Vision Now Revisited: Being And Becoming

They say that hindsight is always perfect. After celebrating 25 years as a physical therapist, and reflecting on those years, I have come to a realization, an epiphany of sorts if you will.

The profession of physical therapy is at a significant crossroads in this country. If we don't firmly and passionately define the profession - for ourselves and for consumers - then somebody else will, if they haven't already done so.

Our profession is struggling with the differences between "being" and "becoming". Therein lies the importance of “Vision Now”.

I originally proposed "Vision Now: A Physical Therapist Manifesto" in May 2012. It started as a few thoughts on the core values and beliefs of the profession. I have received feedback from physical therapists of varied specialties and practice settings around the world. It has become a "movement" of sorts with the growing use of the hashtag #VisionNow. Further real-world discussions with fellow Twitterati (including @pranapt, @ptbise, @jerry_durhampt, @NickTNpt, and @Dr_Ridge_DPT among others) have drawn attention to the small yet growing number of clinicians that represent a culture of accountability, self-responsibility, and professional ownership.

The challenge with these interactions is that it makes the problems more readily apparent than they already were. The profession, as a whole, appears to be quite content with being defined by those outside of it. Gatekeepers define what we do, who can see us and when they can do so. Providers outside the profession offer "physical therapy". We beg for scraps of consumer access from the legislative table. It goes on and on. And in the meantime, we have physical therapists that will turn a blind eye to all of this, sigh, and carry on. Or, perhaps even worse is to have discussions amongst us in hushed tones away from the spotlight just so we don't upset the apple cart.

How do these behaviors reflect on a profession characterized by "independent, self-determined, professional judgment and action"?

Difficult conversations need to take place within the profession. These conversations will need to discuss who we are, what we stand for, and, perhaps more importantly, what we won't stand for or tolerate.

Here's the deal: if you want to remain on a slow path of self-determination, then just keep doing what you are doing. If you do what you've done, you will get what you've got. Pretty simple. But if that isn't acceptable to you, then there have to be changes made.

In order to solve the problems, you have to understand the mechanisms underlying the problems. It all starts with how people within the profession view their profession. I am certain of one thing: if you don't truly, in your gut, believe that you are a member of a profession characterized by "independent, self-determined, professional judgment and action", then your behaviors and actions won't reflect it. Plain and simple. If your actions represent subservience, then you will be seen as such by others.

We have become a profession of mixed messages. It prevents consumers from knowing just what it is we do, who we are, and what we bring to the health care table. It prevents consumers from connecting with our deepest values and purpose - and vice versa. Patients are confused and disconnected by the messages we send. Frankly, I don't blame them.

Seriously though - if physical therapy is so good and has so much evidence to support it, then why do you need a permission slip to go to see a physical therapist, especially when you don't need one to see other providers? A huge disconnect, wouldn't you say?

There is a solution. It requires aligning ourselves with sound principles that can be championed by all in the profession and can be understood by consumers worldwide:

1. We must brand ourselves as one profession with a common set of values - not as a diverse conglomerate of entry-level educational degrees. A title is just that - a title. You earn your stripes and credibility with time in the clinic.

2. Physical therapy covers the full continuum of health and health care. We are movement experts - and always have been. Movement goes to the core of our training and our clinical expertise. We must take ownership of this and brand ourselves as such or we stand to become an unrecognizable entity with consumers.

3. If we truly believe it, then we must BE it. We can no longer accept being defined by others. We must stop seeking permission to BE who we are. What we are "becoming" is important, but far less so than who we are now.

Vision Now reflects that culture of accountability, self-responsibility, and professional ownership. It can and should exist within all of us, each and every day, from now until 2020 and far beyond.

We must LIVE these values - not only for the profession but as a far greater obligation to those we serve: our patients.

Photo credits: Porteous

Related Articles By Allan Besselink

• Vision Now: A Physical Therapist Manifesto
• When A Vision Goes Awry, Or How 10 Words Make A Difference
• Fear Of Success