What We Do Is Ministry
David Qualls, PT | 2016 Robert G. Dicus Award Winner
Terry, thank you for your kind words.
I am really touched and thankful for your friendship. I don’t think I recognize that person you spoke about. Thank you all very much for such a warm welcome. It is an honor to stand here today knowing those who have received this award before me. Fortunately, I knew and still know most of the previous recipients. That elevates this honor even more. However, if you thought that the Colonel was here, I am sorry to disappoint you, but maybe we can get some fried chicken at the reception. Also, I will tell you ahead of time that you will not hear any quotes from Lincoln or Churchill but you may hear from Boudreaux or Thibodeaux. I also appreciate your confidence as you allow me to compete with this small debate that is happening across town tonight. We will be more positive here, for sure.
Seriously, today I am humbled and have been since Terry Brown phoned in July to let me know I had been chosen to receive the Dicus Award. Many of you are deserving of this honor and should be here. I offer my thanks to the Awards Committee for their recommendation, the PPS Board of Directors for their acclamation, and to those of you who took time to write letters of recommendation on my behalf. Many of you have offered your support and encouragement over the years. I must thank George McCluskey who motivated me 42 years ago during my time in Columbus, Georgia, as a student. I also need to thank Betty Wolf who was willing to offer me my first practice position and who for five years put up with this young therapist who thought he could cure everyone, and I am honored to walk in the footsteps of Francis Guglielmo, a Louisiana private practice icon, who was the Dicus recipient in 1988.
This award would not be possible without the tremendous support of my family. My son, Josh, is not able to be with us today. He had scheduled a spiritual retreat and because of that and some unexpected child responsibilities I definitely thought it was important that he honor those commitments. My daughter, Callie, is here. Many times over the past years when asked, “Where is your dad?” her comment was always, “At a meeting somewhere.” My love to them both. And this would definitely not be possible without Cindy. Cindy has kept things going at home all these years. Our faith and giving spirit is all because of her. After Cindy and I married, when asked if she worked outside the home, her answer was always, yes, “I am a PV.” So the next question was what is a PV? “A professional volunteer,” she replied. Cindy is the person who picks up teenage hobos, finds them food at the church, drives them to the laundromat to wash their clothes, and then on to a hotel where she secures a room for them so at least they can have one clean dry night. She is also the person who gives her coat to a stranger while ringing the bell for the Salvation Army at Christmas and usually carries McDonald’s Meal Deal coupons in the car that she gives out to the homeless at red lights. So you wonder why I volunteer. I blame it all on Cindy. Thank you.
However, my early volunteer activities were challenged. I had served in appointed positions in LPTA [Louisiana Physical Therapy Association] and finally decided to run for vice president. I ran against this young professor from LSU and got my butt kicked. I am pleased to tell you that that young professor is now our APTA president, Sharon Dunn, and I don’t feel bad at all. Thank you, Sharon! When Terry called to let me know about being chosen as the Dicus recipient, our conversation was pretty normal. We visited about PPS; we visited about practice and family and summer activities. Then he said, Now I want to get to the real reason why I called. When he told me I had been chosen as the Dicus recipient, naturally, I was shocked. Not me, I think I said, you evidently have called the wrong person. We did visit a while longer, but I really don’t have any idea what else was said, other than, you know you have to give an acceptance speech, and by the way, it is our 60th anniversary. After our conversation ended, I just sat there in disbelief. Not me and surely not me on the 60th anniversary of PPS. It did not take long before I was reintroduced to reality, though. I looked down to see the note on my desk that read, “Change the commode flapper before you leave today.” I was back to reality but all of the sudden was scared to death.
So here we are, the PPS 60th anniversary. What an awesome time for our Section. I think that Bob Dicus and James McKillip would be pleased with our progress. I know Charles Magistro was. They would be pleased but not satisfied. Bob worked so hard for the development of this Section and continued his dedication to service even after his diagnosis of ALS and on until his death. He definitely practiced what he preached. And James McKillip’s dedication and work on reimbursement: Wow. Reimbursement is still in the prime light today just as it was 60 years ago. And how about Charles Magistro? There is not enough time to talk about him. He took the Section to another level and not only served PPS but served APTA as president and founder of the Foundation for Physical Therapy. With all of his success, he never forgot about the little guy. Because of the work and dedication of these three early private practitioners, our Section became more accepted and respected. Even with their dedication to PPS, they always encouraged the continued commitment to APTA.
Service and servitude were what they preached. I love one of the comments Eugene Michaels made in the History of Section meetings. He said, “When you come here, referring to PPS meetings, leave your degrees and pedigrees at the door.” After reading about our founders, it is hard for me to believe we went through the period of time when students were discouraged to enter private practice. The bar was raised by these individuals. Service was what it was all about. Yes, they were able to be financially successful but for what? Not for sacrifice of their patients’ care but to give back to the profession and to drive its progress. And why did they do this? Because what they did and what we do is ministry! We are called to this profession. Listen to your colleagues, stories. How many knew, from the beginning, that physical therapy was for them? They were called. How many chose this profession as a second career? And I said career, not a job. And how many have tried to leave this profession but came back? Why? Because it is a calling and because what we do is ministry.
