A few months ago I was at a family dinner and my sister-in-law was moving gingerly and grimacing in pain. I asked what was wrong and she responded that she had tweaked her back at work (she is a veterinarian) and was really struggling with daily movement and that lifting/bending at work were all but impossible.
She paused, then hesitantly asked, “Would you be willing to show me a few stretches that might help?”
She was hesitating because she didn’t want to ask me to work while I was “off the clock”- but we are never really off the clock, are we? Like most physical therapists, I can’t see someone who is in musculoskeletal pain and not put my hands on them (with permission, obviously!). So she and I moved into the living room, did an evaluation to ensure it was actually simple musculoskeletal pain, and then moved into some treatment. A couple of lumbopelvic manipulations and some soft tissue mobilization later, she was feeling normal. We discussed some pelvic girdle and core strengthening exercises, body mechanics during work, nutrition (the pelvic health therapist in me can’t help it), and, yes, some stretches, and then rejoined the family.
As I was thinking about this interaction, I realized (not for the first time!) how much I love having the knowledge and hand skills to provide immediate pain relief in these types of situations. An orthopedic surgeon, medical student, and former nurse were in attendance that day, and while they had some helpful information to share about back pain, I was the one who was able to do something in the moment to help her achieve meaningful change.
And then, as they often do, my thoughts diverted to how much I wish that our profession was better known and represented in the world. My sister-in-law, like many people, truly thought all I could offer her was stretching. Once we were finished, she exclaimed something along the lines of “Wow, you guys (physical therapists) need to shout what you can do from the rooftops! I had no idea how much you could do to help me!”
Now, let’s acknowledge the glaringly obvious: my own sister-in-law didn’t really know what I do for a living. Granted, I tend to keep work and family life relatively separate, but in some ways, maybe that is part of the problem. It’s true that therapists (I would definitely also include occupational and speech therapists in this category) are quite underrepresented in pop culture. It’s also true that our professional organizations tend to lack funding to have significant ad campaigns (imagine a beautiful commercial like those put out by drug companies, but without the quickly-passed-over side effects of significant injury and death at the end!) and representation.
Maybe education/advocacy needs to start with us-a grassroots effort to spread the word that we do so much more than just providing stretches (don’t get me wrong, I think mobility/flexibility are important and do often prescribe stretching as part of my care plan for a patient). We need to back up APTA’s national campaigns with real, on-the-ground presence in our communities, advocating for what we do.
Of course, we do advocate (hopefully!) one patient at a time by providing excellent care to those who walk in our doors. But that is clearly not enough, if it were, “try physical therapy” would be on everyone’s lips when discussions about musculoskeletal or neuromuscular dysfunction arise. We need to shift our thinking about how we represent our profession and ourselves. What are some ways we do that? I don’t know that I have all the answers, but some shifts I am personally making include:
Providing education and advocacy in my personal circles of influence. I am a mother of young children-this means I am in a lot of Facebook mom groups, chat with other parents at school pick up, and have quite a few medical visits (mostly well child checks thankfully!) as part of my daily life. I have started speaking up when parents talk about having pain, relatives with neuromotor dysfunction, leaking when they jump or cough, and so on, and I am trying to be very conscious of doing so in such a way that I am promoting rehabilitative therapies as professions, not necessarily myself specifically. I don’t think self promotion is wrong at all, but I also realistically can’t see the whole world and I want people to think therapy first, not just think of my name, when in need of care. And, yes, I am talking more about what I do when appropriate with family and friends.
Being more conscious of how I interact with others at marketing events. Of course I have always provided education at these events-but how much more powerful is it to provide free screenings when working an event for moms expecting babies vs just chatting about how therapy can help with pregnancy related back pain or incontinence? When I go to speak with physicians, I try hard to bring a fellow therapist so that we can demonstrate some of the things (outside of stretching!) that we do on each other-if that is not an option, I try to demonstrate on the physicians.
Being more involved in physical therapist education at all levels. This is the future of our profession! I personally really enjoy teaching, so for me this looks like teaching CE locally and nationally as well as guest lecturing for entry level programs when the opportunity arises. I am not 100% clinical at this stage of my career, so I do not function as a clinical instructor when students rotate through my clinical, but I do meet with them to teach them some of the skills that will serve them well during their careers (the super boring ones, like how to read insurance benefits and document effectively). And I absolutely love having the opportunity to hire a new grad and mentor/teach them in their first year or few years out of school.
Being involved in the education of other medical professionals. This is a little “easier” for me because I work in a teaching hospital, and have a supportive department who helps in setting these opportunities up. It is truly amazing how little other healthcare professionals know about what we do, and having the opportunity to share that information with medical students, residents in many different specialties, and nurses at both the student and professional level is a privilege! Sometimes that is formal (lecturing to medical students or at Grand Rounds), sometimes it is informal (having residents come shadow at the clinic), either way, it’s so awesome to be able to have some cross-disciplinary collaboration, and hopefully help make sure those up and coming professionals “think PT” early, not when they have exhausted all other options for their patients.
I would love to hear your thoughts, what are some ways that you can leverage your strengths and passions to advocate for our profession? Nothing is too big or too small, every effort counts, and it would be fantastic for us to all glean inspiration from one another!
