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
As a current DPT student, Vision 2020 has been discussed in the classroom setting. The concepts of Beyond Vision 2020 will directly affect me as I enter the workforce. I fully agree with the goal of educating the public at an appropriate literacy level. Whether the education is for health promotion or for reasons to seek a physical therapist. For "my physical therapist" to take effect the general public needs education on what the benefits of having a PT are, and what services a PT can offer. In the many conversations I have had with the people of in my community it is evident that there is a lack of understanding of the role of a PT. Without the appropriate understanding of the value of a physical therapist, is a patient likely to schedule a visit on his own free will? Innovation of education models and collaboration involving education with other health professionals and communities is vital to the future of PT. Also, with appropriate education of the general public, better utilization of PTs will occur resulting in hopefully more income. I feel a lot of PTs enter the field wanting to help people, and if the general public is educated on the “help” PTs can offer then not only do PTs benefit from more patients but more patients have access to the needed services. Lastly, the profession itself needs to recognize the goals set forth in the revised Vision 2020 in order for it to adequately take effect.
Posted by Alison Happel -> ALY]AJ
on 5/25/2013 12:36 PM
Many of the above entries include statements regarding the lack of knowledge of the general public about what PT entails. But this is hardly surprising. How would the public hear about us and learn what we do unless they have a chance to actually see us at work, either through our intervention with them directly or maybe a family member. The only other way I see PTs portrayed is on television or in movies and usually we are not necessarily portrayed in the best light and especially not an accurate light. Another issue I can foresee is that it will, indeed, take years for all the changes that are envisioned to "trickle down" to all therapists, in all communities, in all the small towns and rural areas of this country. How do we get the vision message out to our many colleagues who are not APTA members? I think it may prove to be difficult not only to get our vision message out to the public, payors, industry, etc, but also to our own professionals.
Posted by Lora Mock -> >OWb@
on 5/25/2013 5:14 PM
I was so glad to see that the 2012 Mary McMillan lecture, delivered by Alan Jette, was the basis for the revision of Vision 2020. If you haven't heard the lecture, please find it on the PTJ podcasts and listen. His vision is powerful yet appears reachable and it moves me each time I hear it. To answer some who wonder why we need a revision when we haven't reached the original goals, I would say that any goal, whether for ourselves, our families, our patients, etc, are all up for revision as time passes and the world changes. We have to be flexible and ready to make changes when the need and opportunities are there, which in the face of our nation's healthcare and financial condition, is now. I applaud the APTA and the Task Force for their willingness to look at the current climate and make changes. As we all know, changes in large bodies and organizations takes a tremendous amount of time and effort - you can't turn a cruise ship on a dime - so the effort must be started when the need is perceived. I think we'll find nothing but improvement for our consumers and for our profession with the visionary process of the revised Vision 2020.
Posted by Lora Mock -> >OWb@
on 5/25/2013 5:59 PM
As a DPT student, Vision 2020 was a topic that was discussed throughout our whole curriculum. I think it is great to see how the vision has been a goal that the whole profession can work towards to better our profession. It is great to see the APTA to continue to set high goals for the profession to accomplish. As stated above, I agree that the relationship between the physical therapist and the patient should evolve into a better relationship where the patient can contact the physical therapist directly for improving quality of life.
I think the best way to do this, is to continue to educate the public on what physical therapy is. I feel that this point is crucial in developing our profession, and it should be done better. Many people still ask me, as a student, what physical therapy is and how it is incorporated into the health care setting. I think that this can be started by a 'grassroots' organization with physical therapists throughout the country getting involved in their communities to educate the public.
