The clinician's best friend.

There's an old saying that a real friend is someone who walks in when the rest of the world walks out.

I have always believed that the American Physical Therapy Association is the clinician's best friend. This past year, I have come across several examples that illustrate just what I mean.

Recently, one of our members was being investigated by the Centers for Medicare & Medicaid Services for a coding issue that could result in fines and back payments of almost a half million dollars. He called APTA and outlined his situation. Between the departments of Reimbursement and Government Affairs, and assisted by our Legal Counsel, APTA provided him with historical data on coding, legal memoranda, and expert opinion that helped him to prepare for his appeal. The outcome was positive; the judge ruled in his favor! The member immediately called to tell me that APTA had saved his practice and his future.... He said he would be forever in debt to our staff of experts.

Take a moment to reflect:

   Who are the friends that you turn to?
     ... the friends who make a difference in your life?
     ... the friends whom you know you can always count on?

APTA is the friend that you can count on.

When you're in the midst of difficult clinical situations, APTA is where you can turn for help. When you need the latest information on Medicare rules and regulations, when you need to know the intricacies of how the federal government works, and when you need the expertise to work through a difficult practice or reimbursement sitnation--APTA can be your best friend.

Another member recently called headquarters looking for some advice on how to handle a request from a referring physician. The physical therapist stated that a physician would like her to see a patient with an uncommon musculoskeletal disorder. She said, "He wants me to develop a plan of care if I think PT is indicated, and I need some help, really quick." A Practice Department staff member, who is a physical therapist, walked the member through a series of questions, including: Can you relate the patient's condition to any of the practice patterns in the Guide to Physical Therapist Practice (1)? Are there ideas in the Guide about possible examination strategies in addition to your routine examination procedures? Have you accessed Hooked on Evidence to see if any of the almost 1,500 extractions currently available might relate to physical therapy interventions that could help you? And lastly, have you thought about asking for assistance from a physical therapist colleague or expert in this case?" The long and short of the story is that the APTA staff member walked the member through the Guide and Hooked on Evidence and assisted her in finding a couple of articles that were exactly what she needed to respond to her current situation.

This scenario is not that unusual. Responding to members is an integral part of our staff's daily activities.

I suspect that each of you would say that a true friend listens closely to you, gives you the tools to think for yourself, and encourages your growth. A friend celebrates your victories and is there when you need someone to lean on, to commiserate with in times of trouble.

In fact, APTA provides resources to hundreds of members who call or e-mail the Association each day, on how products such as the Guide and Hooked on Evidence can help clinicians identify the interventions that can best help their patients.

APTA's mission is to help you, our member and friend, achieve your professional goal of being an outstanding clinician, and to help the profession achieve autonomous practice and Vision 2020. APTA also will be there to celebrate your victories, as the daily achievements of each physical therapist can be viewed as accomplishments for the entire profession.

Perhaps Harry Chapin summed up friendship best when he said that commitment is the true measure of a friend: commitment to friendship, commitment to cause, and most importantly, commitment to making a difference. APTA has a long track record of commitment to making a difference.

What keeps APTA strong are the 64,000+ members like you, who annually pay their dues to ensure the continued existence of an association that represents the profession of physical therapy. Why are yon a member? No doubt there are many reasons, but one probably comes to mind first--you are a member because you truly love this profession.

That is why on some days, when I am in the middle of answering an e-mail from a nonmember or on the road talking with physical therapists from across the country, it is beyond me to understand how we could have an organization that represents the profession of physical therapy to the world and yet still have physical therapists and physical therapist assistants who are not members.

I have to believe it's because they do not realize the depth and breadth of services that are available at their fingertips and because they do not understand the value of APTA in ensuring the future of our profession. They must not know what we know ... that APTA can be their best friend.

I would like to share another true story that involves a physical therapist assistant who called APTA's Reimbursement Department at the point of tears because she was about to lose her job. A major insurance carrier in her area had decided to no longer reimburse for services provided by a physical therapist assistant. An APTA staff member called the reimbursement chair ii/her state to develop a strategy and provided the insurance company with information regarding licensure and the education and training of the physical therapist assistant. The chapter's volunteer reimbursement chair offered to meet with the carrier to discuss how a PTA is utilized under the direction and supervision of a physical therapist. When presented with this information, the insurance carrier reversed its decision and decided to continue to reimburse for services provided by a physical therapist assistant The PTA didn't lose her job, and, more importantly, the patients that she will continue to treat will receive physical therapy services from a qualified provider who is working under the supervision of a physical therapist.