Why did Louise Yurko work all those years for hospital privileges? And why did Peter McMenamin keep his constant march against POPTS [physician-owned physical therapy services] and advocate for PT ownership? It is a call. It is a ministry. To our colleagues from South Carolina, we were sorry to hear about the Supreme Court decision but please know that your efforts will continue to reap benefits even without the decision you wished. We have all benefited from your efforts, and it might not be over yet. And how about Larry Benz’s ministry in Haiti? Our calling to this profession was again brought to life. Larry states that we provide what patients need. We listen first and act second and in turn people provide the gift to us. In Haiti, patients say, “Physical therapy makes me happy.” I am sure they could use some happiness right now. Please pray for them. In the New Testament of the Holy Bible in the book of Romans Chapter 12 starting with verse 3 we read, “And because of God’s gracious gift to me I say to every one of you, do not think of yourself more highly than you should. Instead, be modest in your thinking and judge yourself according to the amount of faith God has given you.” We have many parts in one body and all these parts have different functions. In the same way, though we are many, we are one body in union with Christ and we are all joined to each other as different parts of one body. So, we are to use our different gifts in accordance with the grace that God has given us. If our gift is to speak God’s message, do it according to the faith we have. If it is to serve, we should serve. If it is to teach, we should teach. If it is to encourage others, we should do so. Whoever shares with others should do it generously. Whoever has authority should work hard. Whoever shows kindness to others, do it cheerfully. And in 1 Timothy 4:14 we read, “Do not neglect the spiritual gift that is in you which was given to you when the prophets spoke and the elders laid their hands on you.” Twenty-three years ago, a conflict did arise in my personal life: Do I continue in physical therapy or enter the preaching ministry full time? Once again, Cindy came to my rescue when she pointed out that what I do every day is ministry, whether it is with my hands or my words or my ears, it is ministry. That is when I got it. I knew that patients seemed better after that initial evaluation, before treatment was rendered. There it was and I did not even realize it. What we do is ministry. Listen to what Jay Ashley, a physical therapist in Lafayette, Louisiana, has to say about physical therapy!
I’ve always had a passion to see people at their best, so physical therapy was a natural choice for me. There really isn’t a magic pill for what we do. There isn’t a medicine that makes your muscles stronger. Patients don’t always see the light, so sometime you have to be that light. The last thing they want to do is smile or move, so usually in the beginning it’s less hands and more heart. But once you can get them to see the light then you can start pushing and pulling. My name is Jay Ashley, and my choice is Lafayette General.
Isn’t that a great video!
What we do is special! How about the therapist who walked Patrick Graham down the hall to ring the bell for that first time after his transplant surgery, or the therapist who walked Beth Ward, our former LPTA president, to the end of her block for the first time. I can gladly report she is now cancer free, amen. Or how about that overweight young man who returns to Mike Eisenhart to thank him for the preventative care he received and is now riding bike races, has lost over 100 pounds, and is free of the symptoms of diabetes. Or how about the young therapist who returns to Connie Hauser to give thanks for guiding her as a student, and she is now successful in practice. This happens, ladies and gentlemen, because what we do is ministry. I can tell you that I was touched at the past APTA House of Delegates when I was shown a Twitter post that included a picture of me standing with three students and Kayla Keckeisen tweets, “Famous Poppa Qualls on Seersucker Tuesday. Incredible leadership at APTA House of Delegates. Thanks Poppa.” I had met this young lady three days before and for her to feel comfortable enough to refer to me as Poppa is an honor, I can tell you. You cannot teach that kind of compassion and sensitivity. We know how to make people feel better. We know how to make people happy. It is a gift. It is ministry!
One day Boudreaux was sitting on his porch watching the state highway workers work along the roadside across the highway from his home. His friends Fontenot and Hebert were working on the road crew. All morning he watched Fontenot dig the hole and Hebert cover it up. Fontenot would dig the hole and Hebert would cover it up. Finally, lunch time arrived and they drove over to Boudreaux’s house to eat their lunch. While sitting on the porch Boudreaux asked, “Mais, I been watching all morning and I don’t understand wat y’all doing. Fontenot, you dig the hole and Hebert you cover it up. Fontenot you dig the hole and Hebert you cover it up. Wat going on?” Fontenot answered without hesitation. “Mais, Boudreaux dat easy, he say. Usually Fontenot dig the hole, Thibodeaux put in the tree and Hebert cover it up but Thibodeaux off today.”
I think Boudreaux’s confusion could very easily relate to the health care industry. Don’t you feel this same frustration when those dozens of fax pages come from Align Network every day? What did they do with the ones I returned yesterday? Is their Thibodeaux not at work today? Even Boudreaux can see things need to change. As physical therapists, we have been required to provide evidence to justify what we do more than any other health care provider, but now all those years of data collection are about to pay off. Hopefully this data, with the help of the registry, will allow us to participate in value-based purchasing. Right now, I am not excited about reimbursement levels at all, but I am overjoyed because we have finally found but more importantly recognized our place in this health care craziness. We are about to add some clarity to the confusion.
