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CONVALESCENCE, DISABILITY, AND REHABILITATION At a meeting of a local Committee on Trauma of the American College of Surgeons, a theoretical problem was presented to approximately 50 distinguished surgeons as to when a young man should resume heavy labor following specific injury. The estimates of duration of disability ranged from 2 weeks to a year, with little concentration of the estimates in between. There is little scientific basis on which to predict or measure convalescence or disability. Rehabilitation should begin immediately after injury and its goals should be to prevent disability or shorten its duration and degree and to return the patient to a useful economic status. Rehabilitation should not be reserved for those with established permanent disabilities. RECOMMENDATIONS 1. Development of additional studies on the quantitation of degrees of disability and the stages of convalescence at which return to productive work is indicated. 2. Development of studies on rehabilitation with emphasis on measures to be initiated in the earliest phases of treatment. MEDICOLEGAL PROBLEMS The courtroom sequelae of accidents are often, perhaps generally, dealt with in a manner below the general standards of the medical and legal professions. The courts for settlements of disability claims in some areas are provided with inadequate or inexpert evidence, and judgment may well resect response to social, emotional, or political pressures, rather than to sound medical testimony. In this respect both lawyers and physicians for the claimants and for the defending insurance companies too often produce prejudiced medical testimony, diametrically and predict- ably contradictory. "Expert medical testimony" under these cir- cumstances has commonly lacked clinical expertise. A system has been adopted by the judiciary in a number of localities to provide 25