Stories like these say it all. Where else can a member call and get immediate expert assistance over the telephone? Where else can you develop networks and business relationships that can help you in the management, success, possibly even survival of your practice? What other organization is going to represent the profession of physical therapy? What other organization is going to work tirelessly for a 2-year moratorium on the therapy cap, a MedPAC study of Medicare Direct Access, and an increase in the Medicare physician fee schedule all at the same time? Nobody but APTA!

APTA is there to provide you with the tools you need to move forward in your career, to grow as a professional, and to make a difference in the care of your patients. APTA is a friend you can share your victories with, and a friend to assist when times may not be so good.

Another story that I will share with you comes from a physical therapist member who has been practicing for nearly 30 years. She plans to finish her transitional DPT this month, and she recently sent me an e-mail in which she stated that, although she has been a member for several years, she had not really utilized the services of APTA until recently. She shared with me that she now searches the Web site on a regular basis and is amazed at the vast array of se, vices that APTA offers. She receives MegaVote and Action E-list alerts by e-mail, has requested and received Association pamphlets to give to her patients, and is awaiting a "Balance and Falls Awareness Kit." She uses the "Medicare Fee Calculator" and occasionally calls APTA with questions. She understands the importance of being involved and plans to continue advocating for the profession. In closing her e-mail, she stated that staff has been very helpful, and she thanked APTA for being such a great organization and for helping her keep up-to-date on issues important to the profession.

Isn't it great that APTA had the tools available for her to easily assess her knowledge and to apply for the transitional DPT program of her choice? The Physical Therapist Evaluation Tool helped her and the school to identify the credit hours she needed and those she did not need based on her experience and years in practice. And, because of the DPT program, she became more familiar with the Web site and consequently discovered that there are more than 50 continuing education courses offered via the Internet.

With APTA's assistance, this member is also reaching out to her patients and to her community through the wide variety of public relations tools currently available. And I can only hope that she will take advantage of APTA's new "Find A PT"--an online tool we are building that is designed to help consumers locate PTs in their geographic area. In fact, I urge all of you to enter your names into the database so we will be able to make "Find APT" worthwhile for consumers to use nationwide.

Let me share one other example of how APTA works hard to provide clinicians with the tools they need to prosper and to grow as practitioners. One problem that I have heard over and over again is that physical therapists, and most other health care practitioners today, are literally drowning in paperwork. And at the same time, we are desperately in need of a way to measure our clinical outcomes. To this end, APTA has partnered with a corporation that has an extensive track record with other medical societies to develop a standardized electronic documentation system that incorporates the Guide to Physical Therapist Practice, allows us to measure clinical outcomes, and reduces paperwork! It sounds almost too good to be true! I encourage you to check out APTA CONNECT in the exhibit hall during conference.

In another area, you probably know that APTA has spent millions of dollars over the past several years marketing the profession. But has APTA done enough in marketing? Some of you may say, "no." And I'm not sure that, in all honesty, I'd disagree. I call tell you, however, that APTA does know how to get a "bang for its buck," hut the problem is we have limited bucks! Just imagine what we could do with more members and a $50 million budget, twice the size of our current budget. If other therapists in our profession, who have benefited and continue to benefit directly and indirectly from your dues, would step up to the plate as you have done consistently over the years--if we could double our membership--the possibilities would be nearly limitless. Please remind your nonmember colleagues of this when you get the chance.

It is important that we get the word out to the public about physical therapy. Experts say that there is no better marketing tool than person-to-person, word of mouth. APTA provides a wealth of written information for you to share with your patients. Some of you have sponsored the video, "We Live for Moments Like This," on your local television stations and have received wonderful feedback from your patients. Many of you have gotten involved by distributing patient information brochures and the PT Magazine consumer supplement For Your Health--which are free to APTA members in bulk quantities! In our consumer supplement, we have featured member PTs along with their patients--Olympic athletes Nadia Comaneci and Bart Connor, golf pros Tiger Woods and Mark O'Meara, Cincinnati Reds Ken Griffey, Jr, and Barry Larkin, Pulitzer Prize winner Art Buchwald--and this year's cover story will be former prisoner of war Jessica Lynch. We have the public contacts that are known by consumers, but we need more members to join us in spreading the news about what we can do!

