October 2001

Editor's Message

By Kristen M. Pratt

The Subversion of Surprise
Shock and horror reverberate throughout the United States and the world right now as I sit writing this, just a few hours after the terrifying attack on the World Trade Center and the Pentagon. Few details are known at this time; only that attacks by four hijacked planes-two crashing into the Trade Center in New York, one into the Pentagon in Washington, DC, one crashing in Pennsylvania-have shattered the safety and security felt by the American people.

Soon, the reports will begin coming in on how many people were killed or injured. Miracles will happen as people are pulled from the rubble. Heroes will be recognized as they sacrifice their own safety for others. The health care systems in New York and Washington will be put to the test as their emergency departments are overwhelmed and their medical staff works around the clock.

There will be those who are severely injured; their lives changed for- ever by traumatic brain injuries, limb loss, and spinal cord injuries. Physical medicine and rehabilitation will offer its increasingly wide range of services, from physical and occupational therapy to assistive technology to vocational rehab, to get these people back to functioning in their lives. As these patients face their challenges physically, they will also deal with the emotional trauma that accompanies a tragedy such as this. I know that the rehabilitation professionals in New York and Washington-from Mt Sinai Medical Center to the National Rehabilitation Hospital-will rise to the occasion addressing both the broken bodies and the shattered spirits to give these special patients hope for the future.

In our news section on page 10, there is a story on the federal Office of Inspector General's latest report on the $1,500 therapy cap initiated by the Balanced Budget Act of 1997 and currently on moratorium, which concludes that the cap did not prevent Medicare patients from receiving "necessary and appropriate therapy." The American Occupational Therapy Association refutes the data as I am sure other national rehabilitation organizations will do also.

In the interview with Jules M. Rothstein, PhD, PT, FAPTA (page 20), an icon in the physical therapy field, he predicts the following, "As the Baby Boomer generation ages and begins to heavily tax the health care system to the point that resources severely shrink, the profession of physical therapy will be vulnerable to massive cutbacks."

We must not rest on our laurels. Rehab as a whole must look into the future and anticipate threats to the provision of quality services. Only with preparation will we be ready for the fight.

As the nation looks on, rehabilitation will shine in this dire hour. The field will begin to help the severely injured put their lives back together. The health and vitality of physical medicine and rehab must continue. Keep in touch with your national organizations; put your ear to the pulse of the political process that affects funding for your specialty. As we have seen, the element of surprise can be devastating.

—Kristen Pratt Machado is no longer Editor of Rehab Management. Please address any correspondence to Sarah Schmelling, Senior Editor, at cwolski@medpubs.com.

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