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Why physical medicine, physical disability and physical rehabilitation? We should abandon Cartesian dualism.

Adjectives are supposed to describe the associated noun more fully or definitively, and the adjective physical is sometimes added to words such as medicine, rehabilitation and disability. What increase in description does its use allow? The adjective was probably added when rehabilitation started to develop for several reasons: it contrasted the mode of treatment with pharmacology and surgery; it contrasted the nature of the supposed aetiology with emotionally generated disorders, especially shell-shock; and it justified the presence of rehabilitation within the profession of medicine. Its continued use, however, perpetuates a Cartesian, dualist philosophy. This editorial uses the World Health Organization International Classification of Functioning (WHO ICF) model of illness to analyse its continued use, and concludes that its continued use may disadvantage both patients and the practice of rehabilitation.

Persons with Disabilities↗

Estimates of physician requirements for 1990 for the specialties of neurology, anesthesiology, nuclear medicine, pathology, physical medicine and rehabilitation, and radiology. A further application of the GMENAC methodology.

The Graduate Medical Education National Advisory Committee (GMENAC) adjusted needs-based model for determining physician requirements was applied to the specialties of anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, and radiology, which had not been completed at the time of the original GMENAC final report. Physical medicine and rehabilitation continues to be projected as a shortage specialty; anesthesiology is in near balance. Neurology and pathology are no longer projected to be specialties of oversupply, but rather to be in near balance. Diagnostic radiology continues to be projected as a specialty of oversupply; therapeutic radiology is projected to be in near balance, as is nuclear medicine. The GMENAC aggregate-requirements estimates are thus revised upward from 466,000 to 473,000 full-time equivalent physicians for 1990, reducing the projected surplus from 15.0% to 13.3%.

Anesthesiology↗

Sports medicine in physical medicine and rehabilitation residency programs.

Because sports medicine is a rapidly expanding field within many specialties, it is important to gauge how active physiatrists have become in this arena. A nationwide survey of program directors and chief residents of physical medicine and rehabilitation residency programs was conducted to determine such prevalence. For the purposes of this study, sports medicine was defined as the routine care of athletes involved in organized sporting activities at any level of competition. Questionnaires were mailed to program directors and chief residents with response rates of 79.7% each. Overall, correlation of the answers between groups was high. The level of interest of residents was rated at 46%. Data was also obtained regarding research, clinical rotations, lectures, fellowships, association with academic departments of other specialties, and affiliations with professional sports medicine organizations. The actual level of educational opportunities available was much lower than might be expected given the high level of interest expressed. It is reasonable to conclude that more opportunities should exist for education in sports medicine.

Career Choice↗