APTA, It's time to talk...

When I started writing this blog I was caught in the middle of the decision of whether or not to give up my APTA membership, but then the APTA put a nail in their coffin a couple of days later. I’m done. I’ve had enough. I simply can’t support the APTA at this time. I used to think it was a badge of honor to be a member of such an organization. Then as I got further into my career I was able to gain more wisdom on some of the issues that faced not only my career, but the field of physical therapy. With gaining new perspective, I found that my values do not line up with my field’s association. So it’s time to walk away. Let me explain.

One of the issues that brought my membership front and center in my mind is the direction that my career has recently taken. I was asked by a physician a few years ago to help him start a multi-modal pain management company. Physical Therapy is one of the main specialties in the company, of which I’m the Director. Shortly after taking this position I continually heard the APTA proposing closing a loophole that allows PT clinics to operate within a physician’s practice. If they had their way, I would be unemployed. Thanks APTA. They advocate that a physician-owned clinic is a bad thing and isn’t fair as it takes the chance for other PT clinics to get to treat patients referred by clinicians in the same company. Are there physician-owned clinics that operate unethically? Yes. Does that mean that you try to take down the multi-modal model of patient care? No. It means that you find out a specific problem that happens within the model that negatively affects patient care, and advocate against that thing. This hasn’t been the case with the APTA. Ironically, if they had their way they would cause thousands of their members to lose their jobs. It’s hard to pay APTA dues when you’re unemployed. If the APTA had its way, they would put an end to how my company runs and I would be out of the job and patients would lose this multi-modal care that is truly creating some amazing outcomes. So why would I pay them to continue to advocate for this?

The second thing that has rubbed me the wrong way is the consistent practice of siding with liberal policies and opinions. My point is not that I want them to side with conservative policies. My point is that I want them to be apolitical. Don’t take sides. You don’t need to. When you take sides, you automatically alienate half of your supporters. This is a basic rule of public relations. The latest example of their liberal advocacy is taking an opinion against a bill that President Trump signed that allowed medical professionals to refuse to participate in treatments that are against their religious beliefs. The bill is intended to protect people from having to participate in abortions or other treatments that have strong moral dilemmas associated with them. The bill was not meant to allow physicians, nurses, physical therapists, and everyone else to determine that they don’t want to treat people who believe differently than they do. That didn’t stop the APTA from framing the argument that way and strongly denouncing the bill under their misinterpretation. There are no unethical treatments that physical therapists perform that would cause this bill to be an issue in our profession. So why take a position on it? It’s unnecessary. I guess their only defense is that they aren’t the only ones who mis-characterized that law.

Another issue where I disagree with them is their support of the Affordable Care Act. I’m not arguing that our current healthcare system is perfect because there are some big issues that need to be addressed, but I personally saw things go from bad to worse when the ACA started taking hold. I vividly remember patients who originally got on marketplace plans telling me how great it was because their copays were so cheap. As predicted, after about a year, the price increases started going into affect. Subsidies decreased, prices increased, and the same patients who once sang its praises cancelled their appointments because they could no longer afford their copays, etc. We watched deductibles raise by thousands of dollars, copays became unaffordable quickly and physical therapy clinics got hit hard because people are unwilling to pay for physical therapy treatment compared to other specialists. Now, if people haven’t met their insane deductibles, it’s not common that they will spend their money on physical therapy unless absolutely necessary. The ACA was NOT helpful to our profession. They can’t pretend that it is.

The profession is facing threats that should be taking the full attention of the APTA, including protecting direct access in states that we have it and expanding it as much as possible, protecting our profession against others who try to impersonate us, and get imaging rights for PT’s. We especially shouldn’t be looking to demonize portions of our profession when we could instead be looking to protect the entire profession and empower everyone. The APTA should also spend their time advocating for better health through movement, exercise, etc. They recently published a study that advocates to get patients moving in hospitals to reduce deconditioning. That’s awesome. That’s what we should be focused on. If that was their main focus, I wouldn’t be writing this.

I wondered how many PT’s have given up their membership as I was considering doing. I don’t think it’s uncommon for healthcare professionals to stop supporting their national association after a certain amount of years. At some point I think many realize that either their association doesn’t really get anything done or they don’t get anything done that we want. Looking into the numbers, it looks like only around 29% of PT’s are actually members of the APTA. So it looks like I’m not alone. It’s sad. I want to support them, but I don’t have any reason to right now.

Shaun PalmerComment