India’s healthcare system continues to expand in infrastructure and advanced treatments, but experts warn that rehabilitation – the critical bridge between survival and full recovery – remains neglected. Limited insurance coverage, inadequate infrastructure, and low awareness have left families shouldering the financial and emotional burden of long-term care, while patients often face delayed recovery and avoidable readmissions.
At the IAPMR Mid-Term CME 2025, hosted by the Indraprastha Association of Rehabilitation Medicine in Delhi on September 12–13, neurologists, neurosurgeons, physiatrists, and healthcare innovators highlighted this systemic gap. With the theme “From first steps to golden years – advancing rehabilitation across life spans,” the event underscored how India’s growing burden of stroke, trauma, and critical illnesses demands structured rehabilitation services that remain grossly inadequate.
India has just 1,251 stroke rehabilitation centres for its 1.46 billion people -about one for every 1.17 million citizens. By comparison, global benchmarks recommend at least one rehabilitation bed for every acute hospital bed, a target India is far from achieving. The absence of structured post-stroke rehabilitation guidelines adds to the crisis, leaving many patients discharged without a clear pathway for recovery during the crucial early stages.
Infrastructure Gaps and Insurance Shortfalls
One of the key concerns raised at the conference was the lack of financial protection for patients requiring rehabilitation. Insurance coverage and corporate health plans rarely extend to structured post-acute care, shifting the entire burden of physiotherapy, long-term recovery, and caregiver support onto families. As a result, many patients discontinue treatment prematurely, leading to recurring hospitalizations and lifelong disabilities that could otherwise be prevented.
Experts stressed that mainstreaming rehabilitation requires closer collaboration between physiatrists and private hospitals. The current concentration of services in government institutions leaves large sections of the population underserved, especially in urban private healthcare systems where most patients seek treatment.
Awareness Deficit Among Families and Clinicians
The shortage of rehabilitation facilities is compounded by limited awareness among both patients and doctors. Dr. Rahul Gupta, Senior Director and Head of Neurosurgery at Fortis Hospital Noida and Escorts, Okhla, emphasized that ignorance remains one of the greatest obstacles. “Families are rarely told that rehabilitation exists as a structured specialty that can transform recovery after stroke, spine surgery, or trauma,” he noted. “Even within the medical community, PMR is often overlooked. Until awareness spreads among doctors and patients, thousands of Indians will remain disabled when they could otherwise return to normal lives.”
This lack of awareness often results in patients being discharged without referrals to rehabilitation services, missing the golden recovery window in the first 90 days after a major stroke or surgery.
The Critical Recovery Window
Highlighting the importance of early intervention, Dr. Gaurav Thukral, Co-Founder and President of HCAH India, observed that recovery outcomes are significantly determined within the first three months after a stroke or surgery. “This is the window where strength, mobility, speech, and memory can be restored,” he said.
At HCAH’s recovery-focused hospitals, advanced tools such as robotic gait labs, AI-powered therapy dashboards, and protocol-driven care are deployed to maximize recovery potential. “In the last year alone, we have touched more than 900,000 lives, and we are showing that recovery care is not theoretical – it is measurable, practical, and life-changing,” he added.
Policy Gaps and Medical Education
Policy-level decisions are also contributing to the rehabilitation deficit. Dr. Tariq Matin, Director and Chief of Neurointerventional Surgery at Artemis Hospital, Gurugram, warned that the recent removal of rehabilitation from the undergraduate medical curriculum by the National Medical Commission is a setback. “This is a dangerous decision that will produce generations of doctors who do not prescribe or prioritize recovery,” he cautioned. “We strongly appeal for PMR (Physical Medicine and Rehabilitation) to be reinstated in medical education. Without it, India’s healthcare system will remain incomplete no matter how advanced our hospitals become.”
The absence of national rehabilitation protocols for conditions like stroke, one of the leading causes of disability in India, further limits access to standardized care. Experts argue that mandating rehabilitation as part of discharge planning could significantly improve patient outcomes and reduce the long-term burden on families.
A Call to Mainstream Rehabilitation
The discussions at the CME pointed toward the need for systemic reforms. Dr. P.C. Muralidharan, President of IAPMR and Professor of PMR at Government Medical College, Kozhikode, emphasized that rehabilitation must be positioned at the centre of India’s health agenda. “Rehabilitation is not an add-on to healthcare. It is a right and a necessity across the lifespan – from managing childhood disabilities to supporting the elderly, from rebuilding lives after trauma to helping survivors of ICU syndromes,” he said. “Without rehabilitation, medicine is incomplete.”
The experts agreed that achieving this vision will require a multipronged approach: raising awareness among both medical professionals and patients, ensuring insurance coverage for post-acute care, reintegrating rehabilitation into medical curricula, and scaling infrastructure to meet the growing demand.
Implications for Stakeholders
For hospitals, expanding rehabilitation services represents not only a clinical necessity but also a strategic opportunity. Dedicated rehabilitation centres, day-care recovery units, and home-based rehab models can reduce readmissions, lower costs, and improve patient outcomes. For insurers and policymakers, extending coverage to rehabilitation could significantly reduce the economic burden of disability and long-term dependence. For MedTech innovators, the space offers avenues for AI-enabled monitoring tools, robotics, and assistive devices.
As India’s burden of non-communicable diseases and trauma-related disabilities rises, experts warn that ignoring rehabilitation will undermine decades of progress in acute care. The challenge now lies in shifting the focus from merely saving lives to ensuring that patients recover fully and return to productive, independent living.
