Résumé
The objectives of this paper are to help specialists in Physical and Rehabilitation Medicine plan their careers, influence the future of the PRM specialty and advocate effectively for those with limitations of functioning. The experiences of the authors are the sources of its observations and suggestions. The senior author has had extensive national and international experience in the specialty as a clinician, teacher, researcher, manager, leader and advocate. The junior author adds the insights of one who only recently has become immersed in PRM. The following are suggestions and observations the authors believe could contribute to the future success of individual PRM specialists and the PRM specialty. ①Review and reinforce the significant accomplishments of PRM over the last 70 years. It has significantly expanded the focus of health care to include the importance of functioning. ②Identify the specialty's current strengths, weaknesses, threats and opportunities. As a clinical specialty, it has expanded nationally and internationally, yet its research contributions remain limited. The absence of an evidence base for much of its activity risks reduced support from payers, yet the population needing its services continues to expand. ③Develop strategies to increase the ability of PRM specialists and PRM to improve the lives of people with or likely to have limitations of functioning. These strategies could include sharing best practices, supporting effectiveness research and developing expert consensus guidelines. The need for physicians who are experts in the strategies of improving the lives of those with complex problems of functioning will continue to expand. This need will assure the continuation of the specialty of PRM as long as it improves the abilities of its members to help those with problems of functioning, and it advocates for those whom its members serve.
Résumé
Por meio da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), a Organização Mundial de Saúde (OMS) preparou o terreno para uma compreensão abrangente da Pesquisa em Funcionalidade Humana e Reabilitação que integra a perspectiva biomédica da deficiência ao modelo social da incapacidade. Esta nova compreensão introduz uma série de desafios novos e antigos relacionados ao aprimoramento da capacidade de pesquisa adequada. Resumiremos aqui abordagens que procuraram dar conta destes desafios em relação a três áreas: a organização da Pesquisa em Reabilitação e Funcionalidade Humana em áreas científicas distintas, o desenvolvimento de programas acadêmicos de treinamento adequados e a estruturação de centros universitários e redes de cooperação.