Frank Krusen established the first Department of Physical Medicine in Philadelphia in 1929. He and other pioneers, such as Miland Knapp, Howard Rusk, and Earl Elkins, created a specialty that emphasized rehabilitation of chronically disabled patients rather than treatment of disease as such.1,2 Early neglect of disabling injuries and illnesses is far more costly both in money and in misery than an early aggressive program of rehabilitation designed to restore the person to the highest level of physical, economic, social, and emotional self-sufficiency.3
Physical medicine and rehabilitation is in part a service specialty that helps physicians in other specialties to design patient programs that will relieve pain and contractures and improve strength, as well as to design prostheses, orthoses, ambulation aids, and adaptive equipment and programs for bowel, bladder, and skin care. It is also a primary care specialty for persons with chronic catastrophic disabilities. The specialist in