I suspect that you may have heard, at some point over the years, remarks such as "What does APTA do for me?" or "I called APTA, and no one returned my call." Or, my favorite, "APTA is clueless about the real world." I have received a few e-mails over the years that are short on giving the benefit of the doubt or trust in the good intentions of the Association's leadership and staff.

Maybe this has even been you at one time or another. The truth is, sometimes we have let members down, and for that we are sorry, as it is never our intent to do so. APTA receives close to 650 calls or requests per day, and once in a while one of them may get sidetracked. Usually, however, following a little investigation, complaints that I have received are not what they seemed to be originally. Don't just walk away from the Association. If we don't know your concerns, we can't address them.

As for APTA not being in touch with the real world, maybe we seem that way to those individuals whose daily life challenges are so overwhelming that it is difficult to look ahead and to appreciate the value of what is being proposed for the future of our profession. I believe that an honest look at the past shows that APTA has never missed a major opportunity to advance the profession during the 80 years of its existence. Physical therapy is at the forefront of all nonphysician health care professions--just look at the challengers of today, and note whose playbook is being copied for licensure, accreditation, practice standards, reimbursement, and advocacy. We are already at the tables where others want to be and some may never sit. APTA and its members never rest. We are constantly working to shape the future of the profession in ways that will better serve our patients.

Before I close, I would like to share some great news about our Association's membership. Last year, I stated that one of my goals was to see physical therapist membership rise by 10% over the next 3 years. Well, to date, in just 1 year, PT membership has risen more than 6.5%! We can say we're more than halfway there!

We are a team.

When we succeed, we succeed together.

When our patients get direct access in all 50 states and the District of Columbia, we will have accomplished it together.

When our patients get Medicare direct access, it will he a victory for all of us.

And, when we achieve our vision of being the practitioner of choice, it will be because of each and every one of us, working together, building on the foundation that was laid by our predecessors.

Because friendship is a two-way street, friends hope for friendship in return. And, at APTA, our extremely dedicated staff depend heavily on our member volunteers to provide leadership and much of the actual work that allows ns to progress toward Vision 2020. I'd like to personally express my sincere appreciation to hundreds of you here in this room who have, at one time or many times, volunteered to serve in some capacity within your chapter, section, or assembly or at the national level. You have been a friend to APTA. Feel proud of this, because without you we would not have been able to accomplish all that we have.

For those of you who have not had the opportunity to serve, I understand. Because there are already so many responsibilities in our lives, including families, jobs, finances, and health, I know that not everyone will have the ability to serve during his or her professional career. However, if and when the time is right, I hope you will step up to the plate and serve.

The theme of my talk today has been very simple. APTA wants to help you to be an outstanding clinician and your patients to receive the maximum benefit of your services, and we want the profession to thrive far into the future. We can't do this alone, so the best way you can help is to encourage all of your PT and PTA colleagues to become a part of the Association. You, too, can tell your coworkers what a great friend you have in APTA and what great benefits membership in APTA provides!

In closing, I would like remind you of a song that was written by Carole King and sung by North Carolina's own, Sweet Baby James [Taylor]. To me, these lyrics capture the essence and spirit of the American Physical Therapy Association:

   Winter, spring, summer or fall, all you have to do is call
   And I'll be there--yes, I will.
   You've got a friend.

I consider all of you my friends and I want to remind you, you've got a friend in APTA.

A Friend Like APTA

Imagine our professional lives if we didn't have a friend like APTA. And when I say APTA, I mean the totality of APTA--members, components, leadership, and staff! Without the Association, we might still be called Reconstruction Aides. We probably would not have state licensure in all 50 states--and certainly patients would not have direct access to our services in 39 states. Our education accrediting body would still be the American Medical Association. Our entry-level [professional] degree might still be at a bachelor's degree level--or perhaps just a certification. Clinicians would not have easy access to evidence from research. And, we physical therapists would be creating all of our own patient education materials. Without APTA, we would have no forum for debate and discussion of issues important to the profession and no mechanism for advancing the profession. We would not have a clear vision of our future as autonomous practitioners. In essence, without APTA, we would be a "nonprofession."

Members Keep APTA Strong!

