Wednesday, January 16, 2013
Moving Beyond Vision 2020: Join the Discussion
Vision 2020 has served as APTA's official vision statement for the future of physical therapy since it was adopted by the House of Delegates (House) in 2000. In 2011, the House adopted a motion to revise Vision 2020, and the APTA Board of Directors (Board) appointed a Vision Task Force to manage the process.
Since then, the task force developed a new proposed vision statement and supporting vision elements, which the Board will propose to the House in June.
To generate conversation about the proposed vision, the Vision Task Force invites comments at the bottom of this post. Additionally, individuals attending the Combined Sections Meeting (CSM) in San Diego are welcome to attend the Beyond Vision 2020 Member Forum (also open to nonmembers) on Wednesday, January 23, 6:00 pm-7:00 pm PT, in Ballroom 6C of the San Diego Convention Center.
The new proposed vision statement and vision elements, and background about their development, can be found on the Beyond Vision 2020 webpage. In seeking your feedback, we feel it is appropriate to briefly highlight where we are and how we got here:
From the beginning of our work, the Vision Task Force was guided by a few very broad themes, inspired by the information we collected early on and the charge from the House. We wanted this new vision to be "outward looking" (focused on our role in society and our obligation to meet society's needs) and to reflect the evolution of a physical therapist's role (beyond treating people who are having problems and then discharging them, not to see them again until another serious problem generates a referral).
Those themes might be best captured in the phrase "my physical therapist," which evokes consumers seeing their physical therapist on a regular basis to maintain a healthy, high quality of life so they move efficiently at their highest personal ability level, whatever that means for them. That kind of streamlined, habitual relationship between the consumer and physical therapist would be direct access at its best.
Guided by these themes, the task force decided to aim high and be bold, which was one of the tips provided to us by our visioning consultant, Marsha Rhea, CAE. The proposed vision that will be submitted to the House reads: "The physical therapy profession will transform society by optimizing movement for all people of all ages to improve the human experience."
As many have pointed out, this is a lofty vision. But that's what we believe a vision should be, providing statements of identity (who we aspire to be) and desired outcome (what we aspire to change), while speaking to the public (not "the choir") in language that those within and beyond the profession would understand.
To realize its vision, APTA would of course repeatedly establish specific strategic priorities and objectives, which would be timed and measurable. A vision can and should be something greater, and we hope this proposed statement reflects that.
As you consider your response to this proposed vision, we encourage you to read (or reread) Mary McMillan lectures by Ruth Purtilo, PT, PhD, FAPTA (2000), Andrew Guccione, PT, DPT, PhD, FAPTA (2010), and Alan Jette, PT, PhD, FAPTA (2012), which are available through PTJ. (In particular, note Purtilo's comments on periods of identity and Jette's comments on systems thinking and positive deviants.)
The Vision Task Force believes that the physical therapist's role in transforming society goes beyond our already familiar, traditional image of physical therapy. There is a leadership role within the public sphere that needs to be embraced, such as advocating for walkable communities and physical education in schools, for example.
We shouldn't sell ourselves or our profession short: improving movement of individuals within society has the power to transform society itself.
We look forward to hearing your thoughts on the proposed vision statement.
Vision Task Force
William McGehee, PT, MHS, Chair and Board of Directors Member
Patricia Brick, PT, MS, GCS
E. Scott Euype, PT, DPT, OCS
Edelle Field-Fote, PT, PhD
Pauline Flesch, PT, MPS
Charles Gulas, PT, PhD, GCS
Colleen Kigin, PT, DPT, MS, MPA, FAPTA
Tasha MacIlveen, PT, DPT, CSCS
Lisa Saladin, PT, PhD
it's gonna take more than 7 years to change that vision for sure.
The physical therapist's role in our society it's still developping. I still have to explain to my patients what can i do for them. People don't know yet. It's still a long way to go but we will get there soon.
Everything that make the professionals closer it's always great. The Beyond Vision 2020 ideas looks good but its gonna be like vision 2040. It should be more specific.
Posted by fisio
on 1/16/2013 6:27 PM
What happens to the current vision? I like vision 2020 as it is objective and appropriate for our profession. This newly proposed vision's components appears abstract to me.
Posted by Burton Ford
on 1/18/2013 3:43 PM
Why are we moving beyond vision 2020 when we still only have marginal direct access at best. Autonomy is the foundation of any profession, much work needs to be done.
