The Modern Rehabilitation Medicine Enigma: Treating People with Disabilities, but Sometimes without a Clear Diagnosis.

BACKGROUND: The process of a comprehensive rehabilitation of the disabled person may be more complicated when the diagnosis becomes vague and uncertain. Unknown data about the patient's past, mental, physical or vocational background, may cast a different light on the process. The patient's diagnosis sometimes becomes an enigma. Using the model of Venn, the patient's situation shifts from one circle to another. The only logical solution in these cases is to use the Occam's Razor.

PURPOSE: To draw the attention of rehabilitation medicine professionals to the problem of clients whose diagnoses are vague and uncertain and to share with the readers my personal thoughts on this topic.

METHODS: Reviewing literature and sharing with the readers the author's 43 years of clinical experience in the field of rehabilitation medicine.

RESULTS AND CONCLUSIONS: A PubMed query revealed 1479 articles with the words "diagnostic enigma". The search term "diagnostic enigma in rehabilitation medicine" resulted only in four articles. In the long process of rehabilitation of disabled patients, some patients' diagnoses change during the hospitalization phase and some diagnoses become unclear. The rehabilitation process becomes complicated and sometimes incomplete. Implications for Rehabilitation Medicine:  1. In most instances, patients are referred to rehabilitation medicine facilities with definite diagnoses. 2. The long process of a comprehensive rehabilitation of the disabled person may be more complicated when, prior to the discharge, the final diagnosis becomes vague and uncertain. 3. Facts about the patient's past mental, physical or vocational background may cast a different light on the process. The patient's diagnosis sometimes becomes an enigma.