* There are thousands of members like you who have volunteered countless hours on behalf of the profession;

* There are 160+ dedicated staff members who work daily (and on many weekends) for the enhancement of the profession and the benefit of our members;

* There are more than 100 component staff members who make our chapters, sections, and assemblies thrive and who work tirelessly on issues at the state and local levels;

* And, there are numerous members and other colleagues who help us maintain the Foundation for Physical Therapy, the PT-Political Action Committee, the American Board of Physical Therapy Specialties, and the Commission on Accreditation in Physical Therapy Education [CAPTE], to name just a few of the groups working for you and for the profession.

Speaking of Victories, 2003 Was Certainly a Year of Both Victories and Accomplishments!

* As a result of our very successful rally last year on Capitol Hill, where you and I and more than 2,000 PT, PTA, and student members joined together in a march for the profession, more than 100 congressional sponsors signed on to the Cap and Direct Access legislation. At least one physical therapist assistant was so captivated by the spirit of the event that he has since thrown his hat in the ring and currently is a candidate for his state legislature.

* The APTA Consulting Service became fully operational, with 2 networks--practice management and education--involving more than 30 member consultants.

* The outcome document from the 2002 consensus conference, Professionalism in Physical Therapy: Core Values, (2) was approved and disseminated to prompt ongoing discussion about core values and the manner in which these values should influence our professional behaviors within a doctoring profession.

* A consensus conference was held to develop Education Research Priorities for physical therapy education.

* Nine APTA chapters introduced direct access legislation, and New Jersey, Wyoming, and Louisiana successfully enacted their bills into law. At year-end, 38 states provided direct access to physical therapists--with Ohio's bill signed in early 2004.

* APTA played a major role in efforts to secure national Medicare standards for use of prostheses and customized orthoses.

* We presented our first live Internet broadcast, "issues and Insights," during which APTA staff and I had the chance to update members on federal legislative issues and to hold an interactive Q&A session.

* Responding to action taken by the 2003 House of Delegates, a Task Force on Physician Ownership of Physical Therapy Services was appointed to develop a strategic plan to prohibit physician ownership of PT services.

* The Association provided a variety of assistance to members in complying with new Health insurance Portability and Accountability Act (HIPAA) regulations.

* The Foundation-funded $1.5 million Clinical Research Network completed its first year of operation.

* Development of the outcomes data collection process progressed, with the OPTIMAL instrument incorporated into our patient documentation system APTA CONNECT.

* Preview 2020, APTA's first regional conference, was launched in November in Las Vegas.

* APTA expanded its Advanced Clinical Practice Series to 7 different courses that provide PTs with advanced clinical practice information and skills that are evidence based.

* The Association had a positive net revenue, the first in 4 years, with nondues revenue helping to provide needed funding for efforts that directly help accomplish our goals.

* APTA was recognized by Washingtonian Magazine as one of the top "50 Great Places to Work" in the Washington, DC, area.

* PT-PAC set a new record for non-election year fund raising: a total of more than $800,000--more than halfway to the $1.5 million goal for the 2003-2004 election cycle. Nearly 7,000 members contributed!

* APTA's Key Contact Program expanded to record levels, with roughly 400 PTs and PTAs volunteering to be Key Contacts for members of Congress, a program that definitely works. As an example, at a recent meeting with her Congressman during the Federal Government Affairs forum, one PT from Georgia was told that if she could get 15 letters from physical therapists on his desk, he'd cosponsor direct access legislation. By end of the day, 15 letters from Georgia colleagues were faxed and sitting on his desk. Thanks to PJ Phelps, Congressman Charlie Norwood is now a cosponsor of HR 792, Medicare Direct Access.

Obviously, we had a great year and we can be proud!

References

(1) Guide to Physical Therapist Practice, Second Edition. Alexandria, Va: American Physical Therapy Association; 2001.

(2) Professionalism in Physical Therapy: Core Values. APTA Web site. Available at: http://www.apta.org/documents/public/NSC/corevalues.pdf. Accessed June 2004.

[Massey BF Jr. 2004 APTA Presidential Address: The clinician's best friend. Phys Ther. 2004;84:1087-1091.]

BF Massey, Jr, is Executive Director, North Carolina Board of Physical Therapy Examiners, 18 West Colony Place, Ste 140, Durham, NC 27705-5582 ([e-mail]).

Due to time constraints, parts of the Presidential Address had been left out of the speech given by Mr Massey at the Opening Ceremonies of PT 2004: The Annual Conference and Exposition of the American Physical Therapy Association; June 30, 2004; Chicago, Ill. The full address is published here.