Current research funding methods dumb down health care and rehabilitation for disabled people and aging population: a call for a change.

Health care systems in Western societies are faced with two major challenges: aging populations and the growing burden of chronic conditions. This translates into more persons with disabilities and the need for more Physical and Rehabilitation Medicine (PRM) services. We raise the point of how these emerging needs are faced by the actual research funding. We briefly present the results of an analysis we made about research funding by the Italian National Health Service as an interesting case study, since it relates to Italy (the financer) and the United States, where National Institutes of Health (NIH) reviewers were identified according to their classification of research topics. The topics of potentially greatest interest for aging Western societies, like chronicity, disability and rehabilitation, were among those least often funded and considered in the traditional method of financing research projects. These results could be based on those PRM peculiarities that make the specialty different from all other classical biomedical specialties, namely the bio-psycho-social approach and its specific research methodologies. Moreover, PRM researchers are spread among the different topics as usually classified, and it is probable that PRM projects are judged by non-PRM reviewers. There are at least two possible ways in which research can be better placed to meet the emerging needs of Western societies (chronicity, disability and consequently also rehabilitation). One is to create specific keywords on these topics so as to improve the match between researchers and reviewers; the second is to allocate specific funds to research in these areas. In fact, the not coherence between emerging needs and research priorities have already been periodically addressed in the past with specific "political" and/or "social" initiatives, when researchers were forced to respond to new emergencies: some historical examples include cancer or HIV and viral diseases or the recent Ebola outbreak.

Prospectives and retrospectives: a glimpse of the future of physiatry

Brevemente se ha presentado un vistazo hacia el futuro cercano y lejano de la Medicina Física y el Fisiatra. Siempre habrá una gran cantidad de pacientes envejecientes, crónicamente enfermos, impedidos, incapacitados y con limitaciones. El cuidado a pacientes cambiará constantemente para incorporar adelantos en a tecnología biomédica y de rehabilitación como también por restricciones por control de costos. Los derechos humanos prevalecerán no sólo por razones humanitarias, sino porque los ciudadanos con limitaciones se unirán y cabildearán en las legislaturas para aprobar leyes que mejorarán l calidad de sus vidas