When Walking Fails

To the Editor. —Dr Iezzoni 1 makes an eloquent plea for greater physician understanding and knowledge of the many issues concerning ambulation and wheelchairs. Her problem was not only her own physician's lack of familiarity with walking difficulties, wheelchairs, and wheelchair technology, but also the physician's unfamiliarity with a specialty that is very familiar with these issues. Dr Iezzoni would have benefited from a referral to a physiatrist: a physician specializing in physical medicine and rehabilitation who is skilled in treating persons with disabilities. The physiatrist would have been able to perform a functional evaluation and assist her to maximize her independent mobility. This would include the possibility of ambulation with an assistive device, possibly with bracing or other rehabilitative interventions, as well as helping with the prescription and acquisition of the most effective, comfortable, and safe wheelchair. Many individuals who can ambulate shorter distances will also benefit from the use of a