Posted by Kendall Wilhelm
on 5/27/2013 9:09 AM
After reading about Beyond Vision 2020 and what we as physical therapists strive to be in the near and distant future, I believe that it will be a long road, but in time we will reach our goal. When I first read the statement, I thought “wow, that is very vague,” but it is like they stated; this is our desired outcome at its forefront. As a current student of physical therapy, we have discussed Vision 2020 numerous times. It is incredible the amount of progress that physical therapy has made, but does society know about this progress? When I talk to family members and friends who are not in the profession, the most they know about the progress of physical therapy is that one now obtains a doctorate instead of a master’s or bachelor’s degree. Most do not know that we have achieved our Vision 2020 goal of reaching a higher level of autonomy in achieving direct access. I completely agree the next step beyond Vision 2020 is to “transform” society by engrossing ourselves in what others perceive as physical therapy, and then educating about the advancements of our profession. In achieving this new vision, it will take much dedication and collaboration from all physical therapists in educating others; otherwise it will be a struggle in reaching our ultimate goal.
Posted by Alison Roell
on 5/27/2013 9:24 AM
Beyond Vision 2020 sets a high standard for Physical Therapists to aim. I admire this forward thinking, and feel it is appropriate to have a more current vision statement. As a second year DPT student, I have learned more fully of all of the roles of the PT in the healthcare world. I do believe there is a need in all communities for further education to the general public about the broad scope of PT practice. While finances probably play a large role in inhibiting the amount of advertising/educating APTA is able to do, I believe that continuing to use social media is an appropriate way to get the message out. The Physical Therapy Code of Ethics lists Professional Duty as a Core Value. I believe it is the duty of all PT's to educate family members, co-workers, clients/patients, and members of their own community about the impact PTs can have. I also believe having a broad, highly set vision statement keeps the door open for new facets in the profession I will be entering soon.
Posted by Julie Hamlin -> AMP^>I
on 5/27/2013 10:38 AM
Like some of the other students have said, Vision 2020 has been a key topic throughout our careers so far. I think important concepts in this framework like direct access and autonomous/evidence-based practice are crucial to concretely establish before expanding toward something like Beyond Vision 2020. I wholeheartedly agree with the outward focus of this revised plan and the centrality of collaboration, prevention, and equity in access to care. I also agree that the general public needs to know more of what our profession can do for them as part of the process of integrating PT into more diverse settings. Some recent classes in our summer curriculum have really deepened my understanding of the significance of advocacy and health promotion. For class assignments, we have created resources for a health fair at a low-income, government-run apartment complex and written advocacy letters about community health issues. I think a vital step in furthering overall community involvement in our profession is to include projects like these across all DPT programs. Becoming aware of and actually practicing my role in community health/wellness, especially for underserved populations, has reminded me why I entered this field in the first place and motivated me to pursue these types of endeavors when I graduate. Having DPT programs and work environments that encourage acting upon our core value of social responsibility can go a long way in promoting the goals of Beyond Vision 2020.
Posted by Lindsey Sewell -> ALXa?M
on 5/27/2013 1:53 PM
I feel that the new provisions are a logical next-step after the goals of Vision 2020 are met. However, I agree with other posts that Vision 2020 is less than complete and may not come to fruition until after its hopeful completion date. Direct access will still not be in effect in Indiana until July 1 and most forms of direct access are not what many had hoped for. Lastly, I have also encountered many individuals who do not fully understand the role of physical therapists and the level of service we are capable of providing. Currently, I believe this is one of the largest barriers to unrestricted direct access and recognition of our professionalism.
Although looking past Vision 2020 seems premature, I couldn’t agree more with the key elements that were proposed. I feel they all pertain to/build on the current vision in some form and consider adjusting to future changes in health care. I especially like the focus on advocacy and access in the new vision and would like to see a greater push for this presently. I am curious if any other states have initiated advertisements/public education/etc. to better educate the public about physical therapy, as I have not witnessed much progress in Indiana. In my opinion, educating the public about the skill-set of physical therapists and direct access is paramount in establishing ourselves as the public’s practitioner of choice for musculoskeletal conditions and advancing our autonomy.
Posted by Richard Kaminski -> ALXaDN
on 5/27/2013 4:42 PM
Beyond Vision 2020 appropriately sets a high standard for the profession of Physical Therapy. While it will take time for these lofty goals to be achieved, it is important to aim high. As a second year DPT student, I have learned about all of the settings PTs are able to work to help people - but I believe there is a lot of education that still needs to be done. The APTA lists Professional Duty as one of its Core Values in the Code of Ethics. I believe it is the professional duty of all PTs to educate not only their colleagues and patients, but members of their own community of all of the services PTs can provide. Social media can be a great, inexpensive tool to educate the public about our profession. I believe keeping the bar set high with a broad vision statement is important to leave open all facets of the profession I will be entering soon.
