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Raising the Bar in Rehab

Research and Outcomes Lead the Way

Published February 14, 2014 11:39 AM by Lisa Mueller

(Editor's Note: Throughout the month of February, ADVANCE bloggers Lisa Mueller and Michael Kelley will post "Dueling Blogs," in which they argue opposing sides of the same issue. Topic #2 -- "What Drives the PT Profession?")

There are many different components to a physical therapist's career: patient interaction, documentation, reimbursement and finances, research, and management to name a few. Each of these impacts the therapist and the profession in different ways.

When the physical therapy profession began, around the time of polio in the early 1900s, I would argue that patient interaction was the primary driver of the profession. There was a clear need for restoration of physical function, and working with patients directly catapulted the profession to become defined as a separate entity from other healthcare roles. In the past few decades, physical therapy (along with the rest of healthcare) has been influenced heavily by reimbursement and third-party payers. Today, the future of the PT profession will be driven by research and improved patient outcomes.

We are living in a very transparent, competitive time. Our society is in the best position it has ever been to compare costs of providers and satisfaction with care. So, how are we going to move forward? By proving our value through research. Evidence showing the effectiveness of intervention by a physical therapist compared to other treatment options will speak loudly. Knowledge is power, and educating our patients on the research supporting their plan of care will drive the PT profession forward.

Patient outcomes are the other important driver in our practice. Patients, payers, referring sources, and even our colleagues have seen the qualitative value of our work, but the quantitative data will be critical in the future of our profession. Being able to show a patient progressing from wheelchair mobility to walking around the block compared to a patient improving by 20 feet on a 6-minute walk test in just one number is important. Sure, both patients improved but one made much bigger strides than the other. We need to be able to show that. Connecting the outcomes to research will tell a complete story of the role of physical therapists, and only we can be those storytellers.

The big question is -- drive the PT profession to what? What's next for us? Direct access has been accomplished. The APTA's Vision 2020 to have all physical therapists obtain their doctorate degree is just seven years away. How will we measure the next physical therapy accomplishment?

What do you think? What is the biggest driver of the physical therapy profession?

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Your comments are heartening and I agree 100% with your sentiments. What you fail to provide are the means to the end. Idealism is a very good place to start, now how will we get there? The NIH is cutting funding for research left and right. Private practice PTs have to run businesses and often have little margin for engaging in research. Larger institutions are often beholden to third party payors who simply want to process patients, not invest in research. How do we make it happen?

I must also take issue with your statement, "Direct access has been accomplished". I would say you are partially correct. When third party payors will reimburse for care provided directly from PTs, then I will celebrate with you. Until then, we are also still beholden to get MD prescriptions if we wish to be paid.

I say none of this to discourage you, only to give you back your own question, "What's next for us?" How do we achieve the vision you've articulated so well?

Dean Metz February 17, 2014 4:46 PM

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