It Takes More Than One Voice

Peter Schrey created a petition for all of us to think about and potentially sign. 

Those of you who practice in a direct access state have to sometimes think about how it is that patients come to you.  I definitely know that how those patients come to you definitely can't be due to any real efforts on behalf of the American Physical Therapy Association. 

I believe Peter is on the right track.  I mean, the topics chosen by the APTA have been discussed here the last couple of years and obviously the efforts to educate the public aren't changing anything with regard to our practice... nope, not a single patient with thumb pain... nope, not a single parent calling me up for a consult visit on the fit of a backpack or the weight of the backpack... nope, not a single phone call on whether the bicycle is adjusted correctly... nope, no requests for anything on couch potato exercises....

With any good marketing, there should be goals set and behaviors measured to ensure the message IS getting out and making an impact on the target population.  What do I want for 2008?

1)  10 patients (that don't know me) with low back pain saying, "Can you believe I had to ask my physician for a referral for physical therapy?  Why didn't the physician suggest it?"

2)  75% of patients referred for physical therapy services within 2-3 weeks of onset of back pain that isn't resolving (with no narcotics prescribed and no unneccessary diagnostic testing performed).

Will I actually sit back and measure those goals?  Not with #1, but I can with #2, somewhat.

So, if you'd like to make a little noise and hopefully be heard, check out Peter's petition:  The Petition

Comments

[Ira Gorman]

As I read the message on the blog regarding the APTA marketing plans, I applaud your concerns and appreciate your frustrations but I think we must understand the process and put our efforts in a productive manner. First and foremost bashing our professional association and its employees (with subtlety I realize) is counterproductive. There are many individuals who give many hours of volunteer time and commitment and those that we employ give many extra hours of work to advance the agenda of our organization and our profession in a manner as directed by our Board of Directors. We must remember that this is a membership organization and the policies and actions of the association are directed by the elected Board and the House of Delegates. We are the APTA, it is not some distant foreign controlled body. I often hear from people who are frustrated with APTA and then I discover that they are not even members. With less than 50% of licensed PTs actual members of APTA maybe the first effort we should take is to have everyone on this blog recruit a member to APTA. How many of you on this blog are members? How many attend chapter and district meetings, know who their delegates and chief delegate to the HOD are and speak with them about these issues. How many look at the published list of candidates each year in PT magazine, read their positions and contact their delegate about who to vote for? These are not accusations but questions that we should answer before we sign petitions. We should send emails to the Board of Directors and the President and let them know the concerns. We should elect delegates who will sponsor motions that will address these concerns and charge the Board and the staff to advance these issues.
APTA must represent all of its members and sometimes that can cause conflict. The POPTS issue, ownership issues and credential issues sometimes puts APTA in a position that it has to find a middle ground between private owners and legally practicing PTs in physician ownership or even hospital ownership practices that may conflict with the values and philosophy of others. Marketing the profession clearly isn’t one of these and we should all be able to agree in a strategy that serves our membership and profession the best. I for one feel that backpack education bicycle fitting, health and fitness screening and promotion and the current obesity epidemic are valid campaigns and have led to more people associating PT with first line primary healthcare, but we can do more and better. Advertising campaigns are expensive and increasing our membership by 20,000 can go a long way to helping these campaigns be financed in addition to just imploring the association to do so.
I have listed below some of the motions that were passed this past HOD that may seem relevant to this blog issue. The orthopedic section was able to amend the bylaws for membership categories for fellows and residents an issue that may not directly affect many but is important to the profession as a whole. That is how our association policy should be made and I hope your efforts will focus on this manner rather than petitions that implore action.
Ira Gorman
Chief Delegate, Colorado

