A Conversation Between Past and Present Chairs of the American Board of Physical Medicine and Rehabilitation: Four Decades of History and the Future of Board Certification.

ABSTRACT: On the 75th anniversary of the founding of the American Board of Physical Medicine and Rehabilitation, 11 of the surviving chairs of the board convened virtually to reflect on the past 40 years of major trends for the accrediting body of physiatrists. The field rapidly expanded in the 1980s, driven by changes in the reimbursement environment. This rapid expansion drove an improvement in the caliber of residents choosing the field and in the quality of training programs. As physical medicine and rehabilitation evolved from a small- to medium-sized specialty, the board addressed many challenges: securing a credible position within the American Board of Medical Specialties; addressing a rising demand for subspecialty certification; improving training and exposure to physiatry; enhancing the quality of the accreditation process; and reducing the burden of accreditation on diplomates. The future development of physiatry includes improving diversity, equity, and inclusion, while restoring provider morale, well-being, and meaningfulness in work. Although challenges remain, physiatry as a field has grown to be well established through the board's efforts and respected within the larger medical community.

Assessing the impact of musculoskeletal health conditions using the International Classification of Functioning, Disability and Health.

PURPOSE: To propose the joint use of the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) and to illustrate this proposal using musculoskeletal (MSK) conditions. METHOD: In light of the MSK conditions as classified in the ICD, categories from existing ICF core sets for MSK conditions were pooled to specify functioning. Another approach was to consider other categories from measures or instruments already linked in the literature. RESULTS: ICF Categories have been pooled from six core sets for MSK conditions, two specific care settings, one MSK clinical trial setting and eight instrument linkage papers. CONCLUSIONS: The ICD-ICF joint use would be able to capture the impact of a health condition by taking into account the disease and functioning status which would facilitate clinical care. Therefore, there is reasonable ground to demonstrate the operational linkage and complementary role of the ICD and the ICF in the context of the ICD revision.

Standards of care for acute and chronic musculoskeletal pain: the Bone and Joint Decade (2000-2010).

Musculoskeletal conditions often manifest with the onset of pain and the resulting physical limitations. Musculoskeletal pain is almost inevitable in an individual's lifetime. It is one of the most common reasons for self-medication and entry into the health care system. Musculoskeletal pain affects 1 in 4 adults and is the most common source of serious long-term pain and physical disability. The monumental impact of musculoskeletal conditions is now recognized by the United Nations, the World Health Organization, World Bank, and numerous governments throughout the world through support of the Bone and Joint Decade 2000 to 2010 initiative. Individuals with musculoskeletal pain concerns are regularly ignored, their complaints often misunderstood by health care providers, and accordingly they do not receive timely or effective treatment. The standards of care in this document are designed to provide generic guidelines for appropriate care of people with acute or chronic musculoskeletal pain. This document was developed over a 4-year period using multiple international meetings and a Task Force of the Bone and Joint Decade for developing international standards for the care of acute and chronic musculoskeletal pain. The final document is a product of the World Health Organization Collaborating Centre for Evidence-Based Health Care in Musculoskeletal Disorders.

The Walter J. Zeiter lecture. Global initiatives in rehabilitation medicine.

Global initiatives in rehabilitation medicine. Global initiatives in rehabilitation medicine present significant challenges, as well as great opportunities for the field of physical medicine and rehabilitation. These initiatives are international in focus, from multiple countries, include many different medical specialties, and will impact physiatrists. The Bone and Joint Decade is a global multidisciplinary initiative that aims to reduce the burden of musculoskeletal disorders. Its aim is to improve the health-related quality of life of people with or at risk of musculoskeletal disorders. The International Classification of Functioning, Disability and Health (ICF) is a unified and standard classification system for describing health domains and health-related states with quantifiable assessment measures. The ICF is a significant change from current medical models to patient- and rehabilitation-oriented models of evaluating function, disability, and health status. Medical Professionalism in the New Millennium: A Physician Charter helps define medicines contract with society. The demand for medical professionalism is the result of unparalleled challenges facing the physician on a daily basis. The Physician Charter provides a reaffirmation of the Hippocratic oath in modern terms. The Maintenance of Certification is a response of organized medicine to the demand for physician competence during an entire career. This is a means of establishing safeguards to protect the public and of delivering a criterion standard for health care. These initiatives will have a profound influence on our future. I encourage each of you to participate in your own future through these activities.

Rehabilitation of landmine victims--the ultimate challenge.

Antipersonnel landmines are often used indiscriminately and frequently result in injury or death of non-combatants. In the last 65 years, over 110 million mines have been spread throughout the world into an estimated 70 countries. Landmine victims use a disproportionately high amount of medical resources; the vast majority of incidents occur in regions and countries without a sophisticated medical infrastructure and with limited resources, where rehabilitation is difficult in the best of circumstances. It is suggested that only a quarter of the patients with amputation secondary to landmines receive appropriate care.