The Art of Compromise

By Terry C. Brown, PT, DPT

There has been—and continues to be—debate over payment reform with the main controversy centered on coding reform. There is also much disagreement on the best way to proceed on coding—and for any of you that follow various social media outlets, this discourse has been publicized. It has created a divide within our profession that troubles me.

If together all things are possible, then compromise is the art by which we can get things done. Unless one ideology triumphs over all facets of physical therapy, then compromise is necessary to govern for the benefit of all physical therapists. To reject compromise is to allow the status quo to persevere and change fall to rejection. We must not allow this to happen in our approach to payment reform.

Each of us looks at how we are paid for services through our unique experience. In private practice we may believe that the present system is working reasonably well or we may think the system and our businesses are on the brink of disaster. Some of this is based on geographic location, scale of practice, and style of treatment. Some is based on our ability to thrive in the present environment. Imagine the diversity when we look at payment through the lens of the nursing home or acute care therapist. Is it any wonder that agreement on the perfect payment system for our services is controversial?

So how do we agree on what is best for this profession? I believe that it is through open, honest engagement with all stakeholders. Each of us must stand up for what we want, what is important, make our case, and encourage others to do the same. Listen to someone else’s side, and we sidestep the potential power struggle. Finally, negotiate the compromise. If all of us put aside our personal bias and focus on what increases access to our services and simplifies our regulatory burden, then our compromise has the potential to lead all of us forward together as a strong and unified profession. If we splinter and go off in pursuit of our own best interests, then the status quo is the best we can expect.

The American Physical Therapy Association (APTA) has opened the dialogue and shown true leadership in their willingness to listen and negotiate through honest discussion with all stakeholders. The Private Practice Section (PPS) has taken a leadership role in standing up for what we want, listening to other sides, and leading the art of compromise. Other stakeholders have shown a willingness to work together to do this the right way. I applaud all of those who have stepped up with honesty and transparency. Together we can, and will, move our profession to its rightful place as the entry-level provider for movement dysfunction.