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History of my specialty

A Brief History of the Establishment of the Specialty of PM&R

Physical Medicine

Dr. Frank Krusen, a Philadelphia physician who began his training with a surgical career in mind, contracted tuberculosis during medical school at Jefferson Medical College in 1922. After his recovery, he began to research the uses of physical medicine and soon made it his career. Krusen established a program in physical therapy and an inpatient rehabilitation unit at Temple University in 1929. In 1936, Dr. Krusen moved to the Mayo Clinic and developed a department of physical medicine and the field’s first United States residency training program.
The American College of Radiology and Physiotherapy, later the American Congress of Rehabilitation Medicine (ACRM), was founded in 1923. The membership included physical therapy physicians (the term for physiatrists at that time), physiotherapists, and radiologists. But the physical therapy physicians found themselves with different interests and concerns than their colleagues and eventually began to promote physical medicine as a medical specialty. 
The American Society of Physical Therapy Physicians, the organization that became the American Academy of Physical Medicine and Rehabilitation (AAPM&R), was founded in 1938. The same year, Dr. Frank Krusen proposed the term “physiatrist” to identify a physician specializing in physical medicine. To avoid confusion with psychiatry, he proposed a pronunciation with emphasis on the third syllable. (Today, physiatrists use both pronunciations.) The organization appointed Mayo Clinic physiatrist Walter Zeiter, MD, the executive director, and Northwestern University physiatrist John Coulter, MD, the first president.

Rehabilitation Medicine 

The United States entered the Second World War in 1941. Physical and rehabilitation medicine treatments had already been established in the First World War, and even before. However, as injured soldiers returned home, veterans and civilian hospitals and clinics began using these same wartime techniques and practices. Rehabilitation medicine utilized not just physical medicine approaches, but also multidisciplinary interventions and medications with the goal of restoration of a person’s function after injury or illness. Rehabilitation teams treated patients in inpatient and outpatient settings, and physiatrists further developed their leadership roles.
Bernard Baruch, financier, philanthropist, and advisor to Franklin Delano Roosevelt and other U.S. Presidents, established the Baruch Committee in 1944 to further develop the field of PM&R. He wished to honor his father, Simon Baruch, a Civil War surgeon and general practitioner. Simon Baruch promoted the use of physical medicine techniques and researched hydrology after the War in New York City. Simon Baruch was also a medical journalist and public health advocate. He was responsible for the establishment of free public baths in New York City and other U.S. cities at the turn of the 20^th century.
The Baruch Committee issued recommendations for the establishment of PM&R teaching and research centers in medical schools, fellowships and residency programs, and advocated for wartime and post-war clinical rehabilitation programs. The Baruch Committee also strongly argued for the establishment of a certifying board for the new medical specialty.
As the Second World War was ending, organized medicine began to accept the field of PM&R as a medical specialty. The AMA established the Section on PM&R in 1945. Baruch’s philanthropy and the work of early pioneering physiatrists were crucial ingredients for the birth and development of PM&R as a respected academic field of medicine. By 1946, 25 hospitals had residency and fellowship training programs in PM&R. The Baruch awards at 12 universities bolstered the PM&R with training and research funding for physiatrists such as Arthur Watkins (Harvard University), Robert Darling (Columbia University), and Frances Hellebrandt (Virginia Commonwealth University).
Drs. Howard Rusk and John Coulter were among a group of prominent physiatrists who served in leadership positions during World War II. The Rusk Institute at New York University became a model for the field’s expansion across the nation after the War. Rusk achieved international recognition not only as a physician but as a journalist, radio broadcaster, and a public health advocate. His international work, including for the United Nations, helped to advance the field beyond the U.S. borders. Before the War, Coulter had established a physical therapy program in the orthopedics department at Northwestern University’s school of medicine. After the War, Coulter continued his work with other physicians in industrial medicine and orthopedics in Chicago, laying the foundation for the development of the field in the Midwest.