Key words: Physical and Rehabilitation Medicine; physiatry; rehabilitation; Europe; organizational objectives.
J Rehabil Med 2010; 42: 1–3
Correspondence address: Franco Franchignoni, MD, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Via Revislate, 13, IT-28010 Veruno (NO), Italy. E-mail: firstname.lastname@example.org
Submitted September 25, 2009; accepted November 13, 2009
About 3 years ago, between the end of 2006 and January 2007, the White Book on Physical and Rehabilitation Medicine in Europe (WB-PRM-Europe) was published simultaneously and with open access in the Journal of Rehabilitation Medicine (JRM) (1) and Europa Medicophysica (2) (now the European Journal of Physical and Rehabilitation Medicine (EJPRM)). The two journals went to great efforts to publish the book rapidly and at no cost to the authors’ organizations. Moreover, they have recently produced, under the supervision of the original editors, a unified version (further checked for editorial inaccuracies and inconsistency) that is now available on the websites of both journals and can be used to prepare further translations of the book. The two journals, JRM and EJPRM, have found that WB-PRM-Europe has been cited frequently and that it has been used for background information and description of our specialty. We hope that this will continue and that the revised version now available on our websites will further support this. All authors of this Special Report strongly suggest, when citing the WB-PRM-Europe, that both sources are included as references (1, 2).
The WB-PRM-Europe is a comprehensive document, written to describe the specialty and the competencies of its members across Europe. It also aims to ensure that PRM is seen as a European specialty in which high-quality practitioners working to good standards of care can practise in accordance with the evidence base and within the context of their differing national practices. The book has been produced by means of an impressive collaboration among the main European bodies in the field of Physical and Rehabilitation Medicine (PRM) (3): the Union Européenne des Médecins Spécialistes (UEMS) Section of PRM, the UEMS Board of PRM, and the European Academy of Rehabilitation Medicine (EARM), in conjunction with the European Society of PRM (ESPRM). At present, JRM is the official journal of the UEMS Board of PRM, EARM and the International Society of Physical and Rehabilitation Medicine (ISPRM), and is published in association with ESPRM. EJPRM is the official journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), the Mediterranean Forum of Physical Medicine and Rehabilitation (MFPRM), the ESPRM, the Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP) and the Turkish Society of Physical Medicine and Rehabilitation Specialists (TSPRMS).
The WB-PRM-Europe had, and is having, a significant impact both inside and outside Europe (4–6), and the European PRM bodies are progressing in their joint efforts towards the goals described in the book.
We summarize here the most important results achieved by each PRM body in these last 3 years, within the context of the concepts and actions published in WB-PRM-Europe.
UEMS PRM Section AND Board
Over the last 3 years the following main activities of the UEMS PRM Section and Board have been carried out:
• the presentation and discussion of WB-PRM-Europe at several international and national events. One of the most important was the 50th anniversary of UEMS in Brussels in 2008. Translations of WB-PRM-Europe were made into several languages, under the terms of the License to Publish the White Book;
• publication of their Action Plan for 2008–2010 in EJPRM (7) and in the Annals of Physical and Rehabilitation Medicine (APRM) (8). The main topics are related to: education (Board) (9), quality of care (Clinical Affairs Committee) (10), and field of competence (Professional Practice Committee) (11);
• the creation of a structured programme of cooperation by the representatives of the 5 PRM journals who attended the General Assembly meeting in Cambridge, in spring 2009. The participating Editors-in-Chief were (in alphabetical order): G. Grimby (JRM), C. Marincek (International Journal of Rehabilitation Research), S. Negrini (EJPRM), A. Thevenon (APRM), together with G. Stucki who replaced U. Smolenski (Physikalische Medizin und Rehabilitationsmedizin, Kurortmedizin/Journal of Physical and Rehabilitation Medicine, Stuttgart). The journals that enter the agreement will undertake, amongst other tasks: the periodic publication of papers and news on the main activities of the UEMS PRM Section and Board; the definition of reduced subscription rates for PRM Board-certified colleagues; the immediate availability of free full text for the educational and professional material published; and free access to their e-version one year (or less) after publication;
• the start of cooperation with national PRM bodies. A cooperative agreement in the domains of education, quality of care and field of competence has already been signed by representatives (Presidents of the national PRM Societies and of academic and professional organizations) of some countries (France, Italy, Greece, Lithuania, Bulgaria). Contacts with many other countries are ongoing;
• the planning and implementation of 3 PRM eBooks (on education, quality of PRM programmes and field of competence, respectively), that will be available for open access in our website (www.euro-prm.org). On the same website, you can find a detailed description of the ongoing activities of the Committees of the Section and of the Board;
• the organization of specific sessions under the banner of the UEMS PRM Section and Board in international and national PRM congresses (5th World Congress of ISPRM in Istanbul, 16th European Congress of PRM in Bruges, the National PRM Congresses in France, Italy, Lithuania, Bulgaria, etc.);
• support for International Classification of Functioning, Disability and Health (ICF) initiatives and debate on issues related to its application in the field of PRM (12).
