Volume 85, Issue 4 , Page 687, April 2004
Disability and iatrogenic illness
Article Outline
In the January issue, Batavia and Batavia1 encourage the study of iatrogenic illness secondary to, among other things, the delivery of too much care. I thank them for their thoughts and would like to suggest adding to the definition of “iatrogenic illness” 2 additional postulates not mentioned in their discussion.
One, the reinforcement of the “disabled” concept. In individuals, particularly those patients with myofascial pain, the excess use of diagnostic testing, physical therapy, medications, and leave from work not only may result in actual injury to the patient with drug reactions, narcotic dependence, etc, but also reinforce the patient’s belief that he/she has a crippling disease.
Two, the inability of professionals, even those in the rehabilitation field, to call a halt to fruitless interventions in severely disabled patients who have long passed the ability to make functional gains. One thinks of the low-functioning traumatic brain injury patient who continues to receive occupational, physical, and speech therapies and other services literally for years, with family members holding out hopes that the additional motion of a toe or a finger would mean a return to function of their loved ones. How cruel for the family, and how much waste and abuse of precious resources for our fragile and fractured health care delivery system because the treating physician cannot say no, or the legal system has insisted.
The Foundation for Physical Medicine and Rehabilitation is organizing a Research Summit, to be held in spring 2005, that will promote research productivity in medical rehabilitation. Issues such as those raised by this article need to be addressed for our field to better use its resources and justify what we do to the people who pay the bills.
Acknowledgements
Wolfe is currently the president of the American Academy of Physical Medicine and Rehabilitation, which established the Foundation for Physical Medicine and Rehabilitation, and she serves on the Foundation’s board of governors
References
PII: S0003-9993(04)00166-2
doi:10.1016/j.apmr.2004.01.014
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Volume 85, Issue 4 , Page 687, April 2004
