The founders of the field of physical medicine and rehabilitation (PM&R) took advantage of a confluence of political, technical, and economic opportunities to launch our specialty. In the process, they expressed their values of belief in the importance of function, the team approach to health care, the utility of physical agents and modalities in the management of neuromuscular conditions, the impact of education for our patients and their families, the rights of persons with a disability (PWD), and the responsibility of our field to advocate for public policy issues concerned with the needs of PWD. Advances in the technology of health care delivery and biomedicine will shape our future. Specific trends and factors are addressed. Equally important will be the political dimension, including the aging of our global population, and the economic consequences of health insurance pressures. The field of PM&R should focus on activities that take advantage of emerging trends but are rooted in our traditional values. In particular, the field should look forward to the massive growth of populations in need of our services because of aging and longevity, the emerging global health community, and our increasing technical capacity to impact improvements in health and function. The field is charged to preserve awareness of our core values, to support the common good of research, to keep the use of new and emerging technology in check to serve the needs of our patients, to continue our advocacy for social justice for PWD, and to embrace the emerging global community.