European Academy of Rehabilitation Medicine (EARM)
As from 1 January 2008 the EARM has been granted Participatory Status in the Conference of International Non-Governmental Organisations (INGOs) of the Council of Europe. The president of EARM participates in this conference, also on behalf of UEMS PRM Section and Board. EARM has made a survey of the international regulations regarding the Rights of Disabled People and Access to Rehabilitation. There are 3 important regulations:
• The European Commission has adopted “A Europe Action Plan for Equal Opportunities for people with disabilities” (http://europa.eu/legislation_summaries/employment_and_social_policy/disability_and_old_age/c11414_en.htm);
• the Council of Europe has published a recommendation Rec(2006)5 to promote the rights and full participation of people with disabilities in society (https://wcd.coe.int/ViewDoc.jsp?id=986865);
• the UN Convention on the Rights of Persons with Disabilities was adopted in 2006 (http://www.un.org/disabilities/). This convention needs to be ratified in all UN member states. EARM is trying to promote the ratification process in European member states.
Moreover, under the auspices of EARM a series of monographs on rehabilitation medicine and related subjects has been published. The subjects include: sphincter functions, rehabilitation of cancer patients, plasticity of motor function, vocational rehabilitation and functional assessment (http://www.aemr.eu/index.php?option=com_content&task=category§ionid=8&id=19&Itemid=44).
European Society of Physical and Rehabilitation Medicine (ESPRM)
WB-PRM-Europe is highly relevant, as PRM is the sector of medicine at the centre of the current rapid transformation in health and welfare. Demands are growing and there is a parallel growth in the scientific potential to modify disabilities that previously could not be treated with success, and to guide a global process for regaining a better state of well-being, autonomy and participation for all.
Research and clinical knowledge in our discipline offer increasing possibilities to better meet these demands. However, the need for collaboration in PRM is not only at the clinical level (the ICF bio-psycho-social model overcomes the fragmentation in organs, apparatuses etc., and the rehabilitation team combines the expertise of different healthcare professionals), but also in the long-term management plan (PRM is the medicine of the “person–environment interaction”) (13), for the shared “governance” of all therapeutic options aiming to obtain for our patients an optimal quality of life and whole-person functioning in the community, despite residual disability and the biological aspects of disease.
All this is the focus of the efforts of a young scientific medical society, such as ESPRM (www.esprm.net), using our clinical daily activities as a basis to increase our expertise, visibility, acceptance and support, and to communicate throughout Europe the common contents, standards, instruments and aims of our specialty (14–16).
WB-PRM-Europe is now the main tool for explaining to our colleagues how PRM is and should be interpreted, and for illustrating to other health professionals and the whole community how PRM may be utilized. WB-PRM-Europe describes a “gold standard” for our activities to fully respond to the needs of people with disabilities in the present European socio-economic context. Thus, the main activities of ESPRM have been to communicate its contents, to involve national societies and government bodies to apply them step by step, adapting them to the local cultural, legal or management conditions.
Disabled people’s associations are the partners, as well as other scientific societies (where they are willing to share our vision) (15). Scientific congresses and connections with journals and educational tools are our means of action. Thus, a common framework for PRM congresses has been proposed, developing tracks with respect to each of the distinct scientific fields in human functioning and rehabilitation research (16, 17). Moreover, ESPRM has formalized a relationship with European PRM journals that share its vision, envisioning a “web” of journals that collaborate to strengthen our specialty in Europe and internationally, increasing the visibility of European research and promoting its quality (18, 19).
Enabling the translation of WB-PRM-Europe into many European languages, facilitating its publication in national journals, and presenting and discussing its contents at many national and local meetings have been our main goals in this period. Thus, we have tried to reach all PRM doctors, all parts of the healthcare system, all stakeholders and policy-makers, and, we hope, the entire community too.
In this field, the main tasks for ESPRM can be summarized in a short quote I learned from our Master, Professor André Bardot: “We must work to know, to know how, to let all know”.
Overall, in the 3 years following the publication of the WB-PRM-Europe the main European PRM organizations have fostered continuous teamwork amongst themselves, each working in its main domain of reference within our specialty (UEMS PRM Section – Quality of Care and Fields of Competence; UEMS PRM Board – Education; European Academy of Rehabilitation Medicine – Ethics; European Society of Physical & Rehabilitation Medicine – Research), and at the same time sharing all these fields of activity with the other PRM bodies.
We are very proud of this strong and long-lasting working model among European PRM organizations and we are confident that this cooperation will increasingly facilitate the attainment of the goals (in education, research, clinical care, social participation and human rights) that WB-PRM-Europe lists on its final page as the core of our future activity.