“Rehabilitation … A Key Word in Medicine”: The Legacy of Dr. Frank H. Krusen

• DOI: 10.1016/j.pmrj.2013.02.001
• Publication Date: 2013-03-16T03:20:32Z
• Authors: Carolyn L. Kinney; Robert DePompolo
• Keywords: Specialty; Surprise; Value (mathematics)

Most physiatrists recognize Frank H. Krusen, MD, as an early pioneer in the establishment of physical medicine and rehabilitation (PM&R) a medical specialty also “the father medicine” (Figure 1). Some remember his scholarly contributions, most notably through numerous contributions to literature on use therapeutic modalities medicine, foundational textbook, Physical Medicine, published 1941, subsequently titled, Krusen's Handbook Medicine Rehabilitation (the 4th last edition was 1990) 1]. Few physiatrists, however, fully appreciate other enduring field PM&R. His prescient vision focused education, research, collaboration with colleagues services, framework for professional activities that remains relevant PM&R 21st century. Krusen chairman Mayo & Rehabilitation. Hammond born Philadelphia, Pennsylvania, 1898. professor obstetrics gynecology at Jefferson Medical College who served director public health Philadelphia. mother practicing Quaker, young grew up family prized education instilled him value service community. Therefore, it no surprise chose career and, when he graduated from 1921 2), pursued further training general surgery [2]. circa 1921. trajectory deviated predictable course diagnosed pulmonary tuberculosis during surgical residency training. Forced withdraw training, spent 5 months Cresson Tuberculosis Sanitorium central Pennsylvania [3]. would say this experience “rest cure” “fresh air” used treating time stimulated interest agents medicine. judged unable continue because vulnerability ether fumes [4]. In any case, well enough return changed path branch just beginning develop United States. After returning Philadelphia age 28 years, appointed associate dean Temple University School 1926. Although certainly honor, particularly 28, Temple's school struggling institution. Labeled “embryonic” Flexner Report 1910, critical survey American schools sponsored by Association (AMA), provided opportunity demonstrate innate leadership ability, quickly developed organizational political skills improve school's rating 3). He required 2 years raise necessary funds build new school, overhaul curriculum, establish clinical clerkships, garner “Type A” AMA Dr. 1931 School. Reproduced courtesy Libraries. continued studies therapy foreseeing application knowledge broad array conditions. extensively treatment. advocate using techniques injured athletes became team physician football team, first “sports physiatrist [2] 4). Athletic Council meeting, 1935. Courtesy University. 2nd right. 1928, efforts were rewarded established country's academic department [5]. set standards publishing curriculum Journal Colleges 1930 [6]. 1935, arose expand chair Section Therapy Clinic. Actually, roots Clinic started 1911, 25 before arrived, head Orthopedic Surgery, Melvin S. Henderson, physiotherapy services postoperative orthopedic patients. By 1918, Physiotherapy formed within orthopedics. 1921, concurrent these events, members Social Services Department occupation recognition need avocational, vocational, community reintegration interventions Also, 1923-1924, another developed, Arthur Desjardins, Radiology, treatment tissue healing using, example, high-frequency diathermy, hydrotherapy, electrotherapy. As could be predicted, tension between groups, misunderstandings brewed nearly decade. Over time, neither departments had or supervising practices. Thus, stage recruiting leader developing area centered With all parties agreeing independent section, arrived 28-year Clinic, where major accomplishments [7]. The integrated group practice model proved ideal environment Within 7 successfully various components under one section. staff mere 18 108 people, increase 83% patient population received [8]. Clinic's 1938 5), 54 students each class, program has trained thousands therapists over past 75 years. (front row, far right) class students. skillful educational formats bring people together collaboration. initial rotating residents specialties evolved into nation's 3-year resident 1936. Earl Elkins, MD 6), Robert Bennett, [9], pioneers PM&R, graduates. since hundreds fellows. Elkins late 1930s. Statements diary suggest is likely unique facilitated number ways. It fostered centralize leader, found support grow departments, including surgery, radiology, internal intellectual, organizational, interpersonal their perfect expression resulted gaining needed visibility internationally known “Rehabilitation key word medicine,” predicted William 1925 [10]. Years later, nephew, Charles commented, “My uncle made prediction … ten later brought Rochester, Minnesota, who, perhaps more than individual, helped make come true” [11]. 