Provider: Silverchair
Database: AmericanMedicalAssociation
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TY  - JOUR
T1  - Rehabilitation
PY  - 2024
Y1  - 2024/04/25
DO  - 10.1001/jama.2023.18291
JO  - JAMA
JA  - JAMA
SN  - 0098-7484
AB  - The family physician, after seeing a patient through the acute stages of an illness and subsequent convalescence, watched him until his ultimate return to work. The patient, usually stimulated by the daily needs of life on the farm and in the home, was chiefly interested in regaining his former place in his society. As he recuperated, he could make himself useful in many simple tasks. Gradually more difficult and strenuous skills would be regained. The relationship of the family physician to the home was sufficiently direct to permit him to help substantially in the process.Now, however, and especially in cities, the family physician can no longer help effectively in this rehabilitative phase of medical care. Many people live almost monastically in apartments like cubicles. From the hospital the inmate returns to this cell, where his metabolism can be described in terms like those used by the cytologist in describing the life processes of an erythroblast. Materials to be metabolized are delivered to the service door by the smoothly flowing circulatory system of the metropolis, and the products of this metabolism disappear down chutes, drains and pipes. Of visible motion there is none. The activities of this cell are paradoxically not active, but passive; they consist of looking at papers, listening to radios and watching television. A patient returning to such an environment from a hospital is not stimulated. He has been looking at papers, listening to radios and watching television in the hospital, too. If he gains strength, he may go out to theaters and stadiums, where he will hear and see more of the same thing in the same passive way. Little incentive develops for regaining useful skills. Seldom are there facilities for use by the patient in preparing to resume his former occupation. The physicians who may have served the patient well during the phases of his recovery in the hospital can do little or nothing for him during the rehabilitative phase.
Y2  - 5/20/2024
UR  - https://doi.org/10.1001/jama.2023.18291
ER  -