Physical therapists fought long and hard to earn the professional autonomy that they have today. And yet, it’s still not complete, full autonomy; unrestricted direct access isn’t universal, and PTs have to obtain physician recertification of Medicare POCs every 30 days. It sometimes seems like a frustrating Mean Girls type of situation, where physicians are like the cliquey, cool kids, and you (the PTs) are forced to constantly compete for their attention and respect.
So, maybe you feel like physicians are your eternal frenemy—your personal Regina George, if you will. But, they really shouldn’t be. In fact, finding a physician bestie could be one of the best moves you make in your career.
PT + MD: A History
I firmly believe that understanding past events and actions helps us take meaningful, progressive steps toward the future. So, let’s briefly delve into the history of the PT and MD relationship.
PTs were traditionally viewed as subordinate to physicians.
PTs and MDs haven’t always been the best of friends (i.e., things between them weren’t so fetch). According to this study about the relationship between physicians and physical therapists, just a little over 30 years ago, physicians were generally the end-all-be-all of rehabilitation therapy. They performed every evaluation, made all the diagnoses, and determined what kind of treatment a patient should receive. PTs were required to follow the referring physician’s orders, and functioned—in that same source’s words—like “a technician.” Yikes.
The APTA fought to increase PTs’ credibility and standing in the medical community.
In 2000, the APTA decided enough was enough, and it crafted the Vision 2020 statement: a list of goals for the PT profession to attain by 2020. Those goals included:
- Increasing the reputability of PTs;
- Improving direct access to PT services;
- Increasing PT autonomy;
- Promoting the use of therapist assistants (PTAs);
- Increasing use of evidence-based care; and
- Encouraging PT advocacy.
Over the years—and as a result of its enormous advocacy effort—the APTA accomplished these goals, and even drafted a new vision statement in 2013. This statement forged in a new direction entirely, with the APTA committing to educating the general public about the benefits of physical therapy—and demonstrating that most of them should see a PT.
Physicians could be the key to building a brighter PT future.
Nowadays, PTs have more autonomy than ever before, but there’s still a lot to do in the way of clearing the remnants of physician control and changing perceptions around PT. What’s my advice to speed that process along? Befriend a physician (and perhaps suggest that you wear pink on Wednesdays).
Bestie Benefits
While the history between PTs and MDs isn’t ideal, the good news is that therapists have come a long way from being classified as technicians. Things are evolving in a positive direction—which is good, because having respectful, genuine relationships can do a lot for your professional life and for the industry as a whole.
A physician bestie can provide patient referrals.
Just because you have physician friends doesn’t mean they’ll blast over referrals like they’re using a confetti cannon. Any physician worth his or her salt will want to know about the quality of your care before he or she sends patients your way. And the best way to prove that your care is top notch is to present outcomes data that supports that assertion.
Sharing outcomes data does several things. First, it indicates that you’re interested in evidence-based care, which not only lends the PT profession more credibility as a whole, but also shows how much you care about your patients—and that you’re willing to adapt their treatment based on the information you collect at each appointment. Second, it paints a completely objective picture of how valuable and effective your care is. Third, it shows that you’re invested in advancing health care as a whole by contributing to the overall patient data pool (hello, population health).
Outcomes data in hand, your physician bestie will have peace of mind knowing he or she has a solid place to send patients with the types of neuromusculoskeletal issues you’re adept at treating. At that point, why wouldn’t he or she send patients to you?
A physician bestie can provide POC signatures when you’re in a bind.
One of the big inconveniences for PTs who see Medicare patients is obtaining a signed POC and renewing certification at required intervals throughout a patient’s course of care. If you’ve ever had trouble snagging a POC signature from a patient’s physician, then you definitely need an MD bestie. Why? Because assuming your bestie is already familiar with your stellar track record—you already shared your outcomes data, right?—he or she will likely be more than happy to sign the dotted line so your patient can get on the road to recovery ASAP.
Good communication with a physician bestie can reduce your patients’ recovery time.
The US National Library of Medicine published a study analyzing how communication between physicians and PTs affected the recovery of patients receiving treatment in the neuroscience service ward of a hospital. The study revealed that patients whose PTs and physicians communicated more frequently saw reduced recovery times and shorter hospital stays.
It makes sense: better communication means a better flow of information—which means therapists can make better, more informed clinical decisions. If you and your biggest referring MDs are on bestie-level communication terms, you can both deliver higher quality care to your patients.
Having solid physician relationships puts you—and your profession—in a positive light.
Perception is reality, so if you have a physician bestie, your peers (and the physician’s peers) are probably going to notice—and that’s a good thing! If you and your bestie operate out of a place of mutual respect and understanding, that vibe could travel through your respective networks and help create the image of a level playing field for PTs and MDs. Maybe your PT peers will reach out and provide outcomes data to other physicians. Maybe your bestie’s physician peers will refer more patients to physical therapy—or sign POCs in a more timely fashion.
Or maybe, just maybe, your physician bestie will help advocate for the PT industry, adding another voice to the call for PTs embrace their role as first-line providers for patients with neuromusculoskeletal diagnoses.
It’s time to ditch the idea that PTs and MDs are separate cliques. End the turf battles, torch your pink clothes—not literally; please don’t do that!—and work together. After all, at the end of the day, PTs and MDs are all on the same team with the same goal: eliminating pain and improving the general health and wellness of the world.