Posted by Julie Hamlin
on 5/27/2013 5:52 PM
As a DPT student and in a state that just passed direct access law recently, I’m optimistic about the realization of the Vision 2020. Although there is still a long way to go to be fully autonomous practitioners and be recognized as the preferred providers among the consumers and other health care professionals as stated in Vision 2020, I think it is inspiring to aim high and bold, i.e., to expand our role in society and assume leadership in public health advocacy. With the ever-changing landscape of health care reform and Medicare reimbursement cut, I think it is important to plan for the future and re-visit our vision frequently. Some elements in Beyond vision 2020 may seem too abstract, but I think the two elements—collaboration and innovation—are particular relevant in this challenging time.
Posted by shaojuan
on 5/27/2013 6:34 PM
As a second year DPT student I agree with these vision statements. For in my opinion, for our profession to grow and become what we want it to, we must set lofty goals and strive to achieve these. These vision statements are something to look up to and forward to as a student and help set the stage for what will be expected from new graduates. I believe that we as a profession should re-visit these vision statements and adjust/revise them to further benefit and push our profession into the future. With the last state finally passing direct access I believe we are on our way to achieving the "my physical therapist" goal. This blog and the links are a great way for members to easily find and learn about where the profession is looking to be in the future. As lifelong learners we all naturally strive to better ourselves and thus our profession, so by setting these high goals I believe we allow ourselves to be pushed to be the best we can be and give the best care to the general public.
Posted by Cory Fornal -> ALXcCJ
on 5/28/2013 11:14 AM
As a DPT student in a state that just approved direct access, I feel that Beyond Vision 2020 is completely necessary looking at where this profession is headed. In the direct access setting, this mindset of “my physical therapist” is a powerful concept that will require a lot of work by all physical therapists. I think the two major difficulties with reaching this mindset is the lack of understanding of what physical therapy in the community and limitations in reimbursement. I believe DPT programs play a crucial role in educating their students on promoting themselves by understanding other opportunities to become active in their communities. In doing so, physical therapists could develop these stronger relationships with their patients and promote the field of physical therapy. With all this being said, I am interested to see how current reimbursement issues will impact our ability to develop this “my physical therapist” mindset.
Posted by Cade C. Hall
on 5/28/2013 11:25 AM
Following the completion of my first semester of DPT school, I had a discussion the parent of a friend. She discussed with me how she had walked into a therapy room 25-30 years ago while considering her next move in life. It took her less than 30 minutes to decide therapy was not for her. She described the setting as sad and depressing. No one seemed to enjoy their jobs and were just going through the motions. Having not even been alive at that time, let alone in the clinic, I have no idea what therapy was truly like then. But it is clear that no longer is the case. The vision encompasses the feeling in the therapy world right now. We are growing area of health care that is just beginning to recognize the vast potential we possess. And recognizing that with 9 years left on Vision 2020, the goals needed to be revised and made loftier further prove that point. No one with real aspirations makes a goal that they will achieve before the proposed timeline. Instead they make big goals that are not going to be easy to achieve. Such I believe was the case with Vision 2020, thus making all the more exciting and impressive to see the progress made and the need for revisions.
Having a father that is a chiropractor, the jokes never stop about the relationship between chiropractors and therapists. One issue I have heard raised multiple times about chiropractors is their penchant for trying to create a culture where their patients have to keep coming back, thus creating a revenue stream for them. While I recognize this is not true for all of them, such a danger does exist. Does this danger lurk for us as well as we move towards direct access and hoping to capture the phrase "my physical therapist" in which patients routinely see pts as the article states? I certainly recognize that in ideal situations we see patients maybe once or twice a year when healthy as "check-ups" but is that not the same premise the stigma for chiropractors was based on? Clearly, all of the progress and goals for pts are great and beneficial to all; I just wonder what some of the dangers are, especially with potential squeezes to payment by insurance companies for therapy service.
