3.1 Physical and rehabilitation medicine: Clinical scope – Definition and basic competencies

defInItIons In coincidence with the conceptual description of rehabilitation as a health strategy (see chapter 2.1), physical and rehabilitation medicine (PRM) has been described as the medical specialty that uses rehabilitation as its core health strategy and therefore follows the overall goal to enable persons with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment.[1] To reach this goal, PRM physicians have to diagnose health conditions taking into account the International Classification of Diseases, assesses functioning in relation to health conditions, personal and environmental factors and perform, and apply and/or prescribe biomedical and technological interventions.[1] PRM core competencies also include to lead and coordinate (complex) intervention programs that should be performed as a patient-centered problem-solving process and as a partnership between the person and provider and in appreciation of the person’s perception of his or her position in life. Such interventions programs besides physical medicine interventions mostly include psychological and behavioral, educational and counseling, occupational and vocational, social and supportive, and physical environmental interventions. PRM physicians are trained to deliver health-related rehabilitation over the course of a health condition (in acute, postacute, long-term, and progressive phases), for all age groups and in various settings (including hospitals, rehabilitation facilities, and the community) and across sectors (including health, education, labor, and social affairs). In addition, training in PRM also includes skills to provide education to patients and relatives to promote functioning and health, to manage rehabilitation, health, and multi-sectoral services and to inform and advise the public and decision-makers about suitable policies and programs.[1] Another definition of the specialty has been proposed by the European Alliance of PRM Bodies.[2] It reads as follows: “PRM is the primary medical specialty responsible for the prevention, medical diagnosis, treatment, and rehabilitation management of persons of all ages with disabling health conditions and their comorbidities, specifically addressing their impairments and activity limitations in order to facilitate their physical and cognitive functioning (including behaviour), participation (including quality of life), and modifying personal and environmental factors.”