There's no one to blame but ourselves...
Let's be honest. Every profession has its problems. No profession is immune to it. The field of physical therapy has some big ones. After graduating from grad school I was excited to get into my field and help people. I thought I was walking into a career in an established and respected profession. That was my first mistake. I was oblivious to it for the first couple years of my career, but when I got my first Clinic Director role and had to be intimately involved in the business of the profession, I came face to face with the truth. One of the strategies I used to grow my clinic volume was to connect with a local surgeon who did value PT's and allowed me to see patients with him in his office once a week. I was stunned at what I heard over my time there. Many patients didn't want to do PT - either because they had false impressions of it because of general unawareness or they had a bad experience with PT in the past. My favorite line from someone who was generally unaware came when the surgeon asked a patient if they had ever had PT for their shoulder before. His response was "Yah, I do arm circles before playing basketball." I'm pretty sure I cocked my head to the side like a dog listening to a high pitch sound. I had no words. I definitely didn't have anything pleasant to say. Thankfully the surgeon took over and made him go to PT. As time goes on I continue to hear stories of patients who had unnecessary pain inflicted on them by another PT or hearing surgeons who told patients that they didn't think PT was necessary after surgeries where rehabilitation was absolutely necessary.
My first reaction was to be angry at the patients or the surgeons who held these views for not understanding who PTs are or what treatment they were supposed to receive. But after hearing too many of these stories, I can only come to one conclusion - we did it to ourselves. I can't blame patients for not wanting to go to PT after having a bad experience or not knowing what PT is because the field hasn't done its due diligence to establish itself. I can't blame surgeons for not wanting to refer to PT after having therapists that jeopardized outcomes by either doing treatments that were contraindicated or just not doing enough.
So what is the profession doing about it? Unfortunately not much. They started a Move Forward campaign that is perhaps meant to educate the general public on some main points, but in reading over the main points it mainly just looks like they're complaining about things that they can't control on a daily basis. Things like wanting lower copays for PT and increasing access to PT through insurance reforms. They haven't effectively gotten the information out to the public though. Even being a PT, I rarely hear anything about it. Yes, study after study shows that PT decreases patients' dependence on opioids and lowers healthcare costs across the board. The facts are on the side of PTs. So why don't we see changes? Probably because the real issues aren't getting enough attention. The issue that has gotten the most attention of the association, it seems, is trying to limit the ability of PTs to work inside physician-owned clinics. Listen up PTs - this is the least of your problems. Use your time and influence to go after the real issues that can move the needle and advance the profession . Perhaps the biggest thing to focus on is making sure that the highest quality of care is being administered to every patient in every clinic every day. Show the public who we are and what level of education we hold by being impressive at your craft. There are many ways to accomplish this, but it's going to start with a grass roots effort for PT clinics to get creative and stop implementing cost-saving measures that are detrimental to patient care. In short, make sure that licensed PTs, not just support staff, have their hands on every patient that walks through the door every day.
This is not a positive-sounding post, but we are not looking to sugar coat the issues. We want to provide real and honest commentary on the medical field to educate patients, and to spur on positive change within our fields.
-Shaun Palmer, PT, DPT, ATC