Posted by Kevin Aaron, SPT
on 5/28/2013 12:28 PM
As a current DPT student we have discussed Vision 2020 multiple times throughout our curriculum. While I think the overall guiding themes the task force has come up with are admirable goals, I believe it is going to take a large amount of education to the public before we have instituted a phrase such as "my physical therapist". It is true that you can ask most people about other healthcare professionals and they will respond with phrases like "my dentist" or "my doctor", but I believe we are far from that goal. First off, a large portion of the public still doesn't understand what a physical therapist does. When people hear what I do, even close relatives or friends, the first thing they jump to is exercise like a personal trainer. While this is frustrating at first, it provides an opportunity to provide education to someone who before did not have a full understanding of PT. Hopefully with the new policies allowing physical therapist's in Indiana to have direct access this is something that we can strive to achieve. Advocating to our patients that they do not need to see a physician first, but instead can come directly to "their physical therapist" will help speed this process along. I think if we start by educating our current patients about all that we are able to do for them once they are discharged for their current condition, then we can start integrating ourselves as an additional healthcare provider into their lives.
Posted by Sara Bemenderfer
on 5/28/2013 2:38 PM
I am writing as a student physical therapist and as a family member of a patient needing physical therapy. My father had a stroke 1 year ago, went though neuro rehabilitation for 6 months, and then was discharged. I was proud of my profession as I watched his recovery; however, since his discharge, I see a need for continued therapy as a booster or for the forbidden word "maintenance". His needs go beyond what a personal trainer can provide at the local gym. He could benefit from having a physical therapist (just as he has a neurologist, cardiologist, immunologist, and primary care physician) to which he could visit once or twice a year. A physical therapist, who has been trained in all things musculoskeletal, can provide with him with new and up to date education on how to improve or maintain his current functional status. I also feel as if my father is not the only one who could benefit from this model and can think of many patients in my short 8-week clinical who would have been thrilled to have an option to see a physical therapist more regularly.
Posted by Jessica Newblom -> BJQ[CL
on 5/28/2013 7:01 PM
I am a second year DPT student. We have had many discussions about Vision 2020 in the classroom. I agree that physical therapy as a profession needs to be continually changing and adapting to the changes in the world around us. I think that’s exactly what Beyond Vision 2020 is trying to accomplish. Although the revised vision may seem lofty I think it portrays the direction we want our profession to be heading in the future, which is the whole point of a vision statement in the first place. Beyond Vision 2020 focuses on the growing area of health promotion. It’s time for our profession to take a more active role in primary care and help with prevention of disease and injury instead of just focusing on providing secondary and tertiary care. I also agree that this will be a lengthy process and not something that will happen overnight. We need to find a way to reach both physical therapists and the public. As physical therapists we should seek out more opportunities to come in contact with the public and educate them on all that physical therapists can do and stop just waiting for patients to come to us. By putting ourselves out in the public we may be able to educate the public on the importance of physical therapy and the benefits of having a physical therapist not just to treat specific injuries but also for check-ups prior to experiencing an injury.
Posted by Nicole Derry -> ALXa>F
on 5/28/2013 7:03 PM
I am writing as a 2nd year DPT student. I agree with this direction for Vision 2020. With healthcare being such a big issue in our country right now, it is important to focus on how we can make the biggest impact. It is clear that community education and prevention of injury or disease is an area with much room for improvement. As physical therapists, we have a responsibility to use our knowledge and skills to improve the lives of the community we live in. Integrating our physical therapy practice into new places such as a local gym or community center would bring more attention and availability to the community. The more people understand what we can do for them, the more impact we can have. Overall, I think it is easy even for us as PT's to forget about the health advocacy portion of our profession, and it is important for us to remember and act upon it.
