The Future of Physiatry: With Challenges Come Opportunities

“What does the future of physiatry look like?” The answer is certainly multifaceted and dependent on the context in which it is being asked: economical, clinical, technological, educational, and so forth. Young medical students considering a physical medicine and rehabilitation (PM&R) residency and current PM&R residents are particularly interested and possibly wary about physiatry’s future. In 2006, Gans [1] warned about trends that would potentially impact this specialty. More recently, with health care reform and other political factors impacting the practice of medicine as a whole, the positioning of the specialty of PM&R within the health care milieu has been more closely analyzed [2]. But, with challenges come opportunities. From within the diversity of our specialty, common themes and focus (ie, function and quality of life) should serve us well as we navigate through a changing landscape of health care delivery. My first involvement with organized physiatry was at an American Academy of Physical Medicine and Rehabilitation (AAPM&R) Annual Assembly as a medical student. A resident I met during one of my rotations encouraged me to attend the annual assembly and even offered to share her room with me. I clearly remember that my initial feeling of intimidation changed to one of awe and comfort, as physiatrists from all over the country freely gave me advice and shared their experiences with me. I was hooked. During residency, I was honored to move up within the Resident Physician Council, starting as a bylaws committee member and eventually serving as president. This experience afforded me the opportunity to be mentored by some of the greatest leaders in the field while learning about “big picture” issues that continue to impact physiatry. From my current perspective as the chairperson of the AAPM&R Membership Committee, I have observed an increased bond and pride among physiatrists recently, which I find particularly heartening and which I believe bodes well for physiatry in the future. In this position, and as president of the Resident Physician Council, I also have had the opportunity to participate in the growth and evolution of AAPM&R, beginning with the revision of AAPM&R’s mission statement and the formulation of our strategic plan and objectives. This allows the board of governors to systematically assess proposals and opportunities while minimizing the influence of innate biases and personal agendas. The AAPM&R has changed tremendously in the past 5 years, and, although change was initially met with skepticism, we are definitely better equipped to handle some of the changes coming our way. Our educational offerings have improved, both in terms of relevance and quality. This journal, PM&R, has rapidly become a frequently cited and useful resource for the practicing physiatrist. There is more communication among members and more opportunities for growth, collaboration, and leadership within the AAPM&R. I have not missed an annual assembly since the year I attended as a medical student, watching the changing landscape of physiatry, while realizing the timelessness of common physiatric principles, and emphasis on the importance of patient care and advocacy. This was clearly evident in the standing-room only capacity during the presidential address at the 2010 AAPM&R Annual Assembly in Seattle, where Elizabeth Sandel, MD, shared a video montage of her oral history interviews with physiatrists from across the country and the world. There were common threads identified in the stories recounted by the featured physiatrists, including mentoring and the desire and ability to “build.” This sense of pride continued during the address by Stanley Herring, MD, on sports concussion, and the tragic story and strategy behind the passage of the Zackery Lystedt Law (serving to minimize the chances of catastrophic consequences of brain injuries in student athletes). These moments