RC 4-07 AMEND: BYLAWS OF THE AMERICAN 1 PHYSICAL THERAPY ASSOCIATION, ARTICLE IV.
2 MEMBERSHIP, SECTION I: CATEGORIES AND QUALIFICATIONS OF MEMBERS
3
4 Required for Adoption: Previous Notice, 2/3 Vote to Consider, 2/3 to Vote to Adopt
5
6 FINAL – PASSED (Proposed by Orthopaedic Section) May 21, Page 81
7
8 V-9 That RC 4-07 Amend: Bylaws of the American Physical Therapy Association, Article IV. Membership, Section I:
9 Categories and Qualifications of Members, be adopted as originally moved by the Orthopaedic Section:
10
11 That the bylaws of the American Physical Therapy Association, Article IV. Membership, Section 1: Categories and
12 Qualifications of Members, A. Physical Therapist, 2., be amended by inserting the words “, or APTA credentialed
13 post-professional residency or fellowship program,” after the words “doctoral program” so that it would read:
14
15 A. Physical Therapist
16 1. Be a graduate physical therapist.
17 2. Physical Therapist – Post-professional Student: Be a Physical Therapist member who is enrolled in a
18 post-professional masters or doctoral program, or APTA credentialed post-professional residency or
19 fellowship program, and meets the Membership Qualifications Prescribed by the Board of Directors.
RC 28-07 ANNUAL VISIT WITH A PHYSICAL THERAPIST
48
49 Required for Adoption: Majority Vote
50
51 FINAL – PASSED May 22, Page 518
52
53 V-20 That RC 28-07 Annual Visit with a Physical Therapist, be adopted as amended:
54
55 That the following be adopted:
56
57 ANNUAL VISIT WITH A PHYSICAL THERAPIST
58
59 The American Physical Therapy Association recommends that all individuals visit a physical therapist at least
H of D 5/07
20
annually to promote optimal health, wellness, and fitness, as 1 well as to slow the progression of impairments,
2 functional limitations, and disabilities.
3
4 ORIGINAL (Proposed by Geriatrics Section) May 22, Page 515
5
6 That the following be adopted:
7
8 ANNUAL VISIT WITH A PHYSICAL THERAPIST
9
10 The American Physical Therapy Association recommends that all adults visit a physical therapist at least annually to promote
11 optimal health, wellness, and fitness, as well as to slow the progression of impairments, functional limitations, and
12 disabilities.
13
14 PASSED (Proposed by Pediatric Section) May 22, Page 516
15
16 Amend 20-1 That Annual Visit by a Physical Therapist be amended by striking out the word “adults” after the
17 words “recommends that all” and inserting the word “individuals” so that it would read:
18
19 The American Physical Therapy Association recommends that all adults individuals visit a
20 physical therapist at least annually to promote optimal health, wellness, and fitness, as well as to
21 slow the progression of impairments, functional limitations, and disabilities.
22
23 Cosponsored by Board of Directors, Georgia, Iowa, Missouri, Montana, Virginia and Wisconsin Chapters and Oncology,
24 Orthopaedic and Private Practice Sections
25
26 RC 30-07 “WELCOME TO MEDICARE” PHYSICAL EXAM: CONSULTATION WITH PHYSICAL
27 THERAPISTS –REPLACEMENT – PACKET III
28
29 Required for Adoption: Majority Vote
30
31 FINAL – PASSED (Proposed by Section on Geriatrics) May 22, Page 519
32
33 V-21 That RC 30-07 “Welcome to Medicare” Physical Exam: Consultation with Physical Therapists, be adopted as
34 originally moved by the Section on Geriatrics:
35
36 That the American Physical Therapy Association pursue initiatives with the Centers for Medicare and Medicaid
37 Services that stress the importance of consulting with physical therapists when conducting screenings related to the
38 beneficiary’s functional abilities (e.g. fall risk, ability to perform activities of daily living, home safety) as part of the
39 “Welcome to Medicare” physical exam.
40
41 Cosponsored by Georgia, Iowa, Missouri, Montana, Vermont, Virginia and Wisconsin Chapters and Neurology and
42 Orthopaedic Sections
43
44 RC 31-07 MARKETING CAMPAIGN TO PROMOTE PHYSICAL THERAPISTS AS EXERCISE EXPERTS
45
46 Required for Adoption: Majority Vote
47
48 FINAL – REFER TO BOARD OF DIRECTORS May 22, Page 541
49
50 V-22 That RC 31-07 Marketing Campaign to Promote Physical Therapists as Exercise Experts, be referred to the Board of
51 Directors as originally moved by the Section on Geriatrics:
52
53 That the American Physical Therapy Association develop and implement a marketing campaign, focused toward
54 nurse practitioners, physician’s assistants, and other appropriate providers, to promote physical therapists as experts
55 in movement impairments and exercise prescription.
56
H of D 5/07
21
ORIGINAL (Proposed by Section on 1 Geriatrics) May 22, Page 528
2
3 That the American Physical Therapy Association develop and implement a marketing campaign, focused toward nurse
4 practitioners, physician’s assistants, and other appropriate providers, to promote physical therapists as experts in movement
5 impairments and exercise prescription.
6
7 PASSED (Proposed by Texas Chapter) May 22, Page 538
8
9 Amend 22-1 That RC 31-07 Marketing Campaign to Promote Physical Therapists as Exercise Experts be
10 referred to the Board of Directors.

