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  • Tim Flynn, PT, PhD, Wants Physical Therapists to Take the Lead in Pain Education

    Tim Flynn, PT, PhD, has left medicine.

    For Flynn, a featured speaker at this year's conference of the American Academy of Manual Physical Therapists (AAOMPT), and part of the APTA Innovation 2.0 initiative, it wasn't exactly a unilateral decision. He says that in many instances, it's medicine that did the leaving, moving away from what he believes should be the central focus of health care: the needs of the whole patient.

    "I left medicine because medicine left health care," Flynn says. "I cannot be a part of a system based on the medical model of doing-to people and selling sickness." Flynn thinks the most dramatic departures are around pain treatment, the use of imaging, and reliance on surgeries.

    Flynn took that message to the AAOMPT conference, where he delivered the Distinguished Lecturer Presentation, titled "Why I Left Medicine in America: Stay Wild and Mischievous." The presentation was, if nothing else, provocative in the truest sense of the word, with slides asserting that "the modern US medical-industrial complex has created, promoted, and sustained" epidemics in pain, imaging, and surgical management of low back ache. At times Flynn went even further, asking, among other things, whether spinal fusion surgery is "the lobotomy of our time."

    Other parts of Flynn's presentation focused on the ways imaging is being used to create a culture that characterizes problems associated with normal aging—things like disc degeneration, knee meniscal tears, wrist arthritis, and shoulder abnormalities—as dire conditions that need to be identified through excessive imaging, and then somehow "fixed" through surgery. Flynn calls many of these conditions "wrinkles on the inside," and just a normal part of aging.

    The AAOMPT presentation was also about exhorting physical therapists (PTs) to recognize the unique power they have to move patients away from the assumptions that play into the medical-industrial model, Flynn said.

    "I believe that the term 'medicine' is no longer applicable to what we are as physical therapists," Flynn says. "We’re in the health care business—the medical-pharmaceutical interventions are just a small component of health care."

    This, according to Flynn, represents a real opportunity for PTs—but it may require them to get out of their comfort zone.

    "My call to PTs is that we are at the forefront on educating people about pain, but we have not been aggressive enough about that education," Flynn says. "We can't wait. We have to be going to clients and consumers now, and really educating them. And it may push us into areas where we probably didn't get enough training, but tough: it has to be done."

    Flynn's efforts to that end also include a video, "Keep the Wolves and Opioids Away," now making the rounds on YouTube and social media. The 4-minute video combines interview comments from Flynn with images and text that provide stark, often startling facts about the seriousness of the opioid epidemic, and the ways in which big pharma sold the US health care system on an unsustainable and dangerous approach to pain treatment.

    Like his AAOMPT lecture, the video includes a call for PTs to live out the full potential of their profession.

    "As PTs, we've always been the optimists of the health care system," Flynn says. "But we've undersold that optimism, and now it's time to change that. That's what consumers desperately need."

    And Flynn believes that much-needed optimism is borne out in nearly everything PTs do.

    "At the end of the day we listen, we put our hands on people, we educate, we motivate, and we bring people back to where they want to be," he says. "That's who we are. We've always been that way. We empower people."

    APTA is raising public awareness about the risks of opioids and the benefits of physical therapy via its #ChoosePT campaign, which includes TV and radio public service announcements, national advertising, and free resources at MoveForwardPT.com/ChoosePT.



    • Thank you for your words and inspiration. Although I live in the vestibular world, I think the paradigms we see with chronic pain and dizziness are very similar and we are far beyond the need of shift in medical management approaches.

      Posted by Bridgett Wallace on 11/23/2016 5:26 PM

    • Yes, YES, YESSS!!! Finally, someone in our profession who has the courage to say what has needed to be said. We need to detach ourselves from the sickness management model as well as from the government and private insurance dependency model. Until then, it will only get worse for us and for the public.

      Posted by Brian Miller on 11/23/2016 8:39 PM

    • I'm on board and will be sharing. Thank you. Sincerely, Holly

      Posted by Holly Harding on 11/24/2016 8:03 AM

    • Unfortunately many physical therapists now are employed by the same companies that benefit financially from excessive imaging and unnecessary surgery and do not have the freedom to speak out against these practices.

      Posted by Chris on 11/28/2016 8:39 AM

    • Selling sickness is very profitable, and selling health and wellness is not. Systems only pay lip service to health and wellness, so folks will continue to purchase what they don't need and sometimes will make them worse! We need payment reform, NOT tort reform. Sorry to say that PTs often are guilty of this too, by overtreating or using modalities that have long been shown to be ineffective - but it keeps the referral source happy and the cash drawer filled.

      Posted by edlscottpt@yahoo.com on 11/28/2016 9:08 AM

    • Thank you Tim Flynn...my new hero in the PT profession! It is rare for PT's who have often given their power away to referring physicians to "see" let alone speak out with the abusive trends that have led to incalculable unnecessary suffering, encouraged an addiction mentality, and added to the dehumanization in medicine by mere symptom management. Thank you to the APTA as well for bold leadership by publishing this and also empowering the gifted PT's out there who are highly trained in the art and science of treating chronic pain. We need to start talking more about the recent scientific evidence regarding the amazing 3-D architecture of the continuous bodily connective tissues and the profound influence and integration of the nervous system (this combination is the holy grail here). We have the capacity now, within the scope of the PT practice, to have the greatest long-term impact on chronic pain of any profession. We need to bail from the overly (outdated) mechanistic models that are followed in the medical profession (and often the PT's that partner with them) and attain primary access to this growing population, particularly for the PT's who are skilled and advanced in this area. I have a 1 hour talk given to a MD/PT journal club on the often overlooked neuro-fascial component of chronic pain, that I will provide to anyone who would like. Lets do this, APTA, as true consumer advocates, fighting for what is obviously right and good for society and we will find our profession shining ever brighter! Our PT profession has a history of cowering back in fear (loss of referrals, etc.), but when we stand by and fight for issues like this and empower "the poor", we will become strong and respected...and thanks for the opportunity to vent ;)

      Posted by Matthew Fischer on 11/28/2016 11:54 PM

    • This is a truly inspiring article that needs to open the eyes of not only physical therapists but all health care professionals. I agree that the health care industry sells sickness because the only way to make a profit is on the cause of people getting sick instead of implementing prevention and education in the system. As a prospect physical therapist student, i still have an oath to make and i hope power does not overshadow that oath. I would like to encourage health care professionals to fight back and say "health is not for sale" and donate one day a year to give back to the community by giving their service to a non profit organization. A long term goal of mine is to make a network or organization based on the principle that health is not for sale in which health professionals will give a day of their life to provide free services to the undeserved population. #Healthisnotforsale

      Posted by Christian on 12/13/2016 10:30 PM

    • I can't add much more to what has already been stated in these comments, other than I agree with everyone's sentiments. However, Matthew Fischer, I am interested in your presentation if you'd still like to share it.

      Posted by Mary Meza on 12/15/2016 1:07 PM

    • Thank you for validating our practice! As a therapist who treats mostly complex and chronic pain, I have witnessed the necessity of treating patients with a holistic approach including taming the fear that was established as they sought care elsewhere. It often feels like an uphill battle, but is well worth the reward of providing patients with tools to open their eyes and establish wellness they haven't yet found.

      Posted by Emily Ladd on 12/22/2016 11:52 AM

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