Fall is officially here—and all across the country, people are enjoying cozy sweaters, crisp mornings, and pumpkin spice lattes. For those of us in the physical therapy space, fall brings another exciting seasonal ritual: National Physical Therapy Month (NPTM). Each October, the PT community—led by the APTA—unites around a specific theme as we celebrate and promote our profession. In an effort to bring even more attention to its #ChoosePT campaign, the APTA has decided to make this social-ready catchphrase the theme of NPTM 2016.

Obviously, I am in full support of the #ChoosePT movement, which aims to steer patients, physicians, and insurance companies away from invasive, dangerous, and expensive pain treatment options—namely, surgery and prescription drugs—in favor of the safer, more cost-effective care route of physical therapy. I think this particular effort represents a huge step forward in the industry-wide push to establish a clearer, stronger, more unified physical therapy brand. But, disrupting the status quo—especially in the healthcare arena—is no easy task (just look at how difficult it was to get everyone on board for ICD-10). Old habits die hard; as rehab therapists, we know that better than anyone. But, getting a patient to adopt a regular exercise regimen is one thing; changing the world’s perspective on the role physical therapists play—or should play—within the overall care continuum is quite another.

So, what is standing in our way? What is preventing a world of potential patients from choosing us? What are our barriers to effecting the behavioral change that initiatives like #ChoosePT aim to achieve? The key to changing the behavior of all healthcare stakeholders (including physicians, insurance companies, and patients)—and getting them to actually use the power of physical therapy to its full potential—lies in the answers to these questions. And based on my experience as a therapist, business leader, and industry advocate, I believe those answers boil down to the following:

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1. No one knows what to expect from us.

If you were to gather five different people who’ve seen a physical therapist at some point in their lives, and you asked them to describe their individual experiences, you’d probably get five very different answers. Some would rave about the amazing individualized treatment and one-on-one attention they received; others, sadly, would recount disappointing stories of disengaged clinicians, crowded treatment areas, subpar care, and mediocre results. This is a huge problem, because as the old saying goes, it only takes one bad apple to spoil the bunch. These “bad apple” therapists are tarnishing our collective reputation as a profession, and they’re making it impossible for anyone—consumers, physicians, and payers alike—to truly trust in our skills, expertise, and value as neuromusculoskeletal experts. There’s too much variation—in therapist practice, patient satisfaction, and clinical results—from one therapy provider to the next, and that dissonance is killing our brand. Until we, as an industry, establish, enforce, and uphold concrete standards of care—something that we’ve failed to do thus far—that inconsistency will remain an insurmountable barrier to realizing our full potential as healthcare disruptors.

Yes, we generally ascribe to a philosophy of evidence-based practice. But, we haven’t held ourselves accountable for putting that philosophy into action. In fact, I would argue that we haven’t even truly defined what it means. After all, there’s a big difference between staying current on the latest evidence-based treatment approaches and actually incorporating them into our treatment protocols. To take that a step further, there’s a big difference between adopting an industry-accepted practice and actually testing and measuring the impact of that practice. This is the sort of data-tracking the PT industry is starving for—without it, insurance companies will continue to devalue and deprioritize our services; patients will continue to seek the treatment options they know to be effective (regardless of the health risks associated with many of those options); and physicians will continue to avoid referring their patients to us out of fear that those patients will have negative therapy experiences.

2. We cannot objectively, indisputably prove our value.

Of course, tracking data is only half of the equation. To shatter the world’s long-held misconceptions about PT, we have to serve up the right data—that is, data that’s unbiased, easy to understand and interpret, and perhaps most importantly, big. It’s not enough for each individual therapy practice to amass and use data internally. If we want to change the way PTs are perceived at a global level—if we want to not merely improve our brand, but totally reinvent it—then we must stop thinking about data-tracking as a purely localized endeavor. That means we have to talk to each other; we have to get on the same page with regard to the tools we’re using to collect our data, how and where we’re storing it, and what we’re doing with it. Above all, we have to stop operating in silos. Remember, a rising tide raises all boats. So, while we absolutely should not abandon our efforts to market ourselves as individuals, we should do so in a way that speaks to an inclusive, profession-wide message—because changing behavior across the board requires a cohesive marketing strategy. After all, we’re talking about #ChoosePT—not #ChooseMe or #ChooseYou.  

3. We’re seen as service providers rather than clinical experts.

I’ve written about the commoditization of the PT profession before, and I will continue to bring it up for as long as folks continue to talk about physical therapists’ “branding problem.” That’s because historically, our brand has been defined by its emphasis on the services therapists provide—rather than the therapists themselves. If you don’t think that’s a big deal, then you are, in fact, part of the branding problem—and you absolutely need to read this post I published a couple of months ago. For the purposes of this argument, though, the question I must pose is this: why would anyone choose to entrust their health to a service rather than an expert? When people seek treatment for their health issues, they’re not solely interested in the treatment itself. If that were the case, they would never ask their friends and family members for doctor recommendations—or scroll through pages and pages of Google results and Yelp reviews in search of the perfect provider. Furthermore, they wouldn’t seek their doctors’ opinions before making any major health-related decisions. I mean, how many pharmaceutical ads end with a line urging patients to consult with their doctors before they begin using that particular drug? (Now, how awesome would it be to hear a similar plug urging people to consult with their physical therapists at the end of a ThermaCare® ad?)

Unfortunately, physical therapy is still very much seen as something that is “prescribed” by a doctor—much like the medications promoted in those commercials. And that flawed perception is seriously holding us back from owning our identity as the healthcare provider of choice for patients with neuromusculoskeletal issues. The research is clear: the sooner those patients get to us, the better the results—in terms of time, cost, and above all, clinical outcomes. But while we may know that, the rest of the world doesn’t—and until we confidently step up and claim our rightful place as primary care providers, they will continue to paint us with an ancillary provider brush. They will continue to associate our value with what we provide—not who we are or how we provide it. This is why it is so, so crucial that we get over the fear—and break free of the “this is the way we’ve always done things” attitude—that’s preventing us from embracing direct access, practicing at the top of our license, and proving to the masses that we truly are doctorate-level medical professionals capable of designing, prescribing, and executing customized care plans for our patients.      

4. We’ve isolated ourselves from the rest of the healthcare community.

Now, asserting our role within the healthcare continuum doesn’t necessarily mean elbowing our way to the top with zero regard for other members of the patient care team. In fact, with reform efforts pushing the entire healthcare community toward a system of patient-centered care delivery, teamwork is more important than ever. That means communicating—and collaborating—with a variety of other healthcare stakeholders to ensure each individual patient receives the right care, from the right provider, at the right time. It may sound simple enough, but because we, as an industry, have historically isolated ourselves from our colleagues in other healthcare disciplines, we have a bit of a hole to dig ourselves out of—especially if we want those providers to recognize the unique value we offer to them and their patients. Luckily, with the winds of reform blowing at a gale force, there’s never been a better time to let go of the past and construct a new framework for care provision—one in which we not only play nice in the sandbox, but also know how to leverage the skills and expertise of each occupant to ensure our patients receive the best care possible.

Fall is a season of change—changing weather, changing colors, even changing Starbucks menus. So, what better time to change the world’s view on our profession? Sure, it won’t happen overnight—unlike the PSL release frenzy—but if we make a genuine, concerted effort, it will happen. After all, to get society to #ChoosePT, we must choose to stand up and take action. Are you ready? What are you doing in your practice or your community to promote the #ChoosePT movement? Tell me in the comment section below.

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