[Selena Horner]

Ira, why are you changing the topic to membership? The issue being tackled is marketing physical therapy services - membership is a whole different issue and definitely not the focus of the petition.

Ira, sometimes the only way to really snag the attention of those in positions to create change is to squeak. As I write this, apparently 101 physical therapists or physical therapist assistants agree that there needs to be change with regard to this issue.

You may disagree with the use of a petition but obviously others don't ... you may believe that the previous marketing strategies employed were relevant to our profession but obviously many others disagree with your perspective... How exactly have you measured that those previous campaigns that you believe to be relevant have led to more people associating PT with first line primary health care? I'm just not seeing it.

I believe some important, relevant issues were discussed in the spring of this year as a result of the combined section meeting in February. I don't believe that much action occurred based on those discussions. Just a question for you to ponder, Ira... but does anything change without action?

I would tend to think the majority of physical therapists would applaud a marketing strategy targeting consumers that:
1) embraced our skills
2) educated on when to seek our services
and
3)empowered prospective patients
a) to care enough to compare
and
b) to utilize their freedom to choose

Ira, since you are a chief delegate in Colorado, that is awesome. It appeared to me that there were quite a few signatures on that petition of individuals licensed in Colorado. What will you do about this new information... this information that members in your state really, really want to see marketing strategies change? Do they really need to send an email to you? Do they really have to pick up the phone to communicate their frustration and suggestions... or can you, by reading the petition, understand that something needs to change and you'll do something about it to the best of your ability because you are in a position to represent them?

[Jason L. Harris]

[quote]
I for one feel that backpack education bicycle fitting, health and fitness screening and promotion and the current obesity epidemic are valid campaigns and have led to more people associating PT with first line primary healthcare
[/quote]

Then you are the only one. As stated before, I have had NO pt's come to me because of these campaigns. In fact, the company I work for has 14 clinics and none of them have had any pt's come to them because of these campaigns.

What I DO get are people that have no idea how extensive my education is, that we are on the forefront of care for LBP, that they can come to me without a prescription, that they have a CHOICE of what PT they go to, or that I can effectively treat and screen for balance problems.

I am an APTA member, I go to district and state meetings, and whatever arguments you have against a grass roots movement. However, our meetings are filled with how to fight the chiros from taking our right to manipulate away (oh yeah, another thing the public has NO idea I'm trained in and able to perform), chiros and MD's trying to take away direct access, and POPTS taking pt's choice from them.

Of course, blackberry thumb, bicycle education, and backpack fitting do lots to address the real world issues PT's face and see in the clinic on a daily basis.

[Selena Horner]

Hmmm... Jason, I'm an APTA member. I'm also a member of a few sections.

There seem to be double standards that exist within membership of the APTA. I, as an APTA member, am frequently alerted to a role that I can have in emailing my senator or representative about important issues that would have an impact on physical therapy. (This behavior is something desired by the powers that be within the APTA.) Strange that when physical therapists want to do their own grassroots "voice" that there isn't support for them to communicate with each other to bring change within the APTA through readily established pathways that were designed for members to communicate! I never realized that boundaries existed on listserves FOR APTA members. Just to help you all out, here must be the unwritten rules for member listserves (because I obviously didn't know them):
Rule #1: Don't mention weaknesses or inadequacies of the APTA
Rule #2: Don't do any thinking of what you'd like to see change
Rule #3: Heaven forbid posting a message on a member listserve to assist with voicing the need for change.
Needless to say, I'm a bit irritated over the results of attempting to share the marketing issue/petition and messages not meeting approval. Why am I a member? I thought my opinion mattered; I thought I was valued; and for some reason, I thought the APTA would always be interested in doing and being the best that it can be for its members. For issues like this, am I supposed to buy email addresses and do a mass email after I pay the APTA? Hmmmm.... obviously I need some insight into the matter with regard to my role as a member.