Posted by Emily Luck
on 5/28/2013 9:10 PM
As a second year DPT student I feel that Beyond Vision 2020 is a lofty but good goal to work towards upon graduation. I believe that it is good for our profession to keep changing with the times. By developing stronger relationships with our patients we will be able to further help the community. With "perfect" direct access patients should be able to come in whenever they feel there is a need. This would help physical therapists to prevent problems from developing or getting worse. Prevention will help decrease the number of doctor and hospital visits that are currently happening. I also feel that this could be extremely beneficial for patients who may not warrant a doctor's referral but still need assistance. For example, a close relative of mine could greatly benefit from posture education, stretching, and strengthening of her shoulders and neck. If she were to receive treatment now she would not potentially need as aggressive therapy or possible surgery in the future. Her needs could not properly be targeted by just going to a gym or using an exercise trainer. This perfectly exemplifies why Beyond Vision 2020 could be very beneficial to all members of the community and not just those referred by physicians. As physical therapists we are movement specialists and are the most qualified to provide care that the community may require.
Posted by Alyse Behr -> ALYZAH
on 5/28/2013 9:15 PM
As a DPT student I am extremely excited about the direction the profession of physical therapy is going, particularly in the area of total wellness. This goal seems far more attainable now that Indiana, my home state, has joined the rest of America in having direct access to physical therapy. I feel that as a profession, physical therapists need to reach out to the community more and expand our marketing so that the public knows what we can do and how valuable our services are. Partnerships with local sports teams, gyms, and community events would go a long way in furthering our goals.
Posted by Emily Wuertemberger
on 5/28/2013 11:16 PM
I must say, this updated vision does not sound like an improvement over the previous APTA vision statement for 2020, but rather a regression from the prior vision which actually aimed to elevate our profession with objective categories and goals. This "update" sounds like APTA created more abstract concepts and ideals rather than goals for our profession to attain. Instead of updating a vision statement to foster a sense of who we are or aim to be as licensed professionals, doctorates, clinicians, etc. it sounds like we're merely offering the public a more ambiguous definition, or lack thereof, behind the purpose(s) of our profession and the benefits we have to offer. Sounds like we've been deduced to "movement artists" rather than clinical experts in Musculoskeletal and Neuromuscular science. I feel this does not do much, especially in this day in age, to delineate us from other professions that may offer similar "services", nor does it better advocate for third party pay, something that has been challenging this profession over the last 2 decades. The former Vision 2020 statement was better in that respect. I do, however, appreciate the addition of integrating wellness and preventative health into the vision, but I feel if another update is warranted, it needs to be more objective and closer to the former vision of 2020.
Posted by Michelle De Guzman -> AMT`<F
on 12/13/2013 1:56 PM
Physical therapy as an industry is going in a bad direction: bachelors to masters to doctorate did nothing for the profession other than increase the tuition... meanwhile reimbursements from insurance companies are DECREASING (how the hell our board allowed this to happen is beyond me). DPT's today generally have only one more year of school than PTA's (95% of my graduating class had bachelors degrees in kinesiology or related fields). Anyone in our field should agree you do most of your learning after graduation through experience, so I really don't understand how we've allowed the professions to go this way. RN's with just an associates degree make more than most DPT's (unless you're working in SNF's maybe, and then chances are you hate your job).
Posted by Greg PTA
on 1/9/2014 6:19 PM
I would like to see how Laughter Yoga can fit into physical therapy. It has multiple healing effects and medical evidence-based research, but no research for its use in physical therapy. It uses abdominal and respiratory muscles, decreases chronic pain, decreases HTN, and many more health benefits. I would like to see the field of PT be an advocate of wellness and preventative health even if that means stepping out ahead of the crowd.
Antara Croft, SPTA
Posted by Antara Croft -> AOX]BM
on 1/14/2014 10:44 PM
I would like to see more advancement potential for experienced therapists to pursue-such as nursing degrees have. Why are we not pursuing a "link" program to physiatrists?
Posted by Kirsten DeHart -> BMP`@O
on 2/7/2014 3:16 PM
I agree with the fact the profession by adding the DPT has just increased tuition for PT students leaving them with more student loans to pay for once they leave school. I have been a PTA for 19 years now and also agree whole heartily that your real education starts after you get into the workforce through added experience.
I have worked in multiple settings and most employers do not care if you have a DPT or not, question is can you do an eval? My wife has a masters in PT and basically is a eval machine.
