The state of physical medicine: ‘Making America Healthy Again, we've been doing that’

Physical medicine and rehabilitation has long embraced the holistic, function-focused philosophy at the heart of the Make America Healthy Again initiative — emphasizing movement, exercise, diet and patients' broader living environments as central to recovery and wellness — making the specialty a natural fit for the national conversation rather than a latecomer to it. John C. Cianca, M.D., FAAPMR, president of the American Academy of Physical Medicine and Rehabilitation, notes that what is now being promoted as "lifestyle medicine," a growing field focused on health behaviors and environment, is something physiatrists have practiced as a matter of clinical necessity throughout their careers.

Medical Economics: In our country right now, under the current administration, there is an initiative to Make America Healthy Again. How do you think physical medicine and rehabilitation as a specialty contributes to that national initiative?

John C. Cianca, M.D., FAAPMR: It's not news to us. That's the way we've been going all along, and it's sort of by necessity, right? When you're dealing with somebody's function, not their broken bone or not their brain bleed, but the results of that, you have to very quickly understand their environment and how to make things work, both from their internal locus as well as the external locus. We have long done work outside of the hospital with people, sending them home on a weekend to get into their adaptive apartment so that they can then be ready to go to their own apartment or home in a more safe and functional way. I think Making America Healthy Again, we've been doing that. I mean, we've all long recognized the need for movement and exercise as being central to care, central to health. And the addition of diet probably is something that may be relatively new to my field, but it's not really. I mean, I think we've always had that outward facing view on how to help people adapt and be able to thrive. It's just something that is part of the way we thought and the part of the way we delivered care. It wasn't isolated, it wasn't so narrow and focused. Rather, it's more about their big picture, and to me, that's why I think we've always been effective. One of my colleagues said to me about the area of lifestyle medicine, which is a burgeoning field. She was encouraging me to get involved, and then she said, well, but you've already been doing this anyway. Which is true, it's just something that we do, sort of by way of our training, but also the problems that we have to treat. It demands that outward focus.