Our Great Opportunity

Seventy-nine years ago, Elsie MacGill was on the exciting verge of becoming the first woman from Canada to receive a bachelor's degree in electrical engineering, when, after experiencing flu-like symptoms for a few days, she woke up one morning to discover that she was completely paralyzed from the waist down.1 She was eventually diagnosed with acute infectious myelitis and was told she would never walk again. We have heard those words before. In 1929, times were tough enough for a woman who wanted to become an engineer … the addition of a disability such as this would seem to be too much to overcome. Well, MacGill finished her university tests from her hospital bed and received her degree. She was determined to not be bedridden and eventually used canes for mobility. During her recovery, while writing a magazine article titled Women on the Wing, she learned that it took very little strength to pilot a plane, and she developed an interest in aeronautics. She ended up pursuing further study at MIT and became a well-respected aircraft designer during the Second World War. She insisted on being a passenger on the test flights of each of the aircraft she helped design. Personally, I prefer my planes to be tested long before I ride in them! Although Elsie MacGill did not have the help of formal physical therapy, her story represents the kind of inspiring experiences we are privileged to witness on a regular basis in this great profession. Her story—and many others like it—remind me that opportunity is in the challenge, hope is in the desire, and value is in the effort (Figure). R Scott Ward, PT, PhD, APTA President. The profession of physical therapy is anchored in myriad opportunities that are rooted in the challenges we face, whether in the preparation of new colleagues, the collection and use of applicable data, or the care of our patients. As physical therapists and physical therapist assistants, our common goal is to make lives better for our patients. It is a goal that we can—and should—be proud of. Every day, we are helping others work toward that goal of better health, and—despite what we might believe—the public already recognizes that fact. When I tell the people I meet that I am a physical therapist, and I tell them that proudly, they react very favorably. I have never been asked, “What is physical therapy?” Although they might have some assumption about what I do, the conversation frequently goes 1 of 2 ways. One conversational direction is their desire for an on-site consult, with some comment like “It hurts right here, what do think it is?” I am sure you are familiar with these encounters—what I call “Thanksgiving Day” clinics. The questions do often come at holiday dinners with relatives or friends not often seen, or at soccer matches, in grocery store lines, and elsewhere. The root of their interest in a consult is the basic question all of our patients have for us, which is: “Can you help me?” As you know, the answer to that question, is a definite “yes.” If those talking with me don’t go down the consult direction, the other course the conversation commonly takes is “Where do you practice?” People are intrigued to hear about my work at the Burn Center. They are also interested in conversation about my work at the program in physical therapy at the University of Utah. They often comment on how they have heard “how hard it is to get in to physical therapy school.” They comment on how rigorous they have heard our professional education is. Again, they do not directly ask, “What is a physical therapist?” They are interested in learning more about the profession, or maybe they just hope that I will simply and briefly validate their information. Surveys recently were conducted by CRT/tanaka2 of public impressions of physical therapists. The data reinforce my experiences and include the following information: Consumers—nearly 90% of those surveyed—have a positive impression of physical therapists and consider them the “provider of choice” for the treatment of loss/limitation or a movement problem or injury, or when they are “experiencing pain.” Eighty-eight percent of physical therapy users say the care they received from physical therapists was beneficial. Consumers report they are looking for prevention and wellness options and would be more likely to visit a physical therapist if they knew it would significantly improve their mobility and their ability to perform daily activities, provide an alternative to surgery, or help manage or eliminate pain without medication. Other health care providers—nurse practitioners, in particular—think very highly of physical therapists. Physicians, as we know, also generally have high respect for physical therapists, and, as most of us already know, they view us primarily in the role of rehabilitation. A concern I have is that we tend to think the public does not know what we do or how we can help them. In fact, we might have less confidence in what we provide our patients than they have in us! We often are overly humble about the important work we do and the positive effect of our care. Be proud of the great work you do. Be willing to admit that you do make a major difference in people's lives. That is the core of our work. Also remember that we have much more to be proud of. Our profession includes not only those who provide hands-on care to patients and direct consultation to clients but also colleagues who are esteemed educators and talented researchers and who participate in other related, important pursuits. Our credible education program curriculum enhances our profession in numerous ways. The public expects our graduates to be prepared to skillfully manage their physical therapy care. They have the right to expect that. We know we must deliver on that expectation. Our colleagues in health care expect a rigor to our professional training that is based on evidence and primes our graduates for independent clinical decision making. I am proud to offer the Normative Model for Physical Therapist Professional Education3 and the Normative Model for Physical Therapist Assistant Education4 as evidence of the depth and breadth of our preparation to those who might question it. I readily provide the criteria for accreditation demanded by the Commission on Accreditation in Physical Therapy Education (CAPTE) for our education programs to those who question our rigor. Education provides the profession with our future colleagues, those who will carry on our proud tradition of care. Education also is a part of our ongoing, professional development. Our professional preparation is worthy of praise—and we should be vigilant in making sure that our continuing professional development deserves the utmost confidence of the public. Federally and privately funded research that is related to the care we provide, and that is being carried out by our physical therapist colleagues, totals in the millions of dollars. This research is being conducted at universities, clinics, and institutes across the country and relates to a variety of areas of clinical care such as low back pain, stroke rehabilitation, physical therapy workforce issues, spinal cord injury, joint rehabilitation, cost-effectiveness of care, and many others. Answers to the research questions being asked will help us to better understand the basis for the care we provide and the outcomes of interventions we use. The impact of care will be influenced by data that our colleagues produce. The health policy that affects how we provide care will be influenced best by data. Indeed, we know that payors, regulators, and policy makers ask us—along with our associates in health care—“Where is the evidence?” Our own Foundation for Physical Therapy is a model organization that has seeded research to help address many clinical issues in a way that other professional associations envy. We should be proud of the physical therapy–related research being conducted and being planned. We should take every opportunity to contribute to and support these data collection efforts. We are physical therapists and physical therapist assistants. Never forget what you do, and never forget to make it clear to others who you are. We are all colleagues, whether we provide care in the clinic, teach future peers, carry out research, function as administrators, or serve as policy makers. We are social servants. We are professionals. The variety of ways we engage in our profession adds to the rich texture of our skilled community. We should be proud of ourselves and proud of each other and all the good work we do. We should be confident in declaring that we continue to become even better because of all we are engaged in. Advocacy for our great work is easy because what we do is so important. We all know that the progress of our profession has not occurred as a result of the general goodwill of the broader community. The meaningful changes have come through the hard work, persistence, and cooperation of many esteemed colleagues, both past and present. The end value of this work we do is in the effort we put forth. There is no single threshold to our advocacy labors—our work in this area needs to be considered enduringly cumulative. Given the need for such sustained effort, we should remember that our patients have desires for their future, and we have desires for the profession's future—and it is up to us, in all of our capacities and with continued diligence and work, to bolster the hope contained within these desires. The focus of the work we do in this profession is the care we provide patients. We know, at the end of each day of patient care, that we have made a difference in someone's life. We acknowledge that there are colleagues not directly present in the clinic with us who have helped make that happen. We have all been taught or are in the process of being taught by colleagues, and we rely on data produced by peers to inform our clinical decision making. At the end of any day, our great opportunity as a profession is in meeting the challenge to provide the best available care to our patients. Our great hope—embodied by our research, education, and advocacy—gives life to our desire to provide meaningful care. Our value is in sustaining and increasing our efforts to improve health and quality of life for all members of society. As we work and learn together, let's remember the story of Elsie MacGill —and view our challenges as opportunities, not only for our profession, but most importantly for the patients we serve.

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