APTA President Sharon L. Dunn, PT, PhD, Board-Certified Orthopaedic Clinical Specialist, addressed the House of Delegates, Sept. 11, 2021.
To the 2021 House of Delegates of the American Physical Therapy Association, it's a privilege to address you this morning.
A year ago, I delivered this address in a quiet media center at LSU Health-Shreveport, recording my lecture to be played during a live-but-virtual House of Delegates a few weeks later. I'm still so proud that we have demonstrated our ability to advance our association over Zoom, but after all the digital gatherings we've had since March 2020 this in-person experience feels even more special right now.
Ours is a people-based profession, and community is at the heart of our association's mission. After so long apart, to stand here before you – with you – is an honor.
But the sense of privilege I feel today is deeper than that. This is my last time addressing you in this capacity, after six years as your APTA president, that you honored me with, among 14 years on APTA's Board of Directors, where I learned so much. While I never took this opportunity for granted, and while I always felt the responsibility of the position, I have grown to fully appreciate how few people get this kind of platform, this kind of opportunity, and this kind of experience.
I didn't realize until I was thumbing through our centennial history book earlier this year that only 32 people served in the role of association president before me. Had I known that before I was slated, I might have talked myself out of running. In life, sometimes ignorance doubles for confidence, and here I am.
At the same time, when I pursued this role I knew I wasn't a conventional candidate, nor a finished product. Thankfully there has never been a shortage of people willing to provide advice.
One fond memory from early in my time on our national board is when longtime staff member Bonnie Polvinale told me I had a lot of potential as a leader but I should swear less during the board meetings. I also had a well-meaning friend who will remain nameless instruct me to stop drinking my beer from the bottle at APTA receptions because it made me look like a hick.
A few months later I was at an APTA Federal Affairs Forum reception dutifully pouring my beer into a glass when longtime APTA advocate Linda John approached me with skepticism, asked me what I was doing in a colorful way, and said if I started changing who I was I'd lose her vote and support. I briefly considered splitting the difference and walking around with my classy glass of beer inside a casual paper bag, but then I thought better of it.
That's a silly example of leadership, but it's full of moments like that – instances when multiple people whose perspective you value give you conflicting advice and leave you to figure out how to respond, often without a perfect option.
Maybe the best advice came from, Rachel White, one of my first-year PT students at the time. The knock on me during my candidacy was that I wasn't sophisticated enough to be president of APTA. As I was sharing this perception with her she retorted that “simple is the new sophisticated, Dr. Dunn – just be who you are.”
After some soul searching, and recognizing that, yes, I am quite simple, my approach has been to be as real and authentic as possible, in the things I do and say – and even in the way I say them.
As I'm sure you've noticed over the years, compared to some of y'all I talk a little funny. Sometimes that's for effect, and sometimes it's because I can't help it, but always it's me.
I'm fortunate not to know what it feels like to be dismissed or disparaged because of the color of my skin, but I do know what it feels like to be judged by my accent and Southern roots.
I come from a long line of strong-willed Southern women. My family, who I adore – whose strength and courage have inspired and girded me up – are here with me this morning in the gallery. Mom, Dad, my sister-in-law Melanie, dear friend Margaret, and a passel of nieces and nephews, please stand up and wave to the delegates.
Our family's nature and value is to be blunt, but the Southern drawl gives some people the impression we're too dumb to keep our thoughts to ourselves. My great grandmother's mantra was, “It needed to be said, so I said it; everyone else was thinking it, but I just said it.”
There are risks to that mindset – and I've learned through experience that there is a significant difference between saying what everyone is thinking and saying what needs to be said. But, on the whole, my experience is that authenticity accelerates progress, even when it's uncomfortable. In some cases precisely because it's uncomfortable.
Where we get into trouble is when we're so busy speaking our mind that we don't activate our brain. I also learned that the hard way:
Back in 1998, before I had visions of serving at the national level, I was leading a charge for direct access in my beloved home state of Louisiana. Our lobbyist, now our Secretary of State, cautioned me that we might not have the votes. But determined to achieve what I knew was right for our state and our patients, I demanded we push the legislation to a vote on the Senate floor to see which legislators were truly with us.