I would like to hear from the DPTs, the solid increase they got in compensation by getting the DPT degree?
Also I will say to this day why didn't the APTA allow more PTAs with experience in the field to bridge to a PT program? Having one or two programs in the country was not enough.
Posted by Richard Haynes
on 7/17/2014 3:59 AM
Reading all these blogs I see no vision for the patients in 2020. 1. As the educational requirements have been raised again. The only beneficiaries are the universities. The vision for the patient is"My therapist" has a doctorate degree and I was treated by someone with an associates degree..." Is that really an improvement in care?
2.For us "dinosaurs" with an BSc there has never been any educational credits taken in consideration for all these "masters and doctors of PT that we have educated for years well after they graduated. When I try to endorse my license in another state all that matters is that I don't have a MSc or DPT while I graduated in 1986. Many of my colleagues are now being disadvantaged while we have carried the profession for decennia and developed it to what it is today. Now a state board consisting of "academic elites" decide over our ability practice and what we need to know ...... It's pathetic. Almost 30 yrs in practice and I don't get any credit at all.
Then my thoughts on direct access: I can see direct access only as an advantage if we would also have authority over diagnostic procedures. Even a chiropractor has an X-ray or ultrasound. We got just our (ancient) clinical tests as our skill set.
First priority should be the portability of our PT license so we can provide care in these understaffed facilities who's ads we read every week. I see all these opportunities and the state boards have become nothing more but an obstacle to provide care in the place you want. A national license is a must and it has to be fair to all.
Posted by Kees Oosthoek -> BNV[@I
on 7/31/2014 5:15 PM
Thank you, Kees, Richard and Greg (recent posters) for having the ability to identify the short-sightedness (pun intended) of Vision 2020.
I won't reiterate their excellent points, but will add a few of my own. During a brief, unfortunate experience of helping out a friend who owned an out-patient clinic, I worked side by side DPT's, who truly were the most lackluster bunch of clinicians I have ever seen. I may not have a doctorate myself, but I have a sneaking suspicion that their go-to treatment for patients of all diagnoses involved strapping a pair of ankle weights to a patient in the parallel bars so he/she could perform unsupervised ROM is not as effective as they might have hoped. But because they could treat 5 or 6 patients at a time, they were considered successful clinicians. Meanwhile, their patients would ask the receptionist how to get on my schedule. My long-standing friendship with the clinic owner (not a PT) dissolved. The exploitation of patients and their insurance companies was too much for me.
In the waning years of my practice (and I am a highly regarded clinician with only a BS degree and 34 years of experience), my vision is to encourage bright young things with an ability to connect with people (also sorely lacking in the DPTs I worked with to consider careers as PAs or NAs. As I point out to them, these careers offer individualized care and treatment for their patients, and better pay, more respect and smaller loans to pay back. I'm two for two so far in preventing lifetimes of loan repayments.
Vision 2020 has pointed sticks in the eyes.
I mourn the loss of what used to be a great profession. Thanks, you delicate geniuses of the APTA. Hope none of you ever have to be treated by the robots you've created.
Posted by Doctorateshmockerate
on 1/20/2015 12:03 AM
As a PTA student I think that it is great to have new goals for the physical therapy profession as a whole to work towards. Although I admire the “outward looking” of the new vision, I believe that the proposed statement lacks a connection with the public. Using words like “transforming” and “optimizing” seem very cold and uninviting to me. I agree with the comment made by J. Harvey that physical therapy visits on a regular basis for maintenance seems more profit driven than anything else. As a future PTA this is very discouraging…I came into this field to help people, not to make quotas. Is this how it really is in the field…quantity trumps quality?
Posted by Richard McGilton -> BLW^<H
on 2/16/2015 1:20 PM
I'm a SPTA second year student at NOVA community college. I appreciate the efforts of the task force. Although I think it's going to take longer than seven years for any action to occur. I'm interested in hearing the future of the PTA, in relation to the associated educational needs of the PTA, the future scope of practice and selective interventions for PTAs.
Posted by Ronell Marzett -> BMU[>M
on 2/17/2015 11:17 AM