Rehabilitation is a medical discipline which is needed wherever people
have lost full functionality, and it is needed increasingly in noncommunicable
diseases, such as neurological problems, but also, and perhaps more
importantly, in middle- and high-income countries, where populations are
growing more aged. The burden is borne by the health care systems, especially
where family cannot take the full load of care. Rehabilitation is also a
discipline which is carried out most effectively in multi- or interdisciplinary
teams, which carry their own weight of learning and group tensions. They are
also bound to consider best practice guidelines. Furthermore, there is also a
wide gap between learning in college or university and practice in the ward
which leads to a loss of confidence in newly trained medical and paramedical
personnel such as doctors, nurses, physiatrists, occupational therapists and
physiotherapists. There is a genuine need for expert rehabilitation specialists
who can mediate within teams as well as between groups and patients and their
families. This paper lays out the range of considerations such a rehabilitation
therapist must have under their belt. A model is presented. There are also two
sets of parameters when using the model in practice. The first is the levels at
which it works: hospital, departmental and
individual. Then there are the specific challenges. Curriculum practice
guidelines work at the hospital and departmental and professional levels;
teamwork with its intrinsic challenges is of paramount importance; finally, the
individuals will learn how to represent their insights in writing, most
specifically represented in full-blown case reports. If the levels and roles
coordinate, rehabilitation medicine should develop favourably.
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