Posted by Ryan Grella
on 1/18/2013 9:28 PM
I like the idea that the PT profession be able to simply describe who they are, such that they can differentiate themselves from other professions. I would like that the PT profession can clearly describe the top 5 things that define their practice so that they can be easily demonstrated as the best choice in treating movement dysfunction. I would like the consumer to be able to better identify what a professional physical therapist/therapy practice does and know how to identify PT practices (instead of choosing competing professions look-alike/"wanna-be" PT).
thank you for your work and consideration.
Posted by Erik Moen
on 1/19/2013 9:40 AM
The goal is certainly "lofty". It will probably be considered as
condescending to other non-physician providers who are also
concerned with movement disorders in their clients. As a
long-time practicing clinician of the "old school" (1962 graduate),
I agree with the leaders of the profession in setting a very high
vision standard. However, I am reminded of one of the primary
marketing tools for chiropractors; i.e., the constant encouragement
of the their patients to return regularly for "adjustments" - and this
approach in seen constantly in the media. The approach being
discussed for 2020 should be thoroughly discussed for the
pros and cons in the present and continual climate of increasing
medical costs. I feels the potential for a "bad taste" developing
for the public if we, as a profession, are not most careful in how we
promote a strategy that encourages visits on regular basis
for former patients who may be mostly asymptomatic. I know
many of us have treated patients who were excessively
manipulated by other practitioners. That is not to say that
the adoption and realization of the 2020 goal is wrong
or dangerous, but one must think of the lay public linking
us with mercenary approach to prolong services in the future.
Posted by Herschel Budlow P.T.
on 1/19/2013 10:11 PM
I appreciate the tireless work of the task force. This is a very difficult task.
A vision should be sticky, portable, and clear. The debatable terms like "transform society" and "human experience" while lofty detract from the most important part-the message. I would suggest the following edits.
"physical therapists optimizing movement for all people of all ages, for all times"
The "for all times" is a double entendre.
Posted by Larry Benz
on 1/22/2013 11:52 AM
Finally a message of marketing to the public comes from a larger stage than our 3 clinics. The "waiting for referrals" is an antiquated model for our profession. I have yet to meet another practitioner, non-therapist, who understands the breadth and scope of our practice. Direct marketing is way overdue on a national level. My priorities are as follows for the APTA: Increase our reimbursement and market physical therapy on a national level. Those are 2 things I cannot do as the little guy in one market.
Posted by Brett Michener
on 1/24/2013 3:54 PM
While we are gazing at this wonderful, lofty, sparkly, shiny new object, we have this little thing called Vision 2020 that remains far from accomplished. In 2000, we had 16 states with unrestricted direct access (frankly, REAL direct access), and in 2013, we have 17. Perhaps we shouldn't have a new vision statement, but rather a new approach to make Vision 2020 a reality. Then we can "move forward" to loftier goals of transforming society.
Posted by Allan Besselink, PT, Dip.MDT
on 1/28/2013 4:28 PM
Thank you to those of you that have already responded. I agree with many of the points already made: 1. Vision 2020 has not been realized. I can understand why APTA would like to revisit the statement as we are quickly approaching 2020; but I do not want to lose many of the valuable aspects of the Vision - I feel it is very important that we continue to focus on the charges of Vision 2020 that have yet to become reality. 2. Although I agree that it would be wonderful to have otherwise healthy clients come to "their physical therapist" on a regular basis, I agree with Herschel Budlow, this sounds a lot like the marketing strategy of Chiropractors and I do not feel that is in our best interest at this time as PTs. 3. Larry Benz also brings forth good points, the phrasing of the new Vision is too abstract for me as well and I do not feel that the public would understand it - can we tweak the language to make it more concrete? 4. Thank you Brett Michener, I absolutely agree that the 2 things the APTA can best do for us NOW is to help ensure reimbursement and market PT services to the public.
If we want to move forward with this new Vision statement, I think we need something transitional between Vision 2020 and this new Vision. I agree that this one is very lofty and there is much work that needs to be accomplished in between - maybe this is Vision 2050!
Thank you for the opportunity to comment.
Posted by Susan Cotterman, PT
on 1/31/2013 8:43 AM
Dear Vision Committee Task Force, Thank you for the work you have initiated on revising our Association's mission statement. I am inserting here the observations that I have posted on the 2013 HOD Discussion Board since I would like members outside of the HOD to comment. I hope these comments are helpful.
