appropriate modes of preventive intervention. The longitudinal care described in this report is sometimes provided by specialists in physical medicine and rehabilitation, but most typically it will be provided by general internists, family physicians, psychiatrists, psychologists, social workers, and others. Any long-term strategy must address the education of a broad range of these professionals as part of a national agenda for the prevention of disability.
RECOMMENDATION 23: Upgrade medical education and training of physicians
Medical school curricula and pediatric, general internal medicine, geriatric, and family medicine residency training for medical professionals should include curricular material in physical medicine, rehabilitation, and mental health. In addition, such curricula should address physiatric principles and practices appropriate to the identification of potentially disabling conditions of acute illness and injury. Appropriate interventions, including consultation and collaboration with mental health and allied health professionals, social workers, and educational specialists, and the application of effective clinical protocols should also be included.
RECOMMENDATION 24: Upgrade the training of allied professionals
Allied health, public health, and other professionals interested in disability issues (e.g., social workers, educational specialists) should be trained in the principles and practices of disability prevention, treatment planning, and rehabilitation, including psychosocial and vocational rehabilitation.
People with disabilities and their families, personal attendants, and advocates should be better informed about the principles of disability prevention. Such education would contribute significantly to the prevention of disability and secondary conditions—those brought about by poor self-care as well as those induced by a lack of needed social and other support services, architectural inaccessibility, unequal educational and employment opportunities, negative attitudes toward disability, changes in living environments, and greater exposure to disruptive, frustrating events.
Independent living centers, which are controlled and staffed by persons with disabilities, are designed to deal with the prevention of secondary conditions and to be a source of information on the practical aspects of daily living with a disability. Because these centers are usually staffed by persons with disabilities who are living independently, they offer advice based on first-hand experience of the motivation and ingenuity needed to