A working familiarity with rehabilitation techniques is absent from most primary care settings. Primary care clinicians can benefit greatly from better knowledge of the principles of geriatric rehabilitation. Physiatrists and geriatricians can have a greater impact if future research also explores the practical barriers to providing rehabilitation services outside institutional settings. An active, collaborative search for new models of care is needed. If more elderly citizens are to benefit from effective rehabilitation services, established geriatric rehabilitation programs must learn how to select from the many patients referred for evaluation those who will most benefit from outpatient rehabilitation services. Impending national health care reform creates a window of opportunity to establish rational systems to deliver health services designed for our aging population.