What I Believe

By Sam Brown, PT, DPT, CSCS

The following is adapted from a talk Sam Brown, PT, DPT, CSCS, gave at the Graham Sessions in 2015.

WHAT I BELIEVE:
I believe that Abraham Lincoln was our greatest president.
I believe that Secretariat was the greatest racehorse ever.
I believe that Muhammad Ali was the greatest boxer ever.
I believe that chocolate should be its own food group.
I believe that John Wayne was one of the greatest actors of all time.
I believe that where there is no hope for the future, there is no power in the present.
I believe the properly executed pick & roll is the best play in basketball.
I believe that the Bible is the inspired word of God.
I believe that the new ICD-10 codes are an example of the stupidity of those who govern health care.
I believe that physical therapy is the most underutilized, misunderstood profession with the most untapped potential in all of health care. And that this is our own fault.

And I believe that God created the Earth in 6 days and on the 7th day He rested in Kentucky.

To me none of those are debatable but let’s talk about the next to the last one.

So, let’s break it down a little. Underutilized—when I was in physical therapy school in the early 1970s, we took an administration class and one of the books used was by Robert Hickock. No relation to Wild Bill. It basically said that at any time, and most of this was based on inpatient information, the physical therapist would see at best 10 percent of the patient population. If the hospital had a census of 100, then you would be seeing 10 patients. This philosophy carried over to our mindset and then to the insurance carriers and reimbursement. Then, in the late 1980s and early 1990s, we started trying to help the reimbursement community with rehabilitation guidelines by telling them that a certain diagnosis should only require X number of treatments. We then said, “I can treat that patient in X number of visits.” We cut our own throats. Our outcomes were good, but the foundation of our profession and regulatory decision making was weakened. Today we are paying for those decisions. We have something of value, but we aimed too low.

Misunderstood—I feel we do not know who we are, and if we do not know who we are, how do we expect others to know? For example, this year’s House of Delegates will be defining the physical therapy “professional scope of practice.” Our “scope of practice” should be intuitive. Back in the early 1980s at the House of Delegates in New Orleans, the American Physical Therapy Association (APTA) conducted interviews at some malls. The question presented to the public was “What is physical therapy, and who are the physical therapists?” Some answers were funny (maybe)—overweight, homely, drives a Volkswagen (VW) Beetle—but then they got sad, because the public had no clue as to who we were or are.

You’re looking at the guy who tried several times to get the board to take a “moments like these” film of physical therapy and 4 million dollars and do a Super Bowl ad. Just think, 300 million people would see us in a positive light. Every major network and newspaper, for the couple of weeks following Super Bowl, would be talking about the top commercials. How many of you still remember the VW ad with the little boy as Darth Vader? Or the Mean Joe Green Coke ad, or the three frogs saying “Bud-wei-zer.” Sorry, but saying “move forward” is just not enough. It has no heart, no passion.

Untapped potential—We try to separate ourselves from others (athletic trainers, occupational therapists, chiropractors, etc.), but we avoid actually following through on this. It is not logical that a podiatrist or chiropractor should be an entry point into health care. We are the leaders in rehabilitation. We need to embrace that role and run with it.

Imagine our profession as a football huddle: We make big plans, policies, and procedures, identify problems, and tell each other how wonderful we are. But many times we do not run the plays.

We have to be brave in dealing with other groups and regulatory demands. We have to get out into the communities we serve, not just sponsor a race, but as a business weave ourselves into the fabric of the community so that physical therapy is the first and only thing they think of when the need arises. We not only need to be a part of the community but also a loving partner with the community. Remember, it is all about relationships.

The scriptures I read tell me in several places to be bold in what I do, to be brave in my dealings with others, to love big, not only those I work with but my community as well. This tells me that if you stop learning today, you stop leading tomorrow. We live by what we believe, not just by what we sometimes see.

So the question is: What impact have you had on your patients, your staff, your community, and your profession? We are called to pull the vision of the future into the present.

You are some of the best and the brightest of this profession. My challenge to you today and in the future is to be bold, be brave, love big, and by standing on our history, we will see the opportunities and the light and brightness of our future. And that is what I believe.

Sam Brown, PT, DPT, CSCS, is a PPS member and owner of Monticello Physical Therapy in Monticello, Kentucky. He can be reached at ptmpts@windstream.net.