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Advocacy for Our Profession Isn't a Spectator Sport

I have been a practicing physical therapist for 20 years. When I think about how long that is, it blows my mind.

For many years I was probably a lot like many PTs you know: not involved with APTA or advocacy, happy to be treating my patients and making an impact changing people's lives every day. It was gratifying to know that I was helping my patients to be more fulfilled because they now could walk down the street, or go to the grocery store, or sit on the floor to play with their grandkids. I was satisfied with my role in my profession.

Along the way, however, things changed. And the change wasn't even intentional.

At some point, I wanted to be sure that my education and knowledge base were equivalent to the DPT education currently taught, so I made the decision to get my DPT postprofessionally from Des Moines University. While I knew at the beginning that I was going to learn things, I had no idea that this education would change the course of my life and my core beliefs.

During a class I learned about advocacy and its impact on our profession. It was as if a fog lifted. All of a sudden I clearly saw that the system I had been working in all these years was impacted by the laws legislators make and, maybe more important, that these very legislators had no idea what my profession does or how much of a positive impact we have on the world.

It became clear to me: These legislators were not making laws that were in the best interest of my patients, my profession, or me personally. At that very moment, the light switch flipped, and I knew I must take up the banner to let legislators know. The spark of advocacy lit a flame in me, and I was compelled to come into the advocacy arena.

I knew that while sometimes it is true that one person can articulate her or his dreams and have a great impact, it's a relatively rare occurrence. But I also knew, deep down, that change can be made through many people—that together, we can create a much louder collective voice with a resounding boom. And I wanted to make as big an impact as possible. I knew that aligning myself with my professional association and other like-minded individuals would be the best path for what I hoped to accomplish.

So I started going to conferences and getting to know my colleagues who were already taking up this banner. I joined the PTeam to get advocacy newsletter alerts, became a Key Contact for APTA, went to the APTA Federal Advocacy Forum, went to my state chapter Lobby Day, and attended local district meetings. I started to meet all the people who had been there so many years before me. They had been fighting for me, on my behalf, and on your behalf—we just didn't know it.

Since then, I have gone to board meetings, been on conference planning committee meetings, and become part of several committees of APTA and its components, where we meet to strategize on how to improve things for the entire profession and our patients.

Whether you know it or not, there are so many of us in this volunteer army, fighting for you, fighting to keep reasonable payment, fighting to get more practice rights (imaging and telehealth, anyone?), fighting administrative burden (prior authorization, yuck!), and so much more. The list is long, and the progress is slow, but, still, we all realize that we are #BetterTogether and our #CollectiveVoice is louder when we stand as one.

As I have become part of the army that advocates for change in our system I have witnessed firsthand the dedication, passion, and effort that goes into this fight. The time alone is substantial: days missed out of financial opportunity from the clinic, time away from loved ones, children and pets missed, jet lag, and exhaustion from trying to do it all.

I didn't know these people were doing all this for me. For you. And now I am one of them. And I can't help thinking that if only more of us understood what's truly happening, the commitment and effort it takes, some of us wouldn't be so quick to dismiss what we've accomplished and what we continue to fight for. Thus, I have taken it as my life's mission to spread the word of what we are doing and what we are trying to do.

Here's the deal: Whether anyone likes it or not we all have to operate in "the system" — our American government, its democracy, bureaucracy, and politics. I've learned that making change is painfully slow, takes much patience and perseverance, is built on relationships, has so many moving parts and opposing forces, and often feels like an uphill battle. But I love advocating for my profession and do it with joy. Because what's the alternative? Stand alone? Get swallowed up by another profession that has a bigger association and larger lobby?


This is my profession, damn it. This is my life's work and I will not see us diminished. What about you?

So, yes, I choose the side of the association. I choose the side of the volunteer army that continues to try to launch all these sparks of change, hoping that they will catch. I feel what we as PTs offer to the world is so special that we must safeguard it and hold it close, as it is dear. We make an impact on people's lives in a way that most don't. That's pretty awesome.

Instead of being a clinician inside the system who must succumb to the powers that be, I choose to be someone who is trying to influence the system to operate the way I believe it should. In our profession, there is no "they." There's only us. And it must be us who step up together with our collective voice to create change.

Theresa Marko, PT, DPT, MS, is a board-certified clinical specialist in orthopaedic physical therapy. She is a member of the APTA Public Policy and Advocacy Committee as well as the APTA Private Practice Section Government Affairs Committee. In addition, she serves on the Practice Affairs Committee of the American Academy of Orthopaedic Manual Physical Therapists and on the Finance Committee of the APTA Academy of Orthopaedic Physical Therapy. She was recently named federal affairs liaison for the New York chapter of APTA.

Want to learn more about how you can advocate for the profession and its patients? Visit the APTA Advocacy webpage for involvement opportunities and ways to take action. Better yet, learn about APTA advocacy firsthand (and then take what you've learned to Capitol Hill): join us for the APTA Federal Advocacy Forum, coming to Washington, DC, March 29-31.

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