By Tom DiAngelis, PT, DPT
I am not sure how many of you have been to Alexandria, Virginia, since June, but if you have, you most likely have heard that loud, steady beeping sound. If you are like me and looked around for a truck backing up in reverse, you failed to find one. Rumor has it that the sound is actually coming from our APTA headquarters, and it is the sound of our association now moving steadily backwards. For many of you experienced House of Delegate junkies, this comes as no surprise.
I have been asked by some PPS members, “What happened at the House of Delegates this year?” Even though I was there, I find it hard to explain as the events defy all logic and commonsense. After a lot of hard work by the House in 2011 and 2012, which started with the PPS motion that moved us away from the position that the physical therapist assistant (PTA) is the only care extender that we use, this year’s House managed to erase all of that forward progress. Yes, we have gone backwards, and not by a small step, but by a major leap.
Somehow, we feel confident that we can see patients who self-refer, make a diagnosis, and set up a plan of care—maybe even order imaging and treat a patient—yet our col- leagues in the House of Delegates do not believe we have the skills necessary to decide who is the best person to assist us in providing care. No one can honestly argue that it is in the patient’s best interest that the PTA is at all times and in all situations the only person who should assist us with selected interventions. I would argue that not even another doctor of physical therapy (DPT) is at all times the best person. We have been selling this for decades, and I do not think the outside world is going to buy it much longer.
In my opinion, this is why this occurred: The original PPS motion from 2011 was amended in 2012, and task forces developed to look at models of care. There were some motions at this year’s House to further amend the position, and differing opinions and motions on what the amendments should look like. At the eleventh hour, the APTA Board of Directors felt they had to introduce a motion to rescind the position altogether. Their rationale was that they wanted the House members to know that it was an option! This is an insult to every member of the House. Did they really think that the over 400 members of the House could not figure that out? The minute the board brings something like this forward, it creates the impression that this is what the board wants and is recommending. After all, who knows better than our Board of Directors? Their action set the stage. When the board introduced this at the motion discussion group meeting, they read a support statement for the motion that went beyond making us aware of the option. The support statement was lengthy, and the chair of that meeting—who happened to be the Speaker of the House and a Board member—should not have allowed the support statement to be read. If the board’s intent was truly to let us know the options, then that is what should have been stated.
The debate in the House started to go back down the road with people talking about how this would lead to more fraud and abuse. Many kept saying that we were going to allow others to provide physical therapy. I even heard the Speaker of the House on at least two occasions say “if you decide to allow others to provide physical therapy . . . ” which is not the issue at all. Other issues included an outside consultant’s report that was limited and did not tell us anything we didn’t already know. We had an interpretation that the motion in question would not take effect until specific things happened with the House, yet the Speaker said there was a difference of opinion. Even the APTA attorney spoke and said it would not take effect, but he is only the association’s paid attorney—why should we listen to him?
So the stage was set. The agenda was reordered so that the Board’s motion to rescind was heard first, rendering the other motions to amend dead before they were even heard.
The irony is that the House members were very proud of themselves because they completed the work early. There was much patting each other on the back for efficiency. Well, how hard is it to be efficient when you have wiped out the biggest motions for dis- cussion? If people want to be proud of moving their profession backwards, so be it. In my opinion, this House has nothing for which to be proud.
To say this action is frustrating is an understatement. Remember, you have a say in who your delegates are, and you also have the opportunity to become one yourself. Think about how differently events might have turned out if we had had more private practi- tioners in the House of Delegates? We might have been able to stop the beeping noise!