I wrote a reasonable message to post on the listserve for the geriatrics section and the HPA section. The HPA section listserve apparently has no moderator and the message was immediately posted (hence Ira's response). The geriatric listserve has a moderator and messages need to be approved. The message wasn't approved, yet. This seemed very strange to me because the geriatrics section always seemed more forward thinking than the other sections in which I belong AND more member-oriented. (Other posts have shown up since my message was posted to be approved by the geriatric section moderator.) The Michigan listserve hasn't posted the message yet either, but that listserve isn't used very frequently, so I can suppose that either 1) messages aren't checked very often or 2) 'tis the season and the moderator is away.

Over at PTManager, well, the message didn't meet the moderator's approval either (other messages have been posted since mine was submitted for approval).

We should thank the administrators of this site. The administrators of this site really do value open discussion, even if the venue would be disliked by an association. Apparently they really do believe status quo isn't okay if something else would be better.

I question why a little petition wouldn't meet discussion approval. I question why anyone in the APTA wouldn't welcome the idea of a petition, especially at this time of year with the combined section meeting right around the corner. It would seem to me that if there a few therapists that are interested in a marketing change that the topic doesn't even need to be discussed at section meetings... but if there is a large interest in change, it can be added to the agendas as new business or whatever and get some brains picked of those individuals in the room. Behaviors speak more than words and what I am seeing really begs to question whether sections and the APTA really want to hear what members think. Does anyone in the APTA really care what members think? If you do, show me because the lip service of "thanks for being a valued member" should mean much more than just paying dues.

Thank you EIM team for allowing the venue for difficult topics to be discussed. I appreciate that you all value the simple fact that discussion can lead to change with fears of where discussion may or can lead.

[Carina Lowry]

Hello all.

Although I agree with the idea of a petition, producing it in a public forum such as this blog does not seem to be the proper approach. I think there are ways to do things to get results and the best way to approach this may be to utilize the delegates or to bring this forward at the combined sections meeting--a place that is private where we as members can discuss how and where the dues are distributed. By posting it on the blog for all and every eye to see, it is only showing that we are not supporting our professional association. I don't think this is the message we want to send.

Carina

[Carina Lowry]

Hello all.

Although I agree with the idea of a petition, producing it in a public forum such as this blog does not seem to be the proper approach. I think there are ways to do things to get results and the best way to approach this may be to utilize the delegates or to bring this forward at the combined sections meeting--a place that is private where we as members can discuss how and where the dues are distributed. By posting it on the blog for all and every eye to see, it is only showing that we are not supporting our professional association. I don't think this is the message we want to send.

Carina

[Mark Schwall, PT]

Carina,
While I agree that sometimes certain things shouldn't be discussed in a public venue, I don't see that this is one of them. I respectfully disagree that anything that has been conveyed in this thread of comments or the petition itself is somehow demonstrative of "not supporting our professional Association". This would be tantamount to those who accuse others of being "unpatriotic" simply because they are of a differing opinion than those how are in power. When in fact there is nothing more patriotic than speaking one's mind. That is in fact what many who have come before us and died for.

I'd also suggest that the commentary is not exemplary of "not supporting our professional association" but is perhaps demonstrative of perhaps how our Association is not supporting us as well as it should or could.

[Mark Schwall, PT]

While I have signed on as a petitioner and applaud this effort and am very sympathetic to the sentiment behind it, I would like make a couple of comments.
First we must keep in mind that a real marketing plan is not simply about advertising but about creating demand where it doesn’t currently exist. This requires a multipronged approach in numerous venues. We have all noted many of the EIM blog entries on this very point and it can be summarized simply that Physical Therapy should be the primary intervention for most neuromusculoskeletal conditions when balancing overall efficacy, cost and risk of adverse events.
Secondly this activity shouldn’t be limited to the consumer. This marketing should include the third party payer community with a heavy emphasis on why a fair and reasonable compensation is justified by the immediate and long term cost savings to the insurer and insured. As others have noted before, over fifty percent of the spending on the treatment of back pain is directly attributable to diagnostic imaging which the evidence convincingly demonstrates is typically unnecessary. Additionally this marketing approach should include the various legislative and regulatory bodies concerned either directly or indirectly with the practice of Physical Therapy as these are generally where public health policy is ultimately determined.
Lastly, our esteemed colleague Ira Gorman raises some critical points. It is critical that aside from the petitioning that we all make our concerns and ideas for change clear to those who represent those of us who are members of APTA. I’d suggest that clear and meaningful ideas be conveyed to your various chapter delegates, chapter leadership, and national leadership. For example what would you suggest as a percentage of dues that should be dedicated to such a marketing effort? Over what term of time or in perpetuity? Should consideration be given to raising the annual dues to fund such an effort? If so, how much?
It is easy to vent and we all feel better when we do, but it far harder to take the next step and actually do something constructive about it. I’d challenge everyone who signs the petition or who simply nods in agreement and then moves on to the next thing in their daily routine to actually take the time to put your concerns in writing and email them to your Association leadership. And then once you’ve done that, be relentless and keep their feet to the fire.
When was the last time you corresponded with your Association leadership including the members of the House of Delegates? Therein may lay our problem.