Vision Statement and the Future of Physical Therapy
A vision for our profession is to picture in words the value that the profession of physical therapy can bring to society but does not exist now. Today, all children, adults, and senior adults do not live a physically active, healthy life. Thus, our vision for society is to envision a world where all people live a physically active, healthy life.
This is a critical time for our profession, our Association, and our country. Today, we are hopeful that our U.S. Congress will put aside special interests to govern this country to an economically sound, kinder, and gentler nation that values both a free capitalist economy and respect for civil rights. The 2013 HOD, led by our current BOD, must find the common path that addresses our society’s need for physical therapy.
When we come together in the HOD this year, each of us must understand why this country needs the Affordable Care Act. Today, our profession stands on the precipice of true professionalism. The profession of physical therapy is a value to society because our profession is essential to human health; our country will have better health and better healthcare when our profession defines its value to society. More important than our individual needs as practitioners, educators, or researchers, is the need for the 2013 HOD to forge a path together.
What is the value of physical therapy to society? What is the reality that physical therapists face today in our practice? Why do we face these challenges? How do we establish a vision beyond 2020 that will lead us to the best place?
We all agree that physical therapists are movement specialists. We all agree that physical therapy is essential when disease or injury results in functional limitation that prevent a child, teenager, adult, or senior adult from the ability to perform age-expected functions such as play, school, work, raising a family, and living safely in the home.
A vision for a society where all people live physically active, health lives would require our profession to make strategic changes if we are to achieve this outcome. Our decisions must be based on believing each other, trusting that those who speak from the perspective of the private practitioner is as valuable as the therapist who struggles to meet the needs of the family who has a child who will become an adult with developmental disability. Our society needs all of us. Thus, potential pillars for the profession of physical therapy would include:
1. Equitable access to physical therapy for any child, adult, or senior adult that needs physical therapy for health and wellness.
a. Direct access to practice in every state (i.e., compatible with a primary care model of dentistry).
b. No pro bono care but reform to payment legislation that provides fair compensation to physical therapy regardless of insurance status particularly to the Americans with disability who are dual-eligible (receive both Medicaid and Medicare because of poverty-level and disability status).
c. Rescind the episodic, fee-for-service model of the past to align with a post-Affordable Care Act expectation of life course health management; thus, the physical therapy profession epitomizes a vision for physically active, healthy life expectancy and is responsible for the preparation of physical therapist will protect physical health across the life course for people who are typically-developing/aging or who live with chronic disability.
2. Reform to academic educational curriculum for physical therapists and physical therapist assistants:
a. Educational programs must address the state level shortage and distribution of physical therapist across the state.
b. Educational curricular reform that prepares graduates for primary care physical therapy; with specialists when more specialized cares is needed (similar to family practitioner MD or DDS to specialist MD or DDS)
c. Physical therapist assistants are needed as physical therapist extenders if physical therapy is to address the chronic health management needs for people with developmental disability and the growing senior population.
d. Physical therapist assistant education must be advanced to the baccalaureate level so physical therapists can have higher skilled physical therapy extenders and so our profession can recruit the best candidates into physical therapy rather than lose good candidates to nursing or physician assistant programs.
3. Develop more effective models of knowledge translation that bring our current body of evidence into physical therapist practice:
a. Greater evidence on translational, community-based research models
b. Develop a research agenda that connects the current evidence in physical therapy science into a life course health models that predict ability and disability; thus, are more relevant to future physical therapy practice
c. Prepare for the future application of genomics, technology, etc. and the role that physical therapy will play in optimizing real-life function.
4. Develop a reformed model of professional ethics and responsibility that is based on health informatics and our professions accountability to the needs of society.
a. Objective measures of decreased variability in physical therapist and physical therapist assistant practice.
b. Objective evidence of decreased physical injury in younger and older populations due to leadership from the physical therapy profession.
c. Objective evidence that children and adults live a healthier life due to health life style management for those that are typically developing and aging.
d. Objective evidence that physical therapy brings value to society through chronic health management by a specialist in physical therapy for medical conditions associated with high risk mobility limitations (i.e., developmental disability; arthritis, LBP, SCI).
I am a 2013 delegate from the State of California; however, my observations do not represent the California delegation. Rather, I speak as an individual delegate, a physical therapist for over 33 years, and member of the APTA since 1977 when I was a student at Marquette University.
