© 2003 Canadian Medical Association or its licensors

Medicine evolves to reflect the needs of society.This evolution is commonly viewed to be drivenby scientific research advances. However, factors on a macroscopic, population level can be equally influential. Three such factors in the 20th century led to the cre-ation of a new specialty, physical medicine and rehabilita-tion. For much of the last century, medicine revolved around the concept of saving lives. The result has been prolonged quantity of life with an increase in the preva-lence of chronic disease. During the same decades, armed conflicts not only redefined geographic maps but also en-hanced the public’s awareness of people with disabilities; in some instances, this group came to represent a new seg-ment of society. In addition, the polio epidemic of the 1950s left many people with friends and family members with disabilities, and the presidency of Franklin Roosevelt in the United States led to an awareness that a disabilit