[Selena Horner]

Mark, obviously there are Delegates now aware of this issue. The information about this petition was posted on the HPA and geriatrics listserve. Nothing showing up on the Michigan listserve yet. I have no idea if anyone else who signed the petition posted information on it elsewhere. It does seem feasible that if every state had a listserve for their members, then a member could alert state members. If every section has a listserve, then it is feasible that information regarding the petition could be posted there also.

Ira is a delegate and he responded. Over at the geriatric listserve, Cathy Ciolek did end up approving the post. She also forwarded the information to Paul Rocker - the SOG liaison from the APTA Board of Directors - asking for information regarding the new APTA structure, budget issues including those related to recent HOD motions regarding marketing our profession, etc...so that geriatric members could make an informed decision.

Mark, I have no knowledge of the budget and the budget may actually be adequate. All I know is that the efforts thus far have been a waste of our membership dollars which were flushed down the toilet. The current and past APTA marketing topics/strategies do nothing for us as a profession to assist with the 2020 vision. The current strategies do not assist consumers or third party payors in understanding or choosing physical therapy services for neuromusculoskeletal conditions.

Will the implemented strategy satisfy every member? Heck no. Is it possible to dream up a consistent message that the majority would appreciate? Heck yes. Will the strategy be better because of the open discussion that is now occurring? Probably, but it all depends on how defensive those in control become. If the whole situation is viewed as an important problem that needs to be solved and there is a whole-hearted effort put forth to resolve the issue in a timely manner and take action, then I believe we will be in a better place. Do I believe the something better can be done? Most definitely - if I didn't believe that I would have never signed the petition just to sign the petition.

[Todd]

"The POPTS issue, ownership issues and credential issues sometimes puts APTA in a position that it has to find a middle ground between private owners and LEGALLY PRACTICING PTs in PHYSICIAN OWNERSHIP or even hospital ownership practices that may conflict with the values and philosophy of others"

Absolutely amazing that a delegate would make this statement and it's not the first time I've heard it. IMO the marketing strategy wouldn't need to be addressed if being pimped out in these type of settings would cost you your license such as in South Carolina.

[Vince]

I may not be the brightest penny in the PT world, but why does that APTA needed to consider the POPTS-PTs when considering a marketing program? I would think an effective marketing program would be against the POPTS interests. Am I wrong on that?

I would like to add that I do a great deal of bike fittings, but its not because of the APTA. Its because i'm a competitive cyclist and our office is the primary sponsor for a regional cycling team. We developed that niche, not the APTA marketing stategy.

[John Ware]

I respect Ira Gorman's willingness to come onto the EIM blog and "take the heat" on behalf of APTA, but I must say that I am disappointed by his support of the marketing initiatives with bicycles, backpacks and blackberries. You've heard of the " 5 P's" of marketing, well, I refer to these affectionately as the "3 Bs."

I have performed an average over my career of about 60 patient visits a week, which comes to close to 3000 visits/year. I cannot recall a single patient referring to any of the 3 B's when they came into my clinic for TREATMENT of their condition. Perhaps that's because the 3 B's are primarily geared around prevention of disorders, not treatment for a specific condition (OK, I guess blackberry thumb is a specific condition, though my Medline search came up empty).

While I support the role of PTs in prevention, it is really a minor role in our current health care system. Whether we like it or not, our health care system is a disease treatment system first and foremost, and our role has always been primarily to treat the effects of injury, disease or illness. Why is it then, that the APTA keeps embracing these prevention-based marketing strategies? It smacks to me of an Ivory Tower disconnect between the HOD, the APTA brass and the rank and file out here in the clinics and hospitals. I actually need to contact my chief delegate in order to inform them that my caseload consists primarily of sick people? That's just ludicrous.

