At the end of every year, I like to reflect on what’s happened and a look ahead at what’s to come. I have to say, CMS’s end-of-the-year 8% cut announcement was a challenging piece of news, but even with the obstacles it presents for our profession, I am still incredibly hopeful about our future. We’re finally beginning to find our stride as first-line musculoskeletal experts, and this next decade promises to be a very positive, albeit challenging, one for us—and our patients. That is, as long as we are willing to make changes to the status quo and take a big-picture look at how we can make the most impact. With that in mind, here are four major opportunities for PTs, OTs, and SLPs in 2020 and beyond:

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1. Use telehealth to reach more physical therapy patients. 

Telehealth is about to explode in terms of popularity and utilization. After all, with today’s mobile technology, patients can securely receive health care services from the comfort of their home, office, or even hotel. And we can deliver those services from anywhere as well. As I wrote here, “Not only is this an incredibly convenient means of accessing care, especially for individuals who may have a more difficult time getting to a provider in person, but it also creates more opportunity for patient-consumers to seek out specialty providers who they may not otherwise be able to see.” 

On our end, we’ll be able to reach more patients and potentially schedule more appointments per day—both of which augment accessibility to therapy and (hopefully) our bottom lines. Given that such a large number of adults who could benefit from physical therapy aren’t currently receiving it, this is a huge opportunity for us to capitalize on this currently untapped market—and help more patients reach their functional goals and live without pain. 

Because physical therapy is a primarily hands-on treatment modality, we’ll still conduct most of our sessions in the clinic, but we can provide immeasurable value to patients online. In order to really make an impact on patient volume—and start tapping into the 90% of patients who could benefit from physical therapy but aren’t receiving it—we must meet patients where they are. That said, regulatory barriers to practicing across state lanes and billing for telehealth physical therapy services are still hindering our ability to leverage this technology to the fullest, but I expect to see more pro-telehealth legislation and billing guidelines coming down the pipeline soon. So, it’s high-time that PTs start thinking of ways to incorporate these services into their offerings. With Medicare’s looming cuts, expanding revenue streams will be especially important for practices that serve a large population of Medicare beneficiaries.

2. Expand your care philosophy to account for social determinants of health and support holistic wellbeing at both the individual and population levels.

Individual Health

While a physician’s visit may only involve about five minutes of dialogue between patient and provider, as rehab therapists, we see our patients for significantly longer sessions—multiple times per week for several weeks or months. This affords us an opportunity that our physician colleagues don’t have: time to assess the social factors that not only support our patients’ overall holistic health, but also help determine their ability to meet their health goals. 

For example, we can inquire as to our patients’ living and work situations and use that information to help them incorporate mobility best practices into those areas. We can ask about their social networks and support systems, as those directly correlate with emotional wellbeing—which plays a huge role in not only overall happiness, but also the ability to adhere to plans of care and remain healthy in the long term. Asking about access to safe transportation and nutritious foods can also support patients’ overall wellbeing and help us make tangible differences in their lives. These factors are all so interconnected, and we can make a much greater impact if we’re able to help our patients move the needle in all the areas that matter. 

This information can also inform our efforts to create new patient referral streams via community service organizations, primary care providers, and even home health agencies. Additionally, partnering with other providers and stakeholders to help our patients close the loop on all of the issues that impact their health ensures those patients have continuity of care and holistic support that fully addresses all of their healthcare needs.

Population Health

It’s been a long time coming, but people are finally beginning to think about health from a preventative (as opposed to reactive) perspective, and rehab therapists should be leading the way on that front. The long-term effects of common conditions like type 2 diabetes and obesity are grim, but these are highly preventable diagnoses that we are very well-equipped to address—at both the individual and population levels

As we explained here, while the US remains one of the least healthy countries in the world, we are seeing a shift for the better; for example, the rates of tobacco use and obesity are, for the first time in decades, holding steady—and in some states, even decreasing. That is incredibly promising news, as more and more people are taking an active role in their health. Thus, we’re seeing a shift from a treatment-focused mindset for patients to more of a wellness-focused mindset for consumers, which is a meaningful change. So, how do we change our approach to align with this? Who can we partner with to reach these patient-consumers?