Commented May 3, 2020
This is a very informative article. Thanks a lot! I have come across websites about knee and ankle problems too, for me as considered overweight, I have no High Blood Pressure, got no diabetes but I developed Edema in my feet as I always sit down the whole day, I really need to take this seriously. btw, the websites are https://kneeforce.com and https://ankleaction.com :-)
Commented January 31, 2020
Tracy, Thank you so much for your feedback and kind words! I agree with you that it is more expensive than many of us would like (and while patients are bearing more and more of the cost, therapy services are actually being reimbursed less and less...it's a tricky situation without easy answers). To me, this makes it absolutely imperative that we are providing services that are the absolute top of our licenses-we can't just show people stretches or passive treatments anymore. We have to be cutting edge so we are giving people good value for their time AND money, and make our services worth what people have to pay. And we need to speak about our worth (and have patients like you do the same!) so that hopefully the insurance situation can be improved upon! Best wishes with your recovery!
Commented January 30, 2020
Hi! Great article! As someone who has been in physical therapy for 9 months (shoulder issues and 2 subsequent shoulder surgeries), I would say that Physical Therapists as invaluable. A surgeon may fix you, but PT gives you your life back! That being said, I think the biggest obstacle is the cost. It’s insanely expensive in my state (SD) and for that reason alone, I would try every other option to avoid PT, until I have to see them. Also, a lot of insurance only cover a small number of appointments (and you pay mightily for each session), and once you hit that max, paying out of pocket to continue will also cause people to find care elsewhere. Just my two thoughts. I think PT’s are awesome and amazing and I wish more people could benefit from them!
Commented October 30, 2019
Thanks so much for sharing, Matty! I am very lucky that I work for a relatively progressive teaching hospital that really encourages interdisciplinary collaboration. It was much harder when I was in private practice! Usually when I did it there, it was via shadowing or trading inservices, but definitely MUCH harder than my current setup. Thank you for everything you do to be a change agent!!
Commented October 30, 2019
Thank you for writing this! I too am so often doing "off-the-clock" work for family and friends and also have to dispel many myths about what PT is and, more importantly, is not. I find very interesting your work setup where you have such close contact with peers on other healthcare fields, and how easy communication can be. I am in the private practice outpatient world, and getting even a minute of time on a phone with an MD or DO can be a daunting hurdle to overcome. I like how you work to advocate to all patients, something I know I can do better. Spreading the word publicly about how much we can help, and all of the different avenues in which PT can help, will improve pt's perspective on PT, outcomes of people with neuromusculoskeletal disorders/pain, cost of healthcare in our very expensive world, and the healthcare system as a whole. I find it somewhat of a grievance how much we have to advocate our services to other healthcare professionals, given our well-documented success with our given pt populations, and with the massive increase in level 1 research in our field. Overcoming this obstacle may be one of the largest, most difficult, and most important things that PT can do in the next 10 years. And I hope that with advocates like you, it is an obstacle that will be overcome! Thank you again for thoughts on the matter, just thought I'd share a few of my own.
Commented October 15, 2019
Thank you as always for sharing your thoughts and experiences with us
Commented October 14, 2019
Jessie, I completely agree. I got exactly zero marketing anything in PT school, even when it comes to marketing ourselves to our patients (to some degree we need to "sell" every patient that walks in the door on physical therapy). I only learned about it by necessity because I became a clinic director relatively early in my career, but had that not been the case, I think I still would be fairly uncomfortable with it! Many therapists I think feel guilty for "selling" what they can do, I'm not entirely sure why. I agree that many times these conversations don't have to be intimidating! We can just let our passion flow. I also wonder if some of the issue is challenge with just being so busy in our day to day lives and practices that it is tough to do things like attend a capitol meeting or have lunch with a colleague in another profession. Either way, thanks for your perspective, it's so true and valuable!
Commented October 13, 2019
Jen, Thanks for this excellent post! I often wonder why many PTs feel uncomfortable standing up and saying, "We know AMAZING stuff and we can help!" Is it lack of confidence, confusion between humility and modesty, or simply a lack of know-how when it comes to advocating for our profession? I'm not sure what your PT school training entailed in terms of business, but my entry-level-program sure did NOT have a marketing component, and largely assumed referrals would flow freely from MDs. I'm assuming, little did my professors know over 20 years ago, that we would have direct access, an opioid crisis, and a DIRE NEED for PTs to let the public know what we have to offer! Recently, I attended our state's Physical Therapy Legislative Day. Our state association and lobbyists teamed up to produce a very succinct document (a script of sorts) to share with our legislators. It outlined the various settings in which therapists worked, from prevention (Fit For Work type settings) to neuro, to pain, to post-op. There were at least 20 different settings highlighting the breadth of our knowledge and practice. We were encouraged simply to go through this document and inform them of all therapy has to offer, as well as let them know that if there were bills they were working on pertaining to these types of things, we are here to help. This was particularly useful for the students in attendance, who were quite nervous talking to their representatives and staffers. As I shared some of the content of the document with my representatives' staffers, my passion regarding pain science, patient education, and working to fight the opioid epidemic came through. I followed up with an e-mail to one of my representatives who I learned has a specific interest in substance abuse. We are now chatting about having lunch, and he is curious about a PT perspective on a few Wisconsin health care bills in the queue. I share that simply to illustrate that even things that seem like they might be intimidating really aren't that bad! Whether it's our family and friends, as you eloquently described in your story, the general public, or our public officials, we are all just fellow human beings, and most folks are interested in learning how to navigate the confusing landscape of health in the U.S. We do have a lot to offer and could learn a bit from some of the other folks in the health care scene who have no problem shouting their value from the rooftops. ;-) Thanks for this great reminder! Jessie