If you’ve seen one Will Ferrell movie, you’ve pretty much seen ’em all. I mean, I’ll bust out a Ron Burgundy quote as enthusiastically as the next cheesy ’00s comedy fanatic, but I think we can all agree that our favorite hilariously clueless news anchor is really just Buddy the Elf in a blazer. And in the same way that Hollywood tends to typecast actors, the medical world has pigeonholed rehab therapists as adjunct providers. But as the fee-for-service payment paradigm quickly fades to black—and with the value-based payment sequel coming soon to a payer near you—physical and occupational therapists finally have the chance to score a leading role on their patients’ care teams. In other words, rehab therapists can step up and claim their rightful place as first-contact providers—and outcomes data is their ticket to primary care fame. Why? Because outcomes data:

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1. Indisputably proves that rehab therapy is the best first choice for patients with neuromuscular issues.

Some camera angles are more flattering than others, but with outcomes data, rehab therapy appears attractive from all sides: cost, care quality, and patient satisfaction. Think about it: how many patients with, say, low back pain have undergone invasive—not to mention expensive—treatments (cough—surgery—cough) only to feel no better than they did before? Probably more than the healthcare powers that be would like to admit. And yet, surgery remains a fairly common route of treatment for patients with musculoskeletal pain issues—patients who could avoid going under the knife (or constantly popping pain meds) by seeking physical therapy.

So, what gives? Well, those patients aren’t getting physical therapy first because they’re not seeing a physical therapist first; instead, they are going to their primary care providers, who in turn are prescribing pharmaceuticals and operations (which, as I’ll discuss under number four below, is another problem altogether). But, with enough data—and effective presentation and dissemination of that data—rehab therapists can establish themselves as primary care practitioners (PCPs) for musculoskeletal pain and movement-related conditions. They can rewrite the script for the patient journey—and edit out the scenes involving costly and risky interventions.

Perhaps most importantly, therapists can confidently project their identity as the go-to experts for all things neuromuscular. After all, it’s not only about proving to the rest of the healthcare world that therapists deserve primary care practitioner status; it’s also about proving it to themselves. Just like method actors “become” their characters to make their performances authentic, therapists must “become” primary care practitioners to make that role believable to  the rest of the healthcare community, too.

2. Allows therapists to set care standards and hold themselves accountable to those standards.

When it comes to actually stepping into that role, though, there’s one big problem preventing therapists from rocking their primary care practitioner hat—and it has nothing to do with the wardrobe department. I’m talking about practice variation—a.k.a. inconsistency in the quality and results of care from one therapist to the next. It’s a bit baffling, considering that, generally speaking, rehab therapists strongly identify as evidence-based practitioners. But, as Heidi Jannenga, the president and founder of WebPT, points out in this blog post, “Historically speaking...we’ve been pretty laissez-faire when it comes to standardizing that practice. We’ve failed to establish any sort of objective quality guidelines, let alone develop universal tools for measuring and monitoring adherence to such guidelines across the profession.” Translation: neither patients nor their therapists’ peers in the medical field know what to expect from any given therapy practitioner—and that uncertainty makes them wary of the rehab therapy profession in general.

It’s an uncomfortable topic of discussion, as it’s understandably tough for members of any professional community—especially one with as much shared pride and camaraderie as the rehab therapy space—to call out their underachieving colleagues. But the truth is that not every therapist is totally committed to providing the highest possible level of care quality—and those who aren’t cutting the mustard are dragging down the rest of the industry. It’s like a movie full of A-listers that’s relegated to the 99-cent DVD bin because the director cast his no-talent nephew as the lead: just plain unfair (to the good actors as well as the audience).

But with outcomes data, therapists can finally set objective standards to eliminate practice variation and ensure a consistent caliber of care across the profession. And once that happens, there will no longer be a need for physicians to “direct” therapy care delivery, because therapists will have the tools they need to call the shots themselves.

3. Empowers therapists to embrace a direct access mindset.

Of course, direct access is the the gateway to primary care designation, and nothing encourages payers to make physical and occupational therapy more readily accessible to their beneficiaries quite like—you guessed it—outcomes data. And that’s especially true when many therapy providers in a network can individually present data that supports a universal assertion (e.g., patients with X condition who seek rehab therapy first reach their goals in Y amount of time and report Z level of satisfaction with their care).

Now, many healthcare providers—rehab therapists included—are quick to cast insurance companies as the evil villains of the healthcare scene. Keep in mind, though, that both sides of the claim reimbursement curtain share a common goal—especially now that health care is shifting to a value-based payment paradigm. That’s because virtually all healthcare reform efforts serve the so-called Triple Aim: higher quality care at a lower cost with better patient satisfaction.

Rehab therapists already know they provide great care, and they’re already—hopefully—fostering great patient experiences. And payers want to reward those providers—which is precisely where outcomes data comes into the picture. Because just like a major Hollywood studio wouldn’t blow its budget on a movie with a mediocre script, insurance companies won’t promote rehab therapy as a viable alternative to traditional primary medical care if they assume it yields only mediocre results. So, it’s up to therapists to come up with the proof necessary to promote rehab therapy as the blockbuster hit it truly is.

4. Provides objective proof that the rest of the healthcare community can’t ignore.

First impressions are tough to change. Facts—cold, hard, indisputable facts—are the only antidote to false assumptions. That means outcomes data isn’t just an opportunity to reverse the sidekick stereotype; it’s the only opportunity. After all, outcomes data packs a very powerful one-two punch:

  1. It allows therapists to prove that, compared to other treatment options, rehab therapy helps patients get better, faster.
  2. It supports the idea that the sooner those patients begin rehab therapy treatment, the greater their opportunity to achieve the best possible results.

That second point is the real backbone of the primary care practitioner argument, because it means that in failing to elevate rehab therapists to PCP status, the US healthcare system is doing patients a huge disservice—in terms of both cost and functional outlook. And if rehab therapists can get the rest of the healthcare space on board with that perspective, then—much like Dale in Talladega Nights: The Ballad of Ricky Bobby—they can finally take the wheel and drive their patients’ care episodes from start to finish. They can finally showcase the true value they bring to the table, because to realize the full scope of that value, they have to get to their patients first. As physical therapist and industry expert Jeff Hathaway states in this article, “research shows that we deliver the best value the more acute we see somebody in the musculoskeletal world.” In other words, to quote Ricky Bobby himself (a.k.a. Buddy the Elf in a racing fire suit), “If you ain’t first, you’re last.”


What are your thoughts on the PCP movement? Are rehab therapists ready to own the primary care practitioner designation? Share your thoughts in the comment section below.

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