Future of Physical Therapy 2015 (Part 1)

This is a follow up post from one of my all time, most popular blog posts "Future Thoughts for Private Practice Physical Therapy" from January 2014.

As a one year follow up, I will be comparing my current thoughts to the circumstances from a year ago. Moreover, there will be some discussion on larger issues at hand to where Physical Therapists are very well positioned to disrupt healthcare at large.

PS. This is a long post. Want to skip to the "good stuff?" It starts at "2015 - It's Time To DisruPT!"

PPS. Every once in a while, I diverge from my characteristically positive and constructive presence to delve into some hard, honest topics. There will be some of that in this post. However, as always, I practice what I preach and I bring solutions as well.

Future of Physical Therapy 2015

It has been a very interesting year in physical therapy, in healthcare, and in life. The world has gotten a lot smaller, and sadly, it seems to have also gotten a lot messier. We're doing okay, but people don't seem to be as happy. Many of us want change -- constructive changes. However, it doesn't really seem like anyone really has the answers to be agreed upon.

Yet, for all that we wish to have changed, we can take a look back on 2014 and appreciate that a lot has already changed. For myself, I've finished writing a book and am grinding through the publishing process (P.S. Know of an interested literary agent? Let me know!)

I have also changed employments several times and have officially experienced every segment in healthcare. That's right! Acute care, rehab, skilled, outpatient, home health, wellness, consulting, etc. you name it, I've seen, heard, done it, and moved on. Come April, I will finish an MBA in Marketing from the University of Michigan - Dearborn. From there, who knows!!! Apparently, some people wish for me to go into professional leadership, policy making or even politics... *shudders*

In any case, after some truly inspiring conversations with several leaders in healthcare, I came back to look upon my blog to see what has been the most influential posts, interactions, and concepts in the last year. Sure enough, this exploration into the ideas of THE FUTURE won out. And so, I'm here to give the public what they want with this 2015 follow up.

2014, Year To Date.

To really explore 2014, I had to look back to 2013 to see where we were at. In 2013, the physical therapy world demonstrated a true interest in the external components in the range and scope of the profession. Novel interdisciplinary trends around the world, primarily cooperative and collaborative efforts with the nursing profession were getting traction on the inpatient side of life. On the private practice front, we saw that PTs began to establish independent communities, primarily based on content, products, and schools of thought verified by social proof.

Here is a SWOT analysis in Spring of 2013 that I posted in the month of March. You can find more on this here & here.

I felt that much of the physical therapy world (and healthcare) struggled with the circumstances described in my SWOT analysis through 2013 until things started to get shaken up in early 2014.

This is where things truly got interesting. We've seen that private practice PTs have truly branched out to become owners of businesses. It's not just the clinic hours that PTs are getting income from; there are larger fish to fry including products, new service lines and brand experiences, and some legitimate legal gains in several states.

There exists a growing spirit of unity, particularly amongst the students and new grads. They are interested in finding ways to bring the pieces together. Also, more PTs are getting out there into commercial, retail, and even open market spaces. It also appears the DPT programs are starting to take notice that if they do not facilitate change, there won't be many PT schools left due to reimbursement backflow and cost of loans.

So, all in all, many positive directions were taken in 2014 -- primarily the strategic placement of the many chess pieces involved -- much as a chess master makes before the critical and decisive move.

Unfortunately, while strategic movements was in play, financial decline also occurred. A new wave of audits occurred in a grand and terrifying way. Third party payers were pairing with Medicare dollars in an effort to maximize market share and thus revenue dollars, edging out competition where ever possible under the guise of resource management.

The market responded with another parallel wave of "creative" billing and extension of health services. As there was only so much money in the pot, the powers at be decreased the portions to be divvied out per service in response. This only created a destructive feedback loop. Companies realizing their margins were quickly shrinking continued to push utilization in hopes of demonstrating sustainable growth to senior management and shareholders. Of course, we know what happened... "everyone" did this and "everyone" got hurt as a result.

@CynicalPT @blairgreen @SandyHiltonPT @Jerry_DurhamPT @PTDavidG When money drives, the well dries up quick.
— Dr. Ben Fung (@DrBenFung) December 6, 2014

As an industry, healthcare version 2014 has finally wallowed to a point where we've come face to face with this fact: putting profits before patients has gotten us as close to rock bottom as we can possibly bear.

As dire as that may sound, we also see that opportunities abound. Yet, current processes seem to hinder putting innovative action plans into play.

So, where do we go from here?


The answer and more, coming up in Future of Physical Therapy 2015 (Part 2)