We lost by two votes, a narrow margin of defeat that had the backsliding effect of making our true legislative friends bleed unnecessarily, while increasing our burden of proof moving forward.
I was so devastated in letting everyone down that I sat on the steps of the capitol and cried. I had let my personal agenda cloud my judgment. I wanted the right outcome, but I had narrowed the path to our objective to one approach at a single time, ignoring the signals that caution was the better course. It was a rookie mistake, and I had a legislative loss to prove it.
The late Dave Pariser sat down on those capitol steps and cried with me. It didn't change the outcome, but it made me feel less alone. APTA has blessed me with many caring moments, with many of you in this room, like that. That's the power of community.
One of my favorite quotes is from the movie 300 – it's gory, but it's pretty good: “Your greatest strength in battle is not the shield, nor the sword, but the warrior beside you.” Sometimes that's the fellow servant leader who consoles you. Sometimes that's the person who tells you things you aren't ready to hear – like the lobbyist you paid, whose advice you should have taken. Sometimes that's the person who saves you from yourself.
About 20 years later, as Louisiana was continuing its direct access push, I was invited to testify, surprisingly. Dave had passed by then, but his former student and mentee Cristina Faucheux was leading our legislative charge and was there to be the warrior beside me.
During my testimony I started to get into a heated exchange when I felt Cristina reach over and squeeze my arm. “Please don't argue with the senator,” she whispered in my ear. This time, I listened. This time, we were successful because of her wisdom.
Service to this organization offers a full circle of sorts. We're never done with our efforts to advance our profession, but we come and go as leaders, and if we do it right we pay it forward to those leaders coming behind us. That's what was done for me, and that's what Dave Pariser did for Cristina – a baton passed in the relay race of progress.
If I have one regret in my time as APTA president, and hindsight being 2020, I think we should have continued to press on the payment reform effort we had in play early in my tenure. Advice was across the spectrum from an abundance of advisors, we had a boycott by some large practices, and we had a challenging lack of consensus among our collaborators on the AMA CPT panel, but we had a proposal that was sound – one that was before its time.
The continued payment cuts on procedures are untenable for our profession – this is a priority going forward that must be addressed and I hope to be a warrior beside those leaders who take up this effort. Failure is never final. It's an opportunity to do better next time if we listen and learn as the baton is passed.
Over the years, I've listened and learned from so many of you. The legendary Charles Magistro advised me to keep my powder dry. David “Papa” Qualls reminded me often to stay on the high road. Lisa Saladin taught me to stop emoting and use my words. Connie Hauser helped me learn to keep my passion from interfering with my purpose.
For several decades now, this profession has been my passion, and in my years as president this association has been my purpose. My identity, however, is in Christ, and that brings me a blessed assurance that control is not in my purview but that a greater force is at work with us and through us.
If anyone ever wondered where my strength comes from, unequivocally my strength comes from that spiritual assurance. Otherwise, I'm a scared little girl in a grown woman's body.
Some of you have wondered aloud to me if I have begun to lean a little more left on the political issues that confront our profession and our society. The answer is that I lean on a spiritual and moral compass of right and wrong, rather than a political axis of right or left, and as president of APTA my prayer life has gotten more robust. Any solutions to these complex problems are much greater than me.
Nevertheless, my true north in this service has been the well-being of APTA and our profession, not just for today but for tomorrow – for our next 100 years.
Following this path has led to new ways of doing things that have challenged our sense of the familiar – particularly those changes that embrace systems and alignment as we outgrew an old-school model that was pleasantly intimate for a few of us, me included, but sometimes confusing, alienating, or disconnected for most others.
Following this path has strained friendships and challenged me to confront my own biases. There have been countless times when we, the Board, landed in a place different than where my first instinct would have assumed or preferred to go. But servant leadership isn't about getting what you want. It's about confronting the data, being sensitive to what's happening around us, hearing people different than yourself, trusting people smarter than you, and achieving what our association needs for the whole, for the greater good.
The people smarter than you can be people with less experience. I've learned so much from the generation behind me, the generation behind them, and, yes, the generation behind them. Our future is bright, and I would urge us to make that future an even greater part of our present – and quickly. I haven't decided exactly what the future holds for me, but I know it must include opening doors for them.
