Visionary Leadership in Burn Rehabilitation Over 50 Years: Major Accomplishments, but Mission Unfulfilled

Examples of the application of rehabilitation concepts to the care of patients with major burn injuries began to emerge in the 1960s. Before this time, mortality was so high that there was no significant focus on any outcomes beyond survival. Several physical medicine and rehabilitation (PM&R) physicians led this change in perspective by simply beginning to care for patients and by presenting information gleaned from clinical experience and research at national conferences. The authors of a textbook on rehabilitation issues after burn injury, along with a small group of forward-thinking physiatrists and surgeons, provided the impetus for the expansion of burn rehabilitation medicine in the late 1980s and early 1990s. The change in the major burn journal’s’ title to include “rehabilitation” also was a landmark event. As is often the case, the publication of a seminal textbook or the creation or expansion of a journal’s mission becomes a tipping point for a medical specialty in terms of recognition by other specialties and the public. These activities finally brought to the fore the concepts of quality of life and functional recovery after burn injury. Today, physical and occupational therapy services, ideally accompanied by PM&R leadership and clinical practice innovations, are a mainstay of care after a burn injury. However, despite the advances, more efforts to expand the field through addressing workforce issues and research will be required to benefit all patients in need of burn rehabilitation.