I signed the petition because I want to re-inforce the message to APTA that we are primarily health care PROVIDERS, not good health PROMOTERS. While the latter is a desirable goal, and should be included in our public message, its pie in the sky to keep harping on these prevention messages.

[Ken Mailly, PT]

In light of all the comments on advocacy, planning & funding of APTA;
perhaps we should note the comments below so as to avoid repeating the
mistakes of others? These comments are from the listserv of the American
Academy of Family Physicians (AAFP), and are related to ongoing discussion
of their relationship to AARP. The final paragraph is perhaps the most
salient. IMHO, the moral of this story is that the pursuit of non-dues
revenue must always be a distant second to active & aggressive advocacy.
-------------------

There are always going to be marriages of convenience, but any mention of
the AARP in the same breath as family medicine makes me gag. AARP is an
entrepreneurial operation masquerading as an advocacy organization.

Consider New York Times columnist Paul Krugman's op-ed, "AARP Gone Astray:
From an advocacy group to a business" (Nov 21, 2003) during the battle over
the prescription drug bill:

"This is a bill with huge implications for the future of Medicare. It's
also, at best, highly controversial. One might therefore have expected an
advocacy group for retired Americans to take its time in responding---to
make sure that major groups of retirees won't actually be hurt, and to poll
its members to be sure that they are well-informed about what the bill
contains and don't object to it.

"Instead, AARP has thrown its weight behind an effort to ram the bill
through before Thanksgiving...

"Many of AARP's members feel betrayed. The message boards at the
organization's Web site have filled up with outraged posts. A number of
these posts say something like this: 'Now you're just an insurance company.'
Indeed, that may get to the heart of the matter.

"Over the years AARP has become more than an advocacy and service
organization for older Americans. It receives more than $150 million each
year in commissions on insurance, mutual funds and prescription drugs sold
to its members.

"And this Medicare bill is very friendly to insurance and drug companies...

"So do AARP executives support this bill because they hope to share in the
bounty? Maybe, but it probably runs deeper than that. Once an advocacy
group becomes as much a business as a service organization, its executives
are likely to start identifying more with industry interests than with the
groups they are supposed to serve.

"Thus it may seem odd on the surface that William Novelli, AARP's chief
executive, wrote a glowing preface to Newt Gingrich's book on health care
reform. After all, Mr. Gingrich has long advocated turning the
administration of Medicare over to private companies---an unpopular idea,
and also an expensive one (forget the clichés about inefficient government:
private companies have much higher overhead than Medicare). But what looks
like wasted money to taxpayers and retirees looks like opportunity to
private providers...

"So it should come as no surprise that Medicare 'reform' appears likely to
be another triumph for the coalition of the bought-off---a coalition that,
sadly, includes AARP."

Last month a front page article in The Baltimore Sun confirmed this, and
then some. Headlined, "AARP is drug plan advocate, marketer" (Dec. 20), the
article not only described how AARP, which receives $240 million a year in
member dues, raked in nearly $430 million in 2006 by lending its name to
products including various Medicare prescription drug and Medicare
Supplement plans, but also how the AARP-endorsed plans can cost a person
$500-$700 more per year than the competition. One critic is quoted as
saying AARP "never has come up with the best financial option for
consumers."

The article noted that AARP "expects to collect $4.4 billion over the next
seven years from deals announced this year with Aetna, Inc. and
UnitedHealthcare." AARP's CEO, William Novelli, a Washington public
relations insider, was paid more than $2 million in 2006.

This is the same Novelli who was cited in an incisive expose of the public
relations field, Toxic Sludge is Good for You, published in 1995:

"William Novelli, a founder of the New York-based Porter/Novelli PR firm,
cheerfully uses the term 'cross-pollination' to describe his company's
technique of orchestrating collusion between clients with seemingly
conflicted interests. By 'donating' free work to health-related charities,
for example, Porter/Novelli gains leverage to pressure the charities into
supporting the interests of the firm's paying corporate clients. In 1993,
this strategy paid off when produce growers and pesticide manufacturers
represented by Porter/Novelli learned that PBS was about to air a
documentary by Bill Moyers on pesticide-related cancer risks to children.
The PR firm turned to the American Cancer Society (ACS), to which it had
provided decades of free services. The national office of ACS dutifully
issued a memo charging the Moyers program 'makes unfounded
suggestions...that pesticide levels in food may be at hazardous levels.'
The industry then cited the memo as 'evidence' that Moyers' documentary
overstated dangers to children from pesticides."