For decades now, our House of Delegates has been a place where so many of the next generation have arrived to serve, learn, and grow. I hope that continues, and that the makeup of this body gets a little younger and more diverse to better reflect the demographics of our profession, association, and the world around us.
I'd also love to see this House reborn in its purpose, moving away from adopting dozens of motions at a frenetic pace and instead moving toward a culture where the House retains its function as a deliberative, representative body of our membership and returns to its roots of advancing the profession in order to serve societal needs that without us are otherwise unmet.
To be clear, I'm not arguing for diminishing the House but elevating it. I'm arguing for fewer motions with bigger impact. I'm arguing for a delegate experience that feels welcoming to practicing moms, early career members with student loan debt and a side hustle, and other folks who can give us intensive and thoughtful service but perhaps not the months of detailed governance that our current model consumes.
I'd also like us to create a better environment for thought-sharing and debate within our association, and that starts with the House. Increasingly, the House Hub is more argument than inquiry, more lecturing than listening.
We need transformation, and thankfully technology can support a new, more inclusive, and less burdensome model. All of you deserve a better experience as delegates, and we deserve a better image of our association. And all of us – all of us – are responsible for ensuring that the House remains a strength of our association.
Maybe the first step is to remember that progress is possible outside of motion development. After all, adopting a position is often the easy part. Living our positions is where we find meaning, and that takes more than words on a page. It takes action, commitment, collaboration, and a willingness to do our best, at times fall short, and then try again.
Sometimes the best thing we can do is try to make a difference where we are.
This is particularly true for one of our greatest challenges and highest priorities: advancing diversity, equity, and inclusion in our profession and association. Change is necessary, the time is now, and the House must be part of our collective response. But like achievement of evidence-based practice, success is not as simple as adopting an ideal, and rarely is there one slam dunk solution.
I'm proud of the steps we've taken in recent years: doubling the Minority Scholarship Fund; forming the standing committee on diversity, equity, and inclusion – not to mention multiple component groups focused on advancing DEI; investing in our future through the Centennial Scholars program; collaborating on the Lynda D. Woodruff Lecture; making recommendations to CAPTE about admissions criteria; and creating the PT Moves Me initiative to diversify our pipelines, to name a few.
We haven't transformed our association just yet, and we certainly haven't shattered biases that are deeply ingrained in our country at large, but we have demonstrated our desire to be different and our commitment to be better.
That “we” includes this body. It includes our Board of Directors. And it includes our whole organization – APTA members and staff – who turn our intent into reality. We're all in this together.
In the midst of COVID-19, that togetherness has been harder for us to feel. Zoom has made collaboration easier, but it has worn us out. It has slowed the old-fashioned relationship building that helps grow our trust in each other. Social media is supposed to connect communities, yet I can't help but notice how it seems to pull people apart. Sometimes it feels like we've lost sight of each other, that we see avatars and not human beings.
If the early years of my presidency were defined by people asking me what I think about things, recently it's been more common for folks to tell me what I should think. I don't believe this trend is specific to me, and I hope we can go back to a more generous posture of assuming positive intent and asking questions before jumping to assumptions and accusations.
These recent experiences have made me question our progress, quite frankly. Would our foremothers be proud of our efforts? Or are we resting on their successes? Are we good stewards of what has been handed down to us? Or are we squandering their investments?
Are we living up to our potential? Are we making the most of all the time invested in leadership and in this House? Or are we competing with each other – with ourselves – for space, resources, or attention?
Time will tell.
We have 100 years of history in the books – a century of investments by leagues of heroes who paved our path to self-directed doctoral education, licensure in every jurisdiction, direct access that gets better with every iteration, burgeoning research prowess and grant success, and our regard as an essential health benefit.
Our profession's challenges are real – crippling student debt, not unique to our profession but threatening it nonetheless, is perhaps chief among them. But when it comes to our future, I refuse to wallow in pessimism, so kindly leave me out of any conversations so focused on what we lack that they ignore the gifts that we already have. When venture capitalists are increasingly throwing money at our potential, we, too, ought to bet on us.
