By: Brett Windsor
I'm fired up today...or possibly it's just unbridled enthusiasm and excitement for this thing we call physical therapy. Certainly here at The North American Institute of Orthopaedic Manual Therapy, but not just here. The whole profession. Here's the deal:
- As Physical Therapists, we are THE experts in movement...
- As Physical Therapists, we are THE experts in neuro-musculoskeletal disorders...
- As Physical Therapists, we are THE experts in biomechanics and human performance...
If it affects a person’s ability to move, to compete, to maximize their possibilities, to achieve their potential in any given physical endeavor, I passionately believe we are the go-to profession. No other group has the training OR the expertise to deal across the whole spectrum of human movement like we can. No other profession has the ability to deliver so profound an impact on people as we can. To top it all, we're cost effective, we're preventative, and we're non-invasive. We're what the health care system needs most!! Please understand - I'm not denouncing other professions. I'm promoting mine. Proudly and unashamedly. Big difference.
But here's my problem. I don't think we believe it as a profession. And if we don't believe it, then who else on earth is going to believe it? No one else is going to tell people what we do. No one else is going to explain why our unique education in anatomy, physiology, pathology, and biomechanics leaves us absolutely best suited to manage a persons ability to participate fully in their lives and society. So...we have to do it. Loudly. Every chance we get. Anywhere, any time, to whatever audience will listen.
Bottom line...as a profession we remain young; we’re still finding our identity. Read a PT publication lately? It's almost unreadable, with the largely indecipherable string of letters behind every name. How many doctors do you see with a trail of Shakespearean code trailing their handles? Why do we need them there? Perhaps because of the youth of our profession, this form of standard-bearing allows us to communicate better to each other (and we hope to other professionals and the public) about what distinguishes us as individuals and as groups of PTs coalescing around themes or areas of practice. But let us not forget, letters don't define who we are!! What we do defines who are!! Our results tell the story. Here, I must admit that I’m the pot calling the kettle black. The stones are rebounding pretty hard off the glass at the minute. I may even get a concussion...and for that, I’m going to see a PT. I completely trust a PT to manage concussion.
I think we're very tentative, as a profession, in getting out there to truly advocate, to hustle and bustle, to present our case. As a general rule, we seem to be clinging desperately to the bloated, dying carcass of insurance and the dependency upon referrals from health care practitioners who in many cases don't truly know what we can do for their patients. I'm not really convinced that many PTs truly know just how effective we can be in our chosen field. Too often, we allow ourselves to be managed in large institutions by non-PTs, who see us as a technical, task-based, hourly workforce. Not as professionals. How much do we do to change the dynamic there? More PTs should be in the C-Suite. The % of PTs who are members of the APTA is embarrassing. In some states it is less than 10% of the PT workforce. What profession can possibly prosper in the face of that level of apathy? The APTA is the only group out there that advocates on our behalf. There is no-one else. Many groups would happily see us go away. Perhaps we would all do well to remember the words of Theodore Roosevelt:
"Every man owes part of his time and money to the business or industry to which he is engaged. No man has a moral right to withhold his support from an organization that is striving to improve the conditions within his sphere.”
Sure, the APTA can be a pain in the (insert favored noun here). But if you're not in the game, you really have no right to complain about the rules. I often question APTA priorities and what I see as increasingly excessive burdens being placed on organizations like ours who are just trying to make PT better. But, the APTA is full of people who really care and without the APTA since the late 90's we'd be gone...wiped out as a profession. Swallowed whole.
We've got to change, and we've got to start convincing people. One person at a time. Inside and out.
I'll tell you though; there are PTs out there who get it. I just spent a great weekend with friends from Boston who run a private practice called Marathon Physical Therapy. They get it, and they get it big time. They're convincing people, one at a time, that what we do is valuable, that what we do can truly be profound. They're approaching physicians as colleagues rather than as a teenager asking for an allowance. They're demonstrating value, and getting results. Frankly, it's inspiring. And they're not the only ones, not by far. I could rattle off a long list...But let's be honest...which type is in the majority? Do we really believe? Do we really know as a profession what we can truly be? Are we truly a 'profession'?
I'll leave you with a question that was asked of me by a PT just the other day. I was asked whether or not I thought it was really appropriate for PT's to be involved in the management of patients with concussion? Well, I'll tell you, that question really milks the cows for me in the morning. What kind of a question is that? Of course we should be involved. Further than that, we should be leading. We should be right there in the middle of it all, sleeves rolled up to the armpits. We treat ICU patients, spinal cord injury, strokes, traumatic brain injuries, MSK trauma - the sickest of the sick...and we shouldn't be managing concussion? What? How on earth did we get on that side of the ledger? It's farcical to suggest that PTs can't effectively manage concussion. Comical.
I love physical therapy. I love what we do. I'll do my part. What say you? Where do we go from here?
It's 9.11 today. Remember them - they went up.
Have a great day!!