One of the biggest crises the American Medical Association underwent (and
from which some feel the AMA has never recovered) happened 20 years ago when
several of its executives cut a deal with Sunbeam for product endorsements
by the AMA. So it will be with the AAFP if it confuses the promotion of the
essential, central role of family physicians in the betterment of public
health with the commercial agendas of the pharmaceutical industry, the
insurance industry, and AARP.

--------------

Sincerely,
Ken Mailly, PT
Mailly & Inglett Consulting
Wayne, NJ

[sean]

Todd,
Amen brother. Another problem is that in my area many of the delegates work for huge hospitals and publicly traded corporations which emphasize profits over quality of care. If they were our only way to communicate up through the hierarchy, few private practice PT'S would be interested in membership.

Regarding the issue of increasing membership possibly being a more important issue than marketing, I disagree. If non-members see APTA provide a marketing program that works and brings them more patients, they may consider joining. As someone said above, it needs to be a multi-pronged approach. The bottom line is that for all the APTA does to save us from the attacks and turf wars brought on by less qualified and even unlicensed professions, it has done little in the last 12 years to promote what we do to the public. As I have posted multiple times, the same person has been in charge of marketing for over a decade. Can anyone here recall a successful campaign that brought patients into your clinic?

I contacted APTA about 4 months ago and they said there would be a strategic marketing plan coming out after one of the national seminars they put on. I have yet to be informed as to what the plan is.

Ira, I appreciate you being the lightning rod for this discussion and respect you for the thick skin you must have to take that role. I also understand that many people give their time to try to make our professional landscape better. I am a private practice owner who sees patients for 45 hours per week, pays for my staff's memeberships, and tries to contribute on the discussion boards. But I cannot go to meetings at 5 PM, 20 miles away when I need to see patients until 7PM. My only way to allow my voice to be heard is here, APTA discussion boards, and by calling APTA.
Unfortunatley it is next to impossible to speak to someone between patients when certain departments are open less than 30 hours per week. It also makes it difficult when the volunteers you speak of are in powerful positions and cannot be reached when I call - sometimes for weeks. I understand that they have other commitments, but if they cannot be reached to discuss important matters, should they really be accepting these positions?

Someone also posted above that APTA has reorganized. Was that just the Barnes hire, or is the entire Association taking part?

The APTA has done an outstanding job in providing acces to research with OPTIMAL and OPEN DOOR. These are very powerful tools which could really promote an increase in membership. But I saw nothing to hype it! Which brings us back to the topic of this discussion: APTA's ineffective marketing practices to date. On the other hand, I get 10 emails for every seminar they put on.
How much would it cost APTA or each state Association to e-market this service? Heck, with a viral marketing initiative utilizing this blog and others, it would be nearly free.

I may not be the most educated PT in the world with my BS in PT and minors in Buckeye football and beer. But if I can figure this out, shouldn't our leaders?

[Marshall D.]

I overheard a conversation just yesterday--a patient asking what the difference was between PT and massage therapist. (I'm beginning to think the answer is massage "therapists" have less paperwork, ~$37 more an hour, and less school debt.) I see why patients may be confused with advertising like this:

http://booherhealingrelief.com/default.aspx
I had no idea they were allowed to advertise the treatment of pathology. Huh.

Albiet, I certainly hope we can demonstrate leadership of NMS conditions by being the practitioners of choice, not just legislation. But at the same time, it stresses me out everytime I see another PTs patient who's practice patterns are dreadfully out of date. (In that case, why not go to a 'masseur' where results would be comparable.)

What if the "publicity campaign" was about requiring a license renewal every 10 years, to make sure we contiue to practice with the times. Might this help to separate our identity from other XYZ-therapists'?

[John Ware, PT, MS, FAAOMPT]

Sean,
It sounds like I'm in a very similar clinical situation as you, but our APTA District meetings are held monthly at 6:30PM, not 5:00, so I am able to make most of these meetings. I don't have to drive 20 miles, but I would if I had to.

These meetings are critical for grassroots participation of the membership, and our company (PT-owned, non-hospital-based) makes it a priority for the PTs to make several a year, adjusting the patient schedule to allow it. As a practice owner, you set the tone and policy of the company. I'd suggest you contact your district chair and suggest that they move the meetings to a later time, and then adust your patient schedule accordingly. We must have grassroots participation at the district and chapter level by PT-owned practices to help bridge the gaps that people are complaining about here.

