On January 16th and 17th I had the pleasure to be invited to the 8th annual
Graham Sessions sponsored by the Institute for Private Practice Physical
Therapy. The purpose of these meetings are to openly, safely and vigorously
discuss and debate issues facing Physical Therapy, where the profession is, and
where it is going. The function also serves as a conduit for future leaders
within the profession. The overall mix is a quite impressive list of
practitioners, educators, a few students, and APTA leadership including the
President and CEO of the APTA.
The structure of the event is to explore relevant topics with a brief
presentation of the issues followed by healthy discussion. There are a couple of
ground rules. First, titles do not apply. If you were invited to this event it
is assumed that you have something to contribute. Second, What is said in the
room is welcome to be shared, but the name of the person who shared their
thoughts is to remain confidential. And Finally, there is a moderator to keep
discussion on track, and assure that time is respected for everyone who has
something to contribute.
This was my first time attending the Graham Sessions and I was very impressed.
The collection of people who were there was impressive. The people were engaging
and inviting. The general discourse and discussions were stimulating and thought
provoking. And the freedom to say what was on your mind was clear.
There were several highlights for me, and I will narrow down my thoughts to what
I observed to be the most interesting.
Transformational Thinking
We are in the era of health care reform. Change is occurring whether we like it
or not. Many people are reactionary in their approach. However transformational
thinking is not about reacting, it is about transforming. True innovation in our
field may be disruptive. Transformation may look different. However it is, once
it happens you don’t go back. It is time to think about what would Physical
Therapy look like if we stripped away all our current thoughts about insurance,
marketing, CPT codes, ICD-9 codes, the 8 minute rule… everything? How would we
as Physical Therapists define our role in the health care paradigm? Would we be
rehabilitating injuries? Would we be personal Trainers? Would we be athletic
trainers? Would we be primary musculoskeletal care providers? What would a
Physical Therapist be? What would a PT do? And how would a PT benefit society?
Defining a Physical Therapist?
Are Physical Therapists Defined by what we do? Or, Who we are? Are Physical
Therapists from the “neck down” workers who need to do everything physically to
our patients? Or, Are we “neck up” providers who use our unique knowledge to
team up with the health care community and direct the care of our patients? I
found the discussion about the term “Autonomy” to be fascinating. Apparently
many Physical Therapists have taken this to mean that they are “independent” and
as such, can do everything on their own. This was not the intent of the term
Autonomy when used in vision 2020. However since the terms inception PT’s have
been given the improper reputation for net being “team” players. There several
ways that this as hurt us as a profession. The bigger picture, is that Physical
Therapists have done a poor job of defining who we are to the public and the
Health care community.
Technology
We are in the era of technology. Electronic communication has made great
advances, however communication is not up to speed with our technology. Many
hospitals use Epic, many major provider groups are using NextGen. However most
Private Practice Physical Therapists are using industry specific software such
as Web PT, Clinicient, or in my case Practice Perfect. All of these Physical
Software programs are excellent for managing our practices, but how do we
seamlessly communicate our patient information and data with providers using the
larger software? There are evolving cloud based locations for patient
information. Some on the local state wide level, and evolving personal medical
records that are available nationally. Even with all of this one of the most
widely used piece of equipment in a hospital is the fax machine. There continues
to evolve a need for seamlessness in patient data access while protecting
patient privacy and security.
Big Data
With all of the advances in technology, we are able to produce large amounts of
data. However is this data useful? Meaningless data is useless data. However
meaningful data can be useful data. How do we capture effective patient outcome
data? Currently there are approximately 300 outcomes tools for use in Physical
Therapy. This variability leads to good data that is not standardized and
therefore not reliable in predicting outcomes. The APTA has worked on some
standardization of data in the inpatient setting, however the outpatient setting
requires much more work on reliability and validity of the data we collect. This
is all good and well, however the evolution of healthcare is happening rapidly.
We need to keep up with this to keep Physical Therapists relevant in the scope
of Health Care as a whole.
Big Opportunity
We, as Physical Therapists are at a crossroads in our profession. We are
uniquely positioned with our education and skills to be play a vital role in the
Health Care system. Physical Therapists have the ability to promote and deliver
health and wellness programs as well as help people recover from injury and
functional limitations. The Physical Therapist is primed to play a role in daily
care of the population regardless of diagnosis or condition. Our services can
save the system millions of dollars and enhance the quality of life to all
individuals in our community. We have the potential to enhance our value to the
health care system. It is up to us to do this.
Physical Therapists have many opportunities facing them now
and in the near future. The challenge is to think big! Who
will evolve as the visionary to transform our profession. We
need to get out of our 8 minute rule thinking, and consider
what we really have to offer.
If you are thinking about starting a private practice, NOW
is a great time to go into private practice! For more information on starting up
a private practice you can visit the
Private Practice Section of the APTA or contact Chad at
chadnov@aol.com.
Other Private Physical Therapy Practice related
articles by Chad
-
Starting a Private Physical Therapy Practice
-
Basic Equipment for Starting a Private Physical Therapy
Practice
-
Physical Therapy Private Practice Tips - Red Flag Rules
Last revised: February 15, 2015
by Chad Novasic, PT
