We are living in divisive times—in fact, at this point, “divisive” is practically an understatement. Disagreements over politics, especially as we draw closer to the November elections, have become so consuming and all-encompassing that no matter what conversation you’re trying to have, there’s always a chance you’ll stumble into an all-out political brawl. Due in large part to the coronavirus pandemic, this electric political charge is more present than ever in discussions about health care—whether you’re talking about the insurance system, care access, CDC guidelines, or even masks.
I applaud rehab therapists for raising their voices and fighting to be heard in these conversations, but there are two sides to this coin. While some rehab therapists have used healthcare-centric political discussions as an opportunity to broadcast their voices, others have clammed up because they’ve felt the risk of being judged for their opinions was too great—or they figured it wasn’t worth fighting all the noise. Either way, I’m not trying to cast aspersions—it’s incredibly easy to get sucked into incendiary politics, particularly via social media. However, I believe that engaging in this polarization frenzy (especially in a way that results in name-calling) is distracting us from an incredible opportunity to effect positive change at scale—and to move our profession forward in ways we never could have imagined pre-2020.
We still need to solve our brand problem.
I believe, as I have for many years now, that the biggest obstacle facing the PT industry is our brand problem. We know that 90% of patients who could benefit from physical therapy never receive it. There are many reasons this could be the case. Many patients face barriers to care access: we know that PT copays are high and there aren’t enough PTs working in rural and underserved areas. And many therapy providers aren’t approaching patients with the right marketing message—thus driving them toward riskier “quick fix” solutions. Perhaps most importantly, though, a large portion of patient-consumers simply do not know that physical therapy could help them. A 2016 joint study between Gallup and the Palmer College of Chiropractic actually found that, when given a choice to visit one of five healthcare providers for neck and back pain, only 6% of patients picked a PT.
Whatever the case, we know that—pandemic or not—we’re missing out on 90% of our potential patient audience. Tackling this problem should be one of our highest-ranking priorities—not getting into politically charged online scraps with our fellow therapists.
Finding Unity in Dark Times
The COVID-19 pandemic is, at its core, tragic and burdensome for the entire country. But, for as much tribulation as it has caused, it has also left a PT-sized hole in the American healthcare system that we are perfectly suited to fill. If PTs are willing to distance themselves from political spats and focus on tackling COVID-19, I believe that we can unite our profession and strengthen the PT brand. In fact, we’ve already started to make some headway, as we’ve seen with the fight against the 9% cuts. We’re reaching across the healthcare aisle more than ever, building coalitions with orthopedic surgeons, radiologists, and even the American Medical Association (AMA). This effort to forge collaboration among providers in the pursuit of a patient-centric healthcare model will only make all of us stronger post-pandemic, and we must continue to embrace it.
We have the tools to improve baseline health—which helps reduce COVID-19 symptom severity.
In line with a patient-centric way of thinking, it’s important to consider the impact of the pandemic on the American patient population, specifically. One of the many reasons America has been hit so hard by COVID-19 compared to other developed countries is that we, as a nation, are a decidedly unhealthy population.
In 2019, The Commonwealth Fund compared American health to the health of citizens in 10 other high-income countries. Compared to those countries, the US “has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average.” The US even has the lowest life expectancy. Additionally, we have 50% more hospitalizations for diabetes and hypertension.
What’s critical to note is that, on its website, the CDC lists all of these comorbidities (diabetes, heart disease, hypertension, obesity, asthma, and chronic lung disease) as underlying medical conditions that increase risk (or potentially increase risk) “of severe illness from the virus that causes COVID-19.”
Fighting COVID-19 Together
While there are still many things we don’t know about COVID-19, one thing that’s clear is that those with severe cases are more likely to end up in the hospital—and more likely to die from the disease. Following that chain of logic, we can draw a stunning conclusion: PTs are perfectly positioned to reduce the rate of hospitalization and death due to COVID-19. We have the tools to help prevent diabetes, heart disease, hypertension, and obesity—as well as improve cardiorespiratory fitness—at scale. I would argue that we are the best-equipped profession to decrease the prevalence of these conditions. I mean, take a look at this recently published study, which correlates cardiorespiratory fitness with reduced incidence of hospitalization (and lower risk of complications) following a COVID-19 infection. This is the science we should be paying attention to. This is the evidence we should be blasting out on our social networks. If PTs can unite around the effort to increase the US population’s baseline health and fitness, we have the opportunity to dampen the damage of this pandemic and future health crises. We can literally save lives.
Many COVID-19 patients need our help now.
PTs are well aware that long-term inpatient care is tough on the body. Humans weren’t built to be bedridden, but many patients who experience severe cases of COVID-19 lie nearly motionless for several weeks and require intense cognitive and physical rehabilitation as part of their recovery. Again, PTs are uniquely positioned to help in this regard. We are rehabilitative experts, and we know how to safely get people—especially people who are struggling with muscle and respiratory weakness—back on their feet.
Furthermore, we’ve seen more and more COVID-19 patients come out of the woodwork who call themselves “long-haulers” because they experience symptoms for weeks or months after their original positive diagnosis. These patients can experience chronic symptoms like “fatigue, headaches, shortness of breath, muscle pain” and more—and they also will benefit from rehabilitative care. Plus, some of those patients report that over-exertion causes their symptoms to flare up. A PT (especially a PT who’s well-versed in chronic illness care) could help these patients learn their limits as well as adapt exercise protocols and activity levels to minimize such flare-ups.
We have an unprecedented opportunity to prove our value in the long term.
At this point, I hope I’ve at least convinced you of the immense potential beckoning our profession. Unfortunately, if I’m being realistic, PTs do not currently have the clout or influence necessary to widely impact our nation’s population health and turn the current pandemic around—nor should we fool ourselves into thinking that we could do so single-handedly. However, we do have the opportunity to collect data that will set us up to be more effective in the future. Every time we treat a patient with a comorbidity that may cause complications with viral infections, we must collect outcomes data showing how we’ve improved that patient’s health. Every time we treat a COVID-19 patient, we must collect data that shows how we helped speed recovery and improve long-term quality of life.
Collecting and sharing this data will allow us to publish research and showcase positive results, lending us legitimacy when we try to push our services—and establish our profession—as a viable solution to future healthcare crises.
Opening Access to Care
Collecting and analyzing this type of evidence will have other benefits, too. This data will give PTs leverage to negotiate better payments, encourage better insurance coverage of therapy services, garner support for pro-PT legislation, and build a more prominent reputation in the greater healthcare community. This, in turn, will help us open up access to groups that PTs have historically not been able to reach at scale—like patients in rural and underserved areas, as well as non-white patient populations.
I’m all for friendly discourse, but it’s time for this infighting to stop. We have a chance to build a better future for our profession and our country—but we can only do that if we drop the “us-versus-them” narrative and join forces with our PT peers as well as healthcare providers in other disciplines. We need to look at COVID-19 for what it is: a disease that irreversibly changed our world and our perspective on health care. This will not be the last healthcare crisis we weather during our lifetimes, but we can use what we’ve learned to make damn sure we’re ready for the next one.