The internet will never replace personal communication and participation among stakeholders. In fact, I think the over-reliance on electronic communication has become part of the problem.

Marshall,
Your points are well-taken. A strong PROFESSIONAL code of ethics is supposed to provide the incentive for professionals to maintain current best practice standards. Unfortunately, many PTs practice in a marginally ethical way. Basically, many PTs continue to perform outdated procedures simply because they continue to get reimbursed for them. As the reimbursement squeeze continues, the incentive to continue to perform unnecessary procedures in a system that rewards doing more vs. less is extremely difficult overcome.

But, as professionals, we are obligated to practice ethically. This is a situation where, I believe, if you're not part of the solution, you are, at least, contributing to the problem. Coming full circle, this would be a good topic to bring up at your next district/chapter meeting: "The challenge of ethical practice in a shrinking reimbursement environment-or, Why do you still use ultrasound?"

[Mark Schwall, PT]

In order to provide some "Evidence" as to the woefully inadequate job WE (as members of the APTA, we are all accountable for the current environment of complacency) have done in "branding" our profession. I did a very brief "Googling" survey of key terms one would association with Physical Therapy. These terms included:
Exercise
Functional Exercise
Human Function
Rehabilitation
Shoulder rehabilitation
Back rehab
Arthritis Exercise
Stroke rehab

A link to an APTA page shows up nowhere in the initial few pages of listings.

If our professional association website is not a "relevant" (as determined by Google and other Search Engines) source of information on these and a host of other primary Physical Therapy topics, how are we going to educate the healthcare consumers that we should be the provider of choice for these and a myriad of other conditions.

Also, I'm a bit surprised or else I simply missed it, but I've not seen anybody raise issue with the "Head to Toe" consumer section of the APTA website. I find it ironic that the Association website provides information on Physical Therapy relevant conditions which are not even authored for the most part by Physical Therapists and yes I realize that this content is syndicated by another source. BTW a Google Search of "Physical Therapy Head to Toe" does not even come up with a direct link to that part of the APTA website. Come on APTA and colleagues we CAN and HAVE to do better!

[Ken Mailly, PT]

Lifted from a post on the AHPA lisserv:

Ira, et al,

I completely agree that others are aggressively marketing “physical
therapy”, but isn’t that really the crux of our marketing dilemma? Some may
argue that marketing the effectiveness of “physical therapy” can benefit
physical therapists as much as the non-PT, and at no cost to that PT. I
would agree with this premise if, and only if, we are truly effective in
convincing the public that the only way to access physical therapy is by
seeing a physical therapist. Not only am I unsure as to how effective we have been in delivering
this message, I’m not completely confident that physical therapists believe it
themselves, at least we don't seem to.

What is Physical Therapy? I would hope that the answer is 2 words: “A
profession”. As such, physical therapy is analogous to dentistry, not
surgery. Surgery is a specific interventional strategy utilized by more
than one profession, physical therapy is not. How many of us still describe
physical therapy as an intervention, in one fashion or another? How many
studies do we see addressing the "effectiveness of physical therapy"? By the
way, you can find a sampling of such studies by simply doing a Google search for "effectivenss of physical therapy".

Are these studies addressing the effectiveness of a profession, or the
effectiveness of a specific intervention? If we/APTA promote the "effectiveness of
PT", without linking the intervention to PTs, aren't we really promoting the
effectiveness of anyone claiming to "do PT"?

PT is, simply put, those services provided by PTs, period. If we can't come to agreement
on this point, I don't see how any branding effort can accomplish very much.
I would hope that this would be central tenet of all marketing and/or
branding efforts that we put forth, both individually and collectively.

Sincerely,
Ken Mailly, PT

P.S. If anyone thinks that we don't have adequate term protection, I would
respectfully disagree. I think the problem is more attributable to our own
lack of aggressiveness in applying such protections, not their absence.
In other words, we are having money stolen from under our noses.

[Prentice]

Greeting. Be courteous to all, but intimate with few; and let those few be well tried before you give them your confidence.
I am from Micronesia and also now teach English, give true I wrote the following sentence: "There no single website that best for purchasing your airplane tickets online."

Thanks for the help 8), Prentice.