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  • 'No Bigger Fan': US Surgeon General Believes the Physical Therapy Profession is a Key Player in the Fight Against Opioid Misuse

    If you think the physical therapy profession has an important role to play in improving public health on multiple fronts, you won't get any arguments from US Surgeon General Jerome Adams, MD, MPH. In fact, you might get the rhetorical equivalent of a high-five.

    In an address that repeatedly cited the APTA's community-building mission, Adams told his audience of association leaders that the profession is "well-positioned to change the culture around pain management" in the United States and that "we know that physical therapy is going to be a part of" the evolution toward value-based care. The remarks were delivered as part of the APTA Component Leadership Meeting, an event that preceded the 2019 APTA Combined Sections meeting being held in Washington, DC, January 23-26.

    Adams focused on the opioid crisis and the physical therapy profession's role in addressing it, with an emphasis on the importance of involving and educating communities on nonopioid alternatives to pain management, and compassionate care and treatment of individuals with addictions. It's a concept Adams is extending to public health in general through what he calls "better health through better partnerships."

    Surgeon General Speaks at CSM
    Surgeon General of the United States Jerome Adams, MD, MPH, addressed a meeting of APTA component leaders.


    "We can't operate in silos" to address public health challenges such as the opioid crisis, Adams said. "We need partnerships and we need collaborations. We need to bring people and organizations together that we may never worked with, never thought of before."

    The fact that APTA's new mission statement is rooted in the idea of building a community to improve the health of society wasn't lost on Adams, who cited both the association's mission and its #BetterTogether hashtag as a reflection of the values he believes are key to positive change.

    "APTA is a public health leader within communities," Adams said, and among the "game changers and disruptors" that will be necessary players in turning the tide on opioid abuse.

    Adams acknowledged that the country's health care system contributed to the rise of opioids and in many ways was not prepared for the crisis it now faces. In fact, he explained, the issue wasn't on the radar of most public health experts—but attitudes quickly changed. Paraphrasing boxer Mike Tyson, Adams told the audience that "Everyone's got a plan until they get punched in the mouth."

    "The opioid crisis is our punch in the mouth," he said.

    Adams has a firsthand understanding of the devastating consequences of addiction. He told the audience that is brother is currently in prison, serving out a sentence for theft committed to support his opioid addiction.

    "Addiction can happen to anyone," he said. "Even the brother of the United States Surgeon General."

    And while the opioid crisis has ravaged families and communities, "out of this tragedy there is tremendous opportunity," Adams said. That opportunity is rooted in making connections both across health care disciplines and throughout communities. He urged APTA members to become well-educated on opioid addiction and its treatment—including learning how to carry and administer the anti-overdose drug Naloxone—and to help promote nonopioid pain management through initiatives such as APTA's own #ChoosePT campaign and the Office of the Surgeon General's resources on opioid addiction and prevention.

    "It's an indisputable fact that physical therapists are well-positioned to change the culture around pain management," Adams said.

    He also believes the physical therapy profession is a leader that "should be at the table" for a wide range of health policy discussions—particularly when those discussions center on the evolution away from fee-for-service models and toward value-based care. The reason, he said, is simple: "We know that physical therapy is going to be a part of every one of those value-based practices."

    The bottom line for health care should be "stop paying for things that don't work and start paying for things that do work," including physical therapy, Adams added.

    In a brief Q-and-A session with APTA CEO Justin Moore, PT, DPT, after his remarks, Adams extended his community education philosophy to the challenge of changing the country's exercise habits. The problem for health care providers is that "we tend to talk in ways that make sense to us but don't resonate with other folks," Adams said. Instead, the exercise message needs to be built around the concept that regular physical activity can improve economic and social opportunities—better jobs, more time spent with family, and more prosperous communities.

    And if by the end of his address, anyone in the audience was still unsure of the surgeon general's attitude about the physical therapy profession, a follow-up APTA video interview left little room for doubt as to where Adams stands.

    "Physical therapists are key to overcoming not only the opioid epidemic but in creating healthier societies," Adams said. "Know that you have no bigger fan than the United States surgeon general."


    • This is truly awesome to read about!

      Posted by James Babana on 1/25/2019 12:59 AM


      Posted by LENORE on 1/25/2019 11:07 PM

    • Glad to have the US Surgeon General in our corner!

