History and Background
The Concept of Performing Arts Medicine
Where and when did the term 鈥減erforming arts medicine鈥� first enter the lexicon? It is, of course, likely that this terminology had been utilized many times in the past and was a part of the name of the British organization founded by Ian James in 1984. Discussions regarding the need to establish a clear scope in the burgeoning field of health care for perfomers first began at informal get-togethers at the Aspen meetings as early as 1984. There were two rather divergent approaches to the subject. One, championed particularly by Dr. Richard Lippin, 鈥渁rts medicine鈥� that included all performing and visual arts. Others were involved primarily in the healthcare of instrumentalists and, used the term 鈥渕usic medicine.鈥� The closely-related term 鈥渕usical medicine鈥� had been used in describing a variety of maladies affecting instrumentalists and submitted as brief case reports or letters to medical journals. Some in the group, who were primarily clinicians seeing 鈥渋njured鈥� performers as patients preferred the inclusion of performers in instrumental music, singing, (our ENT colleagues often referred to 鈥渧ocal instrumentalists鈥�), and dance but did not feel a strong clinical connection to the visual and literary arts. Hence, the group eventually settled on promoting use of the term performing arts medicine for this 鈥渘ew鈥� specialty.
Along with adopting a name for the type of practice, physicians who were primarily engaged in this part-time subspecialty, the members in the group also began, as early as 1984, discussing the need for some type of organizational structure with several goals: 1) to promote quality care for performers, 2) to expand and perpetuate the meeting at which topics of mutual interest would be presented and discussed, 3) to support and conduct programs for education and research in this developing field, 4) to establish some form of communication and coordination among the clinical centers already in place and those being planned, and 5) to foster dialogue and cooperation among performing arts organizations, educational institutions in the performing arts, and health care associations and schools. By 1986, the organization was blessed with a vehicle for facilitating communication and education, the journal Medical Problems of Performing Artists (MPPA). By 1988, the Performing Arts Medicine Association (PAMA) had been established, had a mission statement and bylaws, a set of officers and a board of directors, an official journal (MPPA), at least one annual meeting planned in Aspen, Colorado, and an annual dues structure of $100 for physician members. By the following year, PAMA was officially incorporated as a non-profit organization with a Federal Employer Tax I.D number and 16 members.
The Last 30 Years
To say that a lot has happened over the last 30 years would obviously be an understatement and something no one participating in those early meetings would have predicted or believed possible. Literature in the field of performing arts medicine has increased exponentially. Whereas finding studies regarding medical problems producing impairment in musicians and particularly relating playing an instrument to specific ailments was extremely difficult in the late 1970s and early 1980s, case studies and reviews began to appear in the late 1980s, not only in the journal MPPA but in many general and specialty publications. PAMA began to keep track of relevant literature in a bibliography which has, at the present time, reached some 15,000 citations! MPPA has roughly doubled