Respectfully submitted, Katherine J Sullivan, PT, PhD, FAHA
Posted by Katherine Sullivan -> ?LR[@
on 2/3/2013 3:28 PM
On first impression the new vision sentence presented a need for a directive adverb, sub as the insertion of the word 'positively' before transform:
The physical therapy profession will (positively) transform society by optimizing movement for all people of all ages to improve the human experience.
In considering a new vision, with guiding principles (preferred for myself over 'elements' as one speaks to parts of what already exists another speaks to the paths and actions which need to occur to create something new), and reflecting on Vision 2020, a recurring experience over the years was the difficulty for those not heavily engaged in leadership and academic activities to remember the six elements of the vision. As such I would offer that if the seven guiding principles/elements were slightly re-titled, an acronym could be derived to simplify the recall and learning of the vision.
Currently we have: quality, collaboration, value, innovation, consumer-centricity, access/equity and advocacy.
If some stayed the same, and some (changed), we could potentially have this: Quality, (Inter-professional vs. collaboration), (Accountable vs. value), (Leading vs. innovative), (Yours vs. consumer-centricity), (Transcendent vs. access/equity) and (Upholding vs. advocacy).
Quality, Inter-professional, Accountable, Leading, Yours, Transcendent and Upholding.
Re-order - Quality, Upholding, Accountable, Leading, Inter-professional, Transcendent and Yours:
This would provide us with the acronym: QUALITY to form the Guiding Elements, and define Quality first in Physical Therapy.
A consideration. CWM
Posted by Cameron MacDonald -> >KY^?I
on 2/3/2013 7:58 PM
All the information and comments are great, but there are two things being left out. First the ever changing insurance system. Reimbursement rates continue to drop and regardless of the vision, if the money is not there, neither will the therapist. I think most therapists are disillusioned to think that therapy as it was and is currently will remain. Look at other countries and the direction of therapy services-very different. Therapists are just not as valuable.
Which brings me to my next point, the value of therapists. That was, in my opinion, a huge mistake to allow the indirect supervision for PTA's. I have lost two jobs over that and my current job has been significantly changed. What other profession values the assistant more than the professional. It is devaluing the professional and making it more enticing for business owners to justify the need to hire more PTA's and limit the time for a PT. I have tried repeatedly to contact the board with no luck.
If there is real consideration for the survival of the therapist, then there needs to be some serious consideration of the assistance having more serious limitations.
Posted by Steve Beck, DPT
on 2/22/2013 11:51 PM
If you observe the history, and the roots of where our profession has started, I think you will find that the reconstruction aides of days gone by will emerge. The vision of the importance of maintaining and developing the health needs of society is where I personally recommend the task force would start. A vision starts as a dream or a goal just like our patients/clients hope to achieve and the steps, ramps, paths, achievements along the way are what bring everything to fruition. Happy to contribute and hope for the best.
Heidi Harris P.T.
Posted by Heidi Harris -> ?IQZDF
on 3/5/2013 2:35 PM
"Those themes might be best captured in the phrase "my physical therapist," which evokes consumers seeing their physical therapist on a regular basis to maintain a healthy, high quality of life so they move efficiently at their highest personal ability level, whatever that means for them."
This is a ridiculous and profit driven mentality, which is what I constantly think seperates us from the chiropractors. We should work to help people take care of themselves, and guide them, but maintanence, which is not re-imbursed by medicare, should not be a goal of our profession. Medical costs are huge for patients, and seeing them excessively for maintanence bothers me. If the APTA moves in this direction I will not maintain my membership.
Posted by Jamin Harvey
on 3/6/2013 8:11 PM
As a current DPT student, Vision 2020 has been in effect throughout my student career and was even a topic of discussion during my admissions interview. While the goals set forth in Vision 2020 may have seemed sweeping and lofty at the time of their creation, much progress has been made in achieving them, particularly in the prevalence of doctoral degree programs and the number of doctoral graduates. While our profession continues to work toward more fully achieving the goals of Vision 2020 in the coming years, it remains equally important to continue to look ahead. Although Beyond Vision 2020 may seem abstract and unachievable now, its implementation will involve smaller step-wise goals which are more concrete and measurable. Beyond Vision 2020 can serve as a guide for our profession as it moves into a new era of autonomy and social beneficence. Are other student readers familiar with Beyond Vision 2020? Would any current or recent MPT students care to comment on the relatively recent prevalence of DPT programs as a result of Vision 2020? How about any student suggestions or comments on the potential future impact of Beyond Vision 2020?
Posted by Elizabeth Von Hoene -> ALYZDL
on 5/21/2013 2:19 PM