerve conduction studies, and somatosensory evoked potentials. These techniques help the physiatrist to diagnose conditions that cause pain, weakness, and numbness.
What kind of treatments do physiatrists offer?
Physiatrists offer a broad spectrum of medical services. They do not perform surgery. Physiatrists may prescribe drugs or assistive devices, such as a brace or artificial limb. They also use diverse therapies such as heat and cold, electrotherapies, massage, biofeedback, traction, and therapeutic exercise.
Where do physiatrists practice?
Physiatrists practice in rehabilitation centers, hospitals, and in private offices. They often have broad practices, but some concentrate on one area such as pediatrics, sports medicine, geriatric medicine, brain injury, and many other special interests.
  Dr. Brener is a physiatrist. She has been affiliated with Beth Israel Medical Center.
She earned her M.D. from Vinnitsa Medical Institute of N.I. Pirogova and completed her residency in physical medicine & rehabilitation at Downstate & Kings County Hospital Center.
Dr. Frenkel is an obstetrician-gynecologist at Bay OB/GYN, P.C. in Brooklyn. He has been affiliated with New York Methodist Hospital and Lenox Hill Hospital.  
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