My money is on the small practice owner who represents this profession within her community with tenacity, compassion, and enthusiastic presence.
My money is on the student who finally got into a DPT program on their third attempt, who has to work twice as hard as their classmates just to pass – but who considers their admission into this profession as a great honor and privilege.
My money is on that early career faculty member who chose the tenure track because they want to earn their way through scholarly and innovative contributions to our profession's future.
My money is on those who choose residency to develop their clinical reasoning under the mentoring of skilled experts so they can provide optimal service to their patients.
My money is on our colleagues in the clinical trenches who love what they get to wake up and do every day – who go beyond what is expected for their patients.
My money is on this organization as the vehicle that has carried us so far already, and is positioned to serve our future with strong, committed, and invested leadership.
My money is on us and our future.
We've come too far in our first 100 years and have too much for which to be proud to spend so much energy lamenting about what we aren't. That's evidence of an inferiority complex that by now we should have outgrown.
Your mentors fought hard for the opportunities we now enjoy. Let's do something with it.
And when you serve APTA, approach it as an opportunity to bring your absolute best – to build community, to contribute, to listen and to learn, and to move us to an even higher plane.
When we thrive, in this room, APTA thrives, our profession thrives, and those we serve are the benefactors. We truly are better together. Let's keep it that way!
While we're at it, a little bit of levity wouldn't hurt either.
Life is too short to take ourselves so seriously. One of the things I'm going to miss most about not being president is the chance to make Justin Moore's forehead turn red with panic over what might come out of my mouth next.
My most cherished relationships have been born out of service, and that's particularly true with our CEO, who over the years has treated me like family and a true partner in association stewardship. Being president can feel isolating at times, but Justin, his wife Jennifer, and their kids, Connor and Maggie, have ensured that I've never felt alone.
“Never apologize for passion,” Justin once told me. It's fitting advice coming from him, a scrappy Midwesterner with an incredible work ethic. No one in our association is more passionate about our progress than Justin. No one has a higher confidence in what we can become or how quickly we can get there – sometimes the expectations are pretty high. Powered by coffee, Snickers bars, and pure grit and determination, no one spends more energy on APTA.
Years ago, early in his tenure as CEO, Justin and I sat at a white board and talked about bold moves toward our centennial. Our 100th anniversary felt far away, the way college seems to an elementary school student. But the years went by in a blur, like they do for a parent, and now we're here – celebrating our arrival at this historic milestone the same way we got here: together.
We did none of this alone. Every step of the way there has been an army of warriors beside us – selfless leaders on our Board and staff teams who worked tirelessly to bring us to this moment, and I'm so grateful to have shared this journey with them and you all.
One hundred years ago, a group of women gathered at Keens Chophouse powered by the bold idea that a united association is greater than the sum of its parts. They were right.
They couldn't have comprehended what they were starting that day – January 15, 1921. They couldn't have foreseen how our profession would mature. They couldn't have imagined how relatively simple exercises, prescribed with evidence-based precision, could transform lives. They couldn't predict the barriers we'd have to overcome while pursuing a vision that was beyond their wildest dreams.
What they clearly understood, though, is that the proverb is true: “if you want to go fast, go alone; but if you want to go far, go together.”
Over 100 years, we've gone far. Over our next 100 years, we'll go even farther – as long as we stick together, even in the hard times. Especially in the hard times. That's our why.
We are APTA. We are its beneficiaries and supporters. We are its tradition and innovation. We are its realists and dreamers. We are its past and its future.
And of course we are its present, forever holding possibility in our hands.
How will we use this moment before it slips through our fingers? How will we use the next one, and the one after that?
Never underestimate what you can do in a moment. You can pack it with hope, with fervor, with love. You can reach out, console a colleague, open a door, lift someone up, lend a hand. You can listen, you can hear, you can understand.
In the end, a centennial is a collection of countless tiny moments joined together. And that's how we go forward now into our second century: one moment at a time, individually and collectively as one.
That's the power of community. That's the power of 100 years. That's the power of APTA in 2021.
What a privilege it is to be in this moment with you. Together.