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Ankota: Home Care Next Generation Blog

The State of Physical Therapy in 2013

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More great stuff from our friends at PutMeBackTogether.com,  

"I imagine more of a PT civilian superhero, dressed in khakis and a polo shirt, equipped with outcome measures, soft tissue mobilization tools, needles, the critical thinking of MacGuyver and manual healing powers rivaling Mr. Myagi."

--Paul Killoren PT, DPT on PutMeBackTogether.com

All kidding aside, what is the real state of the PT industry? Paul shares a more pragmatic analysis in his own state of the profession address, which you can read below.

One critical area not discussed in the article is the need for Physical Therapists, Occupational Therapists, and Speech Therapists to align more closely with Care Transitions initiatives and Accountable Care models. These models, which focus on reducing readmissions, improving patient experiences, and lowering overall costs, will increasingly incfluence more therapy business in the market. Care Transitions programs and Accounable Care providers will act as "aggregators" for many services including (but not limited to) therapy. Aggregators, a term used in many other markets, refers to organizations that have the ability to influence large volumes of business. Therapy and other types of providers have traditionally called these organizations "referral sources." More than just referral sources, these organizations will become even more powerful in directing large numbers of patients to other providers with which they cooperate.  They are already seeking to formalize relationships to better manage workflow and understand the "performance" of their partners. Therapy practices should align with these business models by providing exceptional service to patients, running their businesses electronically, and offering ways to make doing business with them easier.

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State of the Profession Address: The Image of Physical Therapy in 2013

By: Paul Killoren PT, DPT

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Pick any search engine and type in “physical therapy.” Take a second to look at the top images of physical therapy from this search. Parallel bars, ankle weights and lower extremity stretches. Writing this on the rebound of my “bumpy ball and Tiger balm” tantrum I could easily fall back into the professional despair of misrepresentation (and who knows I may just end up there), but I actually have approached 2013 with an optimistic rejuvenation on the trajectory of physical therapy.

Google doesn’t match the semblance of PT I see through rose-colored lenses. Personally, I imagine more of a PT civilian superhero, dressed in khakis and a polo shirt, equipped with outcome measures, soft tissue mobilization tools, needles, the critical thinking of MacGuyver and manual healing powers rivaling Mr. Myagi. I guess we can meet somewhere in the middle.

But with less applause and likely more substance than the presidential State of the Union address, I thought I would offer my opinion on the State of Physical Therapy for 2013. I propose these thoughts in three categories: Things we as physical therapists have being doing right, things we can work on and challenges we face in 2013. A proverbial good, bad and ugly analysis, if you will.

What have physical therapists been doing right coming into 2013?

  1. Embracing Social Media – It took long enough, but there is now a definite physical therapy presence on blogs, Facebook, and Twitter. This will be a major factor in the “virality” of PT, which will only increase exposure to other health care professionals and the general public.
  2. Concentrated More on Specialization – This could easily go into the “things we can still work on,” but I have already noticed more PTs promoting their specialties versus treating everything possible. I submit that PTs must remain capable to manage every sort of musculoskeletal pain that walks into our physical therapy clinic. But promoting specialties in women’s health, TMD, sports performance, chronic pain or emphasizing specialized skill sets like Triggerpoint Dry Needling, Graston, and manual certifications is what will likely deepen our footprint as health care “specialists.”
     physical therapist
  3. Patients First – With tumult surrounding legislation, reimbursement and interdisciplinary ignorance, PTs could easily lose focus on the absolute cornerstone of our profession – our patients. We have the unique opportunity to spend more time with our patients and provide care than any other health care provider and the exceptional privilege to affect our patients for life. Value that.
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What can physical therapists work on in 2013?

  1. Standardization of Care – It has been discussed before and the alphabet soup of titles and certifications has only worsened, but that isn’t even my issue. I feel we should promote ourselves as PTs first, foremost and exclusively, saving the credential tags for written purposes only. But my main point is that when a patient goes to a physical therapist they should have the expectation that they are seeing an expert with proficiency of musculoskeletal diagnosis and management of their condition. It should be our daily goal to uphold those expectations.
  2. Advocacy – This can always improve and although I think we are slowly catching up to other health care providers, our historic deficiency in promoting our profession has set us back. These efforts will ideally improve on the individual, community and national level. And yes, that may involve being a bit more “sales-y” than you are typically comfortable with. But honestly, you are “selling” health and pain-free function, not a used car. It’s not that bad.
  3. Break Out of The Insurance-Based Practice Model – This is probably the suggestion most will disagree with, because it is the furthest from the status quo. I’m not saying you should advocate for higher reimbursement rates or documentation standards. I’m saying stop allowing them to dictate your practice patterns. I see cash-based practice as the future image of physical therapy and I see that as a good thing. If you are afraid to take the leap completely, set-up a specialized cash-based service or program to supplement revenue.

Some challenges we face in 2013:

  • Direct Access – Before I am corrected and told that direct access is established in 90 percent of U.S. states, I am referring to true direct access. This implies recognition by third party payers, MDs and the general public. We have ways to go.
  • Practice Protection – Dry needling vs. acupuncturists, manipulation vs. chiropractors (I live in Washington State), and sport coverage vs. athletic trainers. Combine those with the general belittlement of our value as a health care specialist and the challenge is evident. In this case the best defense is a good offense. Be active and show your value, don’t rely on others to eventually realize it.
     physical therapy practice
  • Value Your Services – How do we expect others to value our services if we don’t instill enough faith in them ourselves? People will pay out-of-pocket for massagetherapy, acupuncture and chiropractic. They will do the same for physical therapy if they truly believe it will improve their pain, function or performance. This topic is worth revisiting in the future, but I will leave it with a simple question. Does your practice pattern reflect a value on your services? Are you maximizing quality of care, or maximizing patient volume?

To conclude, I extend my challenge to move forward with your physical therapy practice in 2013 and keep it's image in mind. If you own a clinic, have a meeting to set your own goals and implement new ideas or delayed inspirations. If you are working in a clinic, take a second to identify some personal goals or challenge the powers that be to take action. If you are a patient, challenge your physical therapist to provide the expertise you deserve.

As always, thank you for reading and we encourage your feedback. Discussion breeds education.

Follow me (@DPTwithNeedles) and my colleague (@DrAustinWoods) on Twitter to share more of your comments! You can also find us @DoctorsofPT and on Facebook.

About the Author: Dr. Paul Killoren is a member in both the American Physical Therapy Association (APTA) and the American Academy of Manual Physical Therapists (AAOMPT). He is also a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA).

Click here for more articles by Paul Killoren, PT, DPT, CSCS.

Therapy professionals, if you enjoy writing or would like to share your expertise and are interested in becoming a PutMeBackTogether contributor, please click here.

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