      Posted by Jocelyn Beideman on 1/26/2019 4:47 PM

    • As a PT that has personally seen the effects of opioid misuse in my own family, I am so ready to help in this endeavor!!

      Posted by Crystal Limings on 1/26/2019 10:15 PM

    • Yes! Good to hear. Now will they pay us to help? As a PT in private practice we have not had a raise in 15 years that has been meaningful. We have added administrative burdens that increase our costs and lower visit limits for insured clients that decrease our ability to provide the kind of care our clients need.

      Posted by Caroline Taylor on 1/27/2019 10:04 AM

    • Who can afford PT with copays @ $15 per visit? Three times a week for 4-6 weeks?

      Posted by Kim on 1/27/2019 10:40 AM

    • This very much is true! I personally am proof of that! Although all PT is helpful it is my experience that the most benefit treating chronic pain comes from the use of Myofacial Release therapy and Craniosacral therapy which I believe is at the cutting edge of helping people deal with chronic pain without opioids. These types of PT saved me from nearly 10 years of living on very high doses of pain narcotics of which I have now been off of for over 9 years. Ive seen and lived this truth! Thank you Integrative Physical Therapy your hands on techniques that continue to save my life and keep me pharmaceutical free! 👐🙌👏 💞

      Posted by Joni on 1/27/2019 4:56 PM

    • This is fantastic!! Better Together and collaborations is so Important in healthcare with physical therapists at the table more and more to help lead the way. Linda Sylvester Sylvester Physical Therapy, Ltd.

      Posted by Linda Sylvester on 1/28/2019 5:04 AM

    • If you're gonna preach about the value of PT then the pay for that value must follow.. Valuable services deserve valuable compensation # know your worth PT

      Posted by Nikelous Patterson on 1/28/2019 8:14 AM

    • Thank you to our current surgeon general! He gets it. Now to get payors to put the money where their mouths are. A note for clarification, what training do we need to be able to “including learning how to carry and administer the anti-overdose drug Naloxone”? As far as I know state practice acts regulate what we can do and I know medication administration is not included. Nor is it covered in our CPR/First Aid training requirement. Can someone clarify how we are to be trained and how legally we can administer this possible life saving drug to patients?

      Posted by Cristina Bracamonte on 1/31/2019 12:27 AM

    • The article is a prime example of PTs on par with CNP and PAs. We are the only profession the has rehabilitation in our careers not MDs, not ortho surgeons, not CNP, and not PAs. Our profession is due a huge raise and should not make the same income for 4-5 years in a row with exception on small inflation changes. Please reassess. PT students cannot afford to get a doctorate degree and get paid less than professions with their bachelors degrees.

      Posted by Douglas Sklenka on 2/1/2019 5:13 PM

    • The treatment of pain is complex and requires time. PT can be a game changer for society, but we can't realize our potential with poor reimbursement and being leveraged into treating patients for 45 minutes. Our reimbursement levels now are below most payment schedules in 1996 and regulatory changes that constrain the use of aides further complicates treatment execution. If we are to realize our potential, we must acknowledge the need for dramatic change. Dr. Brian P. D'Orazio PT, DPT, OCS

      Posted by Brian P. D'Orazio on 2/3/2019 3:57 PM

    • I am so happy to read about the Surgeon General's support of PT over opioid use. You can get amazing relief and improve your quality of life without having to take medication that will just temporarily offer relief and not fix the underlying problem

      Posted by Heather on 2/12/2019 8:02 PM

    • To Caroline Taylor, you're fortunate. I'm making less on a per patient basis now than I was 27 years ago. And this is in nominal dollars terms. In inflation adjusted, real dollar terms, the reimbursement is even worse. To Kim, you're fortunate as well. There are many individuals now with 30, 40, and even 50% co-pays. I don't call that insurance. I call that insurance fraud. But it's being allowed by government legislators and regulatory authorities. I guess we know whose pocket they're in.

      Posted by Brian Miller on 2/19/2019 9:48 PM

    • This is so encouraging- P.T. are in a position to be great advocates for wellness and healthcare and it is wonderful to have the U.S. Surgeon recognize the possibilities!

      Posted by Julie Finnell -> EOS_D on 2/22/2019 10:33 PM

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