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APTA's early days were marked by a clear understanding of the importance of international collaboration, according to Judith Deutsch, PT, PhD, FAPTA. Now, Deutsch believes, it's time APTA returned to those roots, using its community and collective expertise to empower physical therapy around the world.

Deutsch's call to action was at the heart of her Mary Millan Lecture delivered at the 2024 APTA Combined Sections Meeting in Boston. Titled "Arriba y Adelante: Looking Outward and Moving Ahead," her presentation upheld the annual lecture series' tradition of challenging the profession to fulfill its potential. For Deutsch, that potential is global in scope.

"I want to talk today about the imperative of looking outward to move ahead — outward from the silos within the profession, outward from the profession, outward from the United States, and even further outward to consider our planet," Deutsch said. "We are citizens of the global community and in particular the Americas … and we have the privilege and imperative to commit, communicate, connect, collaborate, and contribute."

Deutsch explained that her interest in global collaboration is bound up in her own life story. Born and raised in Mexico City to refugees from Nazi Europe, Deutsch grew up with an expansive perspective. That perspective ultimately informed the direction she chose for her lecture, which she described as "not my area of scholarship but rather my lived experience."

"I was raised to look at the world and consider my role in it," Deutsch said. "This has served me well in my career as a physical therapist, clinician, educator, and scientist. The richness of my experience is gained from collaborations with colleagues and students all over the globe."

For Deutsch, the pivot toward a more globally facing profession is a three-step process that begins with making and communicating a clear commitment to global engagement, followed by using internal connections to further strengthen APTA's ability have even more impact internationally. The third step: With a clear, unified, and multilayered strategy in place, the U.S. physical therapy profession can make significant collaborative contributions to global health.

Deutsch also shared her thoughts on APTA's current level of global involvement and communicated commitment. She said that while she was pleased to discover a range of collaborative efforts — including strong working relationship with physical therapy associations in other countries and significant involvement with World Physiotherapy — the association should seize other opportunities to build on those successes. Those include a deeper relationship with the Pan American Health Organization, more centralized globally focused resources, and an exploration of possible funding for international research in the Americas. Deutsch also suggested the creation of an "APTA ambassador" role that would oversee the association's internationally facing work.

The shift to a more global focus is needed sooner than later, Deutsch explained, if for no other reason than to support the World Health Organization's recently adopted resolution on strengthening rehabilitation in health systems.

"For the first time in [WHO's] 75-year history, rehabilitation is acknowledged as a critical part of health," Deutsch said. "We need to act now as the world community embraces rehabilitation so we can better meet our social responsibilities to the global community while at the same time enhancing our own practice."

Attention to issues outside U.S. borders shouldn't be thought of as something new for the profession, according to Deutsch — in fact, just the opposite. To make her point, Deutsch shared moments from APTA history that demonstrated an acknowledgment of the importance of global connectedness.  Deutsch asserted that history can be traced back to Mary McMillan herself, who was born in the U.S. but moved to Scotland as a child. "What I think is important to note in the context of this lecture is that her training was abroad and she brought it back to the U.S.," she said.

"My sense is that in our very early days we demonstrated a strong connection in the global community and engaged with it fully," Deutsch said. "We continue to contribute, but I really have a lot of questions. Are we contributing enough? Are we well organized and strategic in our global engagement? Are we really living our values of social responsibility? Do we look outward enough? I believe we can do more."

While Deutsch's lecture made it clear that there's much work to do, she also pointed to indications that APTA is already moving in a more global direction, citing the international outreach conducted to create APTA's soon-to-be-published clinical practice guideline on telehealth as "the best example of what we're doing now that gives me hope."

"I strongly believe we are well positioned to build on the history of our early founders and on our previous engagements with the global community," Deutsch said. "Now we just have to look outward and move forward by communicating, connecting, committing, collaborating, and contributing."

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