Vision Now: A Physical Therapist Manifesto

The American Physical Therapy Association (APTA) has done a fine job of producing a vision statement – Vision 2020 – that contains many issues that are both pertinent and relevant to the health and survival of the profession. But the harsh reality is this: a 20 year window in which to accomplish this has seriously undermined the profession. Two decades? Glaciers have been known to move faster. Congress even moves faster – albeit barely.

Professional autonomy drives the success or failure of all of the issues of our profession. At this point, we talk the talk about autonomy, but frankly, we don’t walk it.

As Henry Ford once noted, “Whether you think you can, or you think you can't – either way, you're right”. People will behave in a manner that is consistent with their self image and self perception.

It is time to put an end to incremental thinking and self-destructive behaviors about our professional autonomy. It is time for a reality check, for disruption, for revolution, and for change.

It is time for “Vision Now” – a manifesto for physical therapists.

A few thoughts would help to clarify the root origins of “Vision Now”.

Let’s start with the words of Vision 2020:

“Physical therapists accept the responsibility to practice autonomously and collaboratively in all practice environments to provide best practice to the patient/client. Autonomous physical therapist practice is characterized by independent, self-determined, professional judgment and action.”

Note the words “independent” and “self determined”. As a profession, it is time to stop seeking permission from other professions or stakeholders who wish to define who we are or what we do. Until the profession decides that professional autonomy and true direct access are the ONLY acceptable options for this profession, and we do what it takes as a profession to own it fully and fight the battles that need to be fought, we will remain the subservient profession that is one of the few in the nation to require a gatekeeper.

“If you don’t stand for something, you will believe in anything”. (Hamilton)

With that said, let us implement behaviors and affirmations consistent with that vision. Here are the four points that make up “Vision Now”:

Vision Now: A Physical Therapist Manifesto

1 I am a physical therapist. I act in accordance with the values of professional autonomy, including independence and self-determination. My professional behaviors reflect my professional autonomy as both clinician and consumer advocate.

2I will not accept the limitations imposed by other professions seeking to define who I am or what I do. My profession defines itself, its roles, and its expertise, of its own accord. I will not relinquish ownership of my professional duties to other professions who illegally claim to perform that which is physical therapy.

3I will not seek permission for that which is rightfully mine in a free market economy. I will seize it and take full ownership of it. I will not accept laws that promote legalized gatekeeper monopolies or foster restraint of trade of my profession. I will seek to abolish laws that either promote these monopolies and/or restrict the free and fair practice of my trade as I am trained to perform it.

4Consumers participating in a free market economy, one that is protected under the US Constitution, will have the right to choose myself and those in my profession as an independent autonomous practitioner as they would any other practitioner in the United States. They will do so freely based on their freedom of expression and choice.

The time to act is now.

I urge each and every one of you to commit to the principles of “Vision Now” for the benefit of our profession and the consumer. In the words of Thomas Paine -

"Perhaps the sentiments contained in the following pages, are not YET sufficiently fashionable to procure them general favour; a long habit of not thinking a thing WRONG, gives it a superficial appearance of being RIGHT, and raises at first a formidable outcry in defense of custom. But the tumult soon subsides. Time makes more converts than reason."

If we take ownership of professional autonomy – and have behaviors that are consistent with the vision – then we WILL be the undisputed practitioner of choice for “the diagnosis of, interventions for, and prevention of impairments, activity limitations, participation restrictions, and environmental barriers related to movement, function, and health.” Why? Because we will act like we are – and not just talk about it any more.

Photo credits: porteous