Three or four years ago, I was mulligrubbing (complaining) one evening to Sharon Dunn about the fact that we were losing everything. We were giving everything away. Everyone else was doing what we do, not better but cheaper, and what were we going to do? We had too many practice settings with no common goal or mission. Well, my friends, I can truly say that that is not the same feeling I have today. That practice diversity is now going to be our strength as we move forward. We have found our identity. As movement specialists, our worthiness is high across all treatment settings. Whether you practice in critical care, the emergency room, acute care, rehabilitation, home health, outpatient, or wellness and disease prevention, physical therapy is the answer for the most beneficial and cost-effective care. Movement is the healer. Other providers, payers, clients, and patients will be seeking our services more and more in the future.
During a time when other health care providers are looking for fewer hours to practice, physical therapists, especially in private practice, are extending their hours to meet people where they need to be met. And why? Because what we do is ministry and that is what ministers do. With the increased demand on the nurse practitioner and physician’s assistant to see more patients, they will be seeking our knowledge and expertise to help with their new challenge. They cannot do it, and many don’t even know how to do it. And really, many don’t even want to do it. They need us and guess what; we need to do it right because these other health care providers will ask for guidance, not only for the care we provide but help with their new practice model.
Once again, our practice diversity that was a burden for many years is about to be the model that other professions will look at to guide them. Other health care professionals who used to stand alone in private practice are now becoming more diverse. This new ownership employee/employer model will change their practice patterns and requirements. Many may not like what they see.
However, just as with any ministry, we will always have challenges. Good is attacked. Reimbursement negotiation and legislative advocacy continue to be big and foremost for everyone. Just read everybody’s campaign statement. We must pursue physical therapist participation in Merit-Based Incentive Payment Systems and new Alternative Payment Models. Medicare Direct Patient Access along with unrestricted patient access in all states will be necessary as we prepare for consumer-driven health care. Continued input on the redesign of diagnosis codes and bundled payment must continue along with the push for Locum Tenens across all regions. Legislative work on student debt will continue, but also accountability and ownership from the educational institutions, the financial institutions and students need to be included. These activities will benefit those who we serve.
So the reimbursement challenge for physical therapy continues today just as it was 60 years ago. Now it seems that our 21st century James McKillip is Helene Fearon. Helene, do you really have any idea how many people have referred to you in their Dicus address? It’s a lot. With our movement specialist recognition, we have a unified message for public relations, and this should make Jay Goodfarb happier than ever. PR has always been his message. I also hope that with direct patient access we will become more independent in our contract thinking as Peter Towne encouraged years ago. Be independent no matter what your practice setting. Remember, our practice is a career, not a job. Fortunately for us, it even goes one step further. It is a career but more important, it is ministry.
I would like for you to watch a clip from the movie Antwone Fisher. This is a true story. Antwone Fisher was born in prison, raised in foster care, was abused in foster care, and had very rocky teenage years. However, he survived. After he enlisted in the Navy, he was ordered to see a psychiatrist for his anger. This is when his life changed. As part of his care he was encouraged to find his family and he did. He confronted his foster mother and visited an old friend. He finally found an aunt and uncle who were able to take him to see his mother. Antwone had a reoccurring dream about being invited into a large dining room where the table was covered with food and surrounded by family. At his seat was a large stack of pancakes. This clip is what transpires when he meets his extended family. Please watch!
You might ask, what does this clip have to do with PPS? Two things, I think. (1) Dreams can become reality. Antwone Fisher’s did and so did those of Bob Dicus. Many of you have experienced the reality of a dream, also. Maybe that is why you are here. There is power in prayer, and maybe a dream is that mental picture of a prayer that many times we seek or maybe attempt to avoid. (2) There is power in the family. Antwone Fisher was excited when he found his family. I believe PPS is an extended family, and we are happy when we are together. The family is where sharing begins. PPS is a place that for 60 years, members and even nonmembers have felt at home and have come to share, ask questions, or just listen to ideas about the business of physical therapy and not get chastised for it. This is what families do.
As I close, today I see Bob Dicus, James McKillip, and Charles Magistro sitting at the table in place of Antwone Fisher’s grandmother. These founders have saved a place for us at the table because we are part of the PPS family. We have never been more prepared, focused, directed, or united around a single message than we are today. What we choose to do with the gifts that have been passed on to us is now in our hands, and it is our responsibility. Let’s not disappoint those who have worked so hard for so long but even more important those who will drive our history for the next 60 years in this ministry called physical therapy!David Qualls, PT, has been president of Rehab Institute, Inc., dba Qualls & Co., in Sulphur, Louisiana, for the past 37 years. The corporate name has changed several times to meet the demands of the community and the advancing scope of professional practice. In addition to providing treatment, prevention, and wellness to patients and clients, volunteer service to the church, community, and profession have always been a high priority at Qualls & Co.