As APTA celebrated 100 years of history, the association's House of Delegates turned to the future, and set a course for the association's next century by affirming APTA as an organization more committed than ever to embracing inclusion at both internal and external levels and taking on systemic racism. Those actions were among the most notable in the 77th House session, which included adopting revised bylaws that, among other things, expand the role of PTAs in governance, and passing motions to address unethical productivity standards and promote the role of physical therapist services in recovery from COVID-19.
[Note: This article was published before the official minutes of the House were formally adopted. Language quoted here may be different from final content of House positions, which will be posted in the coming months.]
Addressing Systemic Racism and DEI
The importance of addressing racism and supporting diversity, equity, and inclusion was a theme that emerged repeatedly during the House session. That theme was turned into action in three important areas: a statement on APTA's role in addressing racism, the addition of "inclusion" to the profession's list of core values, and an affirmation that the association will take a careful approach when selecting and planning events to ensure that they make a positive impact on vulnerable populations in the host location.
A commitment to anti-racism. While addressing issues of diversity, equity, and inclusion in the physical therapy profession has been a pillar of APTA's strategic plan since 2019 and a component of the association's operations decades before that, the 2021 House saw to it that the organization made its position unequivocal.
In a statement adopted overwhelmingly by delegates, APTA is "committed to being an anti-racist organization" that believes the association and members, collectively and individually, "have an obligation to address policies and practices that perpetuate systemic racism and inequity in our association, the profession, and society."
Inclusion as a core value. The core values for physical therapists and physical therapist assistants have been built around accountability, altruism, collaboration, compassion and caring, duty, excellence, integrity, and social responsibility. Now PTs and PTAs can add "inclusion" to that list.
Described as occurring when the PT and PTA "create a welcoming and equitable environment for all," inclusion is demonstrated by "providing a safe space, elevating diverse and minority voices, acknowledging personal biases that may impact patient care, and taking a position of anti-discrimination."
Care with APTA event planning. Consistent with a previous statement of the Board of Directors, APTA will leverage its standing committee on diversity, equity, and inclusion in the site selection process for national conferences and events, and in how APTA uses those events as opportunities to advance DEI. The new House position doesn't limit meeting locations but requires that APTA "pursue safe, inclusive experiences for attendees of national conferences/events" and "identify and promote opportunities for members and attendees to make a positive impact on the needs of vulnerable health populations” through those events.
Additionally, APTA will implement proactive strategies with its components to collaborate on proposed dates and locations for revenue-generating, open registration events to identify and mitigate any potential scheduling, location, and financial concerns across APTA’s federated model.
Focus on Internal Inclusion
The House overwhelmingly adopted revised set of association bylaws and standing rules, the result of a two-year special committee review.
A highlight of the bylaws is a change that gives PTAs more rights in the House. Two members of the PTA Caucus will now be seated as full voting delegates with the same rights and responsibilities as voting delegates from APTA chapters and sections/academies.
Delegates also considered the ways the House's own culture has evolved into "year-round governance" that demands continuous attention from delegates as motions and other discussions are presented throughout the year. Critics of the model say that the current demands of being a delegate make it hard for many potential leaders to make the time for service, including a disproportionate number of those from underrepresented populations.
In response, the House charged APTA to conduct an evaluation of the House governance cycle to assess its "purposes, outcomes, and sustainability." A report with a description of the evaluation and recommendations for change, including a calendar, are due in 2022.
Attention to Productivity Standards that Respect Clinical Judgment
Productivity standards, used in many practice settings, can and should be reassessed and amended when necessary: That's the bottom line behind a new House position and related directive.
Rather than a list of the many potential dangers of inappropriate productivity standards, the association's new position describes how acceptable standards must strike a balance between patient experience and outcome, respect for clinical judgement, adherence to the code of ethics for the physical therapist, economics of care delivery models, and improved provider work experience. In a related action, the House directed APTA to address unreasonable clinical productivity standards by developing resources that "prioritize professional ethical standards and clinician well-being."
Highlighting Physical Therapy in COVID-19 Care and Recovery
Patients who have or are recovering from COVID-19, including those with lasting effects known informally as long COVID, can benefit greatly from physical therapist services—but are they aware of that? And perhaps even more important, are PTs, PTAs, and other stakeholders knowledgeable about the role physical therapy can play?.A charge to the association adopted by the House aims to get the word out.
The charge instructs APTA to launch a media campaign to promote physical therapist services "as essential and integral providers in the interprofessional team of health providers for management of individuals affected by the multisystem impact of COVID-19 and post-acute sequelae of SARS CoV-2." Additionally, in collaboration with sections/academies and other pertinent organizations, the association will distribute evidence-based resources related to serving the physical therapy needs of individuals with COVID-19 and its sequelae.
A Closer Look at Specialization
Delegates agreed that it's time for APTA to dive deeper into specialization within the physical therapy profession, and charged the association with conducting an examination of its history and current state, with the aim of creating "a long-term strategy to enhance the evolution and integration of specialization, and potentially sub-specialization, into the advanced practice of physical therapy." A report on that analysis is due to the House in 2023.