I believe rehab therapists can support this movement in a few ways, including developing collaborative relationships with other providers. After all, improving health and wellbeing at scale is going to require a team effort with everyone from nutritionists and psychologists to physical therapists and physicians on board. We also have an opportunity to expand our reach beyond individual patients by developing relationships with employers. Employee wellness programs are excellent initiatives that can encourage large groups of people to shift their lifestyle habits for the better—everything from making more nutritious food choices to being more active and less sedentary at the office.

3. Employ the principles of behavior change theory to help patients create lasting habits.

To continue with that train of thought, occupational therapists, speech-language pathologists, and pediatric therapists are particularly well positioned to help people—especially young people—form healthy habits that will last a lifetime. But in order to accomplish this, we must help patients overcome their natural inertia when it comes to behavior change. That’s where the principles of behavior change theory come in handy, as WebPT’s Ryan Klepps and Scott Hebert explain here

According to Hebert, “If terms like social cognitive theory and transtheoretical model only remind you of that one class in school you skipped a little too often, then it might be time for a refresher course, because it turns out that people aren’t great at following through with the healthy behaviors we try to help them practice when we create our care plans. And if you don’t know how to help them do so, then there’s a good chance they are going to fail.” That said, “By knowing how to use tools like behavioral staging and self-efficacy evaluations to improve your patients’ success, though, you’ll have a much better shot at both achieving desired clinical outcomes and improving patient engagement.” This can involve using technology to continue patient communication via email, text, portal, or mobile app to help support your patients through these tough changes. This speaks to the importance of building a clinic community where patients always feel supported and have continued access to education and, potentially, their provider.

In other words, you’ll be more likely to set your patients up for success inside and outside of the clinic—and a track record of success is a wonderful thing for your patients and your business, especially if you leverage outcomes data to market your practice to other patients, payers, and referral partners.

4. Model a healthy culture in health care to improve the wellbeing of providers.

As I explained here, while the issue of burnout isn’t exclusive to health care, we have notoriously high amounts of it because of the added pressure of being responsible for our patients’ wellbeing. That’s on top of the fact that our culture prizes productivity and busyness in general, which can create a propensity to overdo it. Now, add in shrinking reimbursements and increasing regulatory burden, and it’s easy to see why we are at risk of burning ourselves and our teams out simply to keep our practices afloat. 

Instead, I propose that in 2020 and beyond, we take a step back and recognize that we have the ability to actually model a healthy culture within the often unhealthy habits modeled around us—and still be profitable (in fact, more profitable than we would be with exhausted, overworked, undernourished employees). We know the importance of prioritizing health and wellbeing better than most, so let’s provide our best examples of healthy behaviors for our patients, our staff members, and other healthcare providers. 

As leaders, that means recognizing when the goals that we’re setting are too much for our teams to accomplish—and establishing more realistic ones—as well as learning to recognize early signs of burnout and lack of engagement. It may also mean moving away from traditional productivity goals in favor of alternative metrics that reward staff members for jobs well done—regardless of how many patients they see in a day. In other words, let’s focus on the big picture of what we’re trying to accomplish. That requires putting people first—our patients as well as our staff. Now, that doesn’t mean we shouldn’t optimize our operations and staffing protocols to minimize waste; it just means we should do it in a way that is respectful of our people and incredibly effective for our patients, all while helping us meet our financial goals.

It also most certainly means embracing the technological developments that are available to us to support our practices and our people—by reducing burdensome workloads and enhancing our care delivery models, for example. And that includes everything from software that enables us to automate patient appointment reminders (thus completely removing that task from our team’s plate) to telehealth technology that enables us to provide essential care to patients across the country. This year, we’ll also see a rise in artificial intelligence (AI) and AI-supported rehab therapy that ultimately improves our patients’ lives as well as our staff’s. In this next decade, technological efficiencies are going to be what sets clinics apart and allows them to not only survive, but also thrive in this era of lean reimbursement. Long-term success is not going to come from stuffing schedules or overworking our people.


There you have it: four major opportunities for PTs in 2020 and beyond. Where do you see our profession primed to excel in this next decade? I’d love to hear your thoughts in the comment section below. 

Want even more opportunities for 2020 and beyond? Join me and and a handful of my colleagues on Thursday, February 6, 2020, for a live webinar titled, “The Roaring 2020s: 7 Rehab Therapy Predictions for the Next Decade.” We’ll cover everything from provider burnout and payment reductions to revenue diversification and legislative trends in depth—as well as how to capitalize on these trends. Trust me—you won’t want to miss it.