1938, included following comments personal journal Clinic: “As relationship been satisfactory our standpoint. every endeavor, there certain amount passive resistance its development; less apparent institution which I have connected. feeling cordial cooperation exists throughout never-ending source pleasure” (internal document, MN). realized growth ongoing commitment proponent outcome evidence-based practice. output abundant, publication 400 scientific articles many textbooks [12]. best work modalities, 100 topical area. 1930s, modality fever therapy, shortwave heat lamps, colonic irrigation, radiotherapy. 1940s, diathermy but added ultraviolet, infrared, atomic energy. 1950s, multiple ultrasound plus microwave electrical stimulation articles. main focus, 1930s industrial followed 1950s disabled workers health. During World War II shortly after, several States defense programs. Later career, stressed important role should play hospital outpatient settings, offered commentary future broader successes administration, research are impressive enough, what recognized about nationally played establishing Board Specialties. addition, joined John Stanley Coulter others Congress Therapy, president, involved effort Academy Physicians, organization 1955. therefore, worked decades [13]. supported strategic alliance wealthy influential philanthropist M. Bernard Baruch 7) formation Committee, large grants centers create programs country. eventually codified Specialties 1947. elected 8) certificate granted Coulter, pioneering field. Certificate No. Mr. (right) (left), October 18, 1950, MN. Photograph original September Front, seated left right, Richard N. Kovacs, MD; Lt. Col. Ben R. Strickland; L. MD. Back, Kristin G. Hanson, Watkins, Leonard Huddleston, Otto Schmidt, Ewerhardt, Walter J. Zeiter, entry reflects long road achievement. “I feel must record point my extreme gratification concerning Medicine. all, culmination eighteen now look back diary, realize privilege participating contributing toward birth specialty. hard me put words feelings realization fact fight won labor specialty, train field, practice, teaching finally proper organized whole” 1948, Howard Rusk, widely acknowledged pushed introduce “rehabilitation” better emphasize holistic aspect care range diagnoses. This view government veterans, whom physicians short supply. agreement Rusk worried “rehabilitation absorb “physical component. expressed fuse editorial Archives Medicine: “It obvious close relationships recognized. While special can other, interconnections indicated. There phases (as definitive acute diseases agents) cannot called rehabilitation. Similarly psychosocial readjustment persons) Yet, part, closely interdigitated illogical either go separate way” [14]. extensive discussions, board name 1950. Whether curse blessing, term “physiatrist” credited given specialized 1940s. To day, periodic discussions both conferred practitioners (including pronunciation). might said, acknowledgement wisdom leaders, option surfaced then. saw continuing increasingly devoting defending groups intent limiting scope respect concept culminated compromise arbitration committee meeting 1955, retention certifying board, while dropping only structure councils [15]. addition focus national scale. 1959, tasked working Office Vocational Washington, DC, direction Mary Switzer, administrator shaped 1954 Act, legislation greatly expanded disabilities. [16]. 1958, stepped down chair. asked assume Sister Kenny Foundation Minneapolis, experienced financial difficulties. From 1959-1963, once again diplomacy help save insolvency, secure programs, restore institution's image. On completion mission, retired position returned There, founded 1929 prominence again. 1968, sights Boston, moving third department, Tufts–New England Center. 1969 moved Cape Cod, died 1973 year death, Lifetime Achievement Award honor him. Academy's fourth recipient award bears name. Rehabilitation's highest recipients gold medallion selected basis outstanding areas care, administration difficult overstate impact Without vision, perseverance, astuteness, not A very plausible alternative 1940s subsumed umbrella visionary recognizing though body accredited underpinned increasing productivity. practiced preached 3 countless physicians, went become leaders researchers. Perhaps legacy rendered millions patients board-certified numbering 10,000, 77 [17, 18]. Through leadership, highly productive institutions, fulfilled Mayo.