The Biggest Issues in Physical Therapy Today—and How We Can Solve Them Together

Let's face the biggest issues in physical therapy. Brian Beaulieu, Athletico Senior VP of Clinical Operations, shares action items and advocacy tips.
Addressing The Biggest Issues In Physical Therapy Today

If you manage or own a physical therapy practice, you’re looked to as a leader in the field.

But do you consider yourself an advocate for physical therapy?

Brian Beaulieu is the Senior Vice President of Clinical Operations at Athletico, and a vocal advocate for not only the profession, but for the art of advocacy itself. He recently joined the Therapy Matters podcast to share his perspective on the biggest challenges and current issues in physical therapy, today.

In the process, he makes a powerful case for joining the professional communities that are actively shaping the physical therapy profession.

The Biggest Issues in Physical Therapy Today

This isn’t the first time we’ve talked about top challenges facing the physical therapy profession. (Listen to our chat with APTA CEO, Justin Moore, for example!)

When we sat down with Beaulieu, his focus was on two main topics: general supervision and reimbursement cuts.

Issue #1: General Supervision and Physical Therapy Practices

According to Beaulieu, one top priority in the therapy space is the introduction of the TEAM Act, focusing on Therapeutic Equity and Access to Medicare—which has since become part of the EMPOWER Act.

This legislation aims to address the issue of general supervision versus direct supervision for physical therapy assistants (PTAs) in the outpatient space, a standard different from other healthcare settings.

Whether it’s home therapy or hospitals, many forms of healthcare are offered under general supervision. However, PTAs have only been allowed to practice under general supervision during the health care emergency period, but that standard is set to expire on January 1st.

“We are held to a different standard, which nobody can seem to explain in the outpatient world,” says Beaulieu. For that reason, we need legislation that will level the playing field, for good!

Issue #2: Rising Costs and Lower Reimbursements

Another piece of legislation that Beaulieu says physical therapists should support is the Strengthening Medicare for Patients and Providers Act (HR 2474).

Co-sponsored by Reps. Larry Buchson (R-IL) and Raul Ruiz (D-CA), this bipartisan legislation would replace the two separate Medicare conversion factors for APM participants and other clinicians with a single conversion factor. The new conversion factor would “provide for an update that is equal to the annual percentage increase in the Medicare Economic Index, beginning in 2024.”

A Chart Showing Trends In Medicare Reimbursement For Rehabilitation Therapy Compared To Cost Of Service Delivery And Other Factors.
A chart comparing trends in the Medicare conversion factor compared to inflation, PT and OT salaries, and sequestration. Source: National Association of Rehab Providers & Agencies (NARA).

“Instead of continuous cuts, which we’ve seen to date, we would be getting adjustments based on inflation,” says Beaulieu.

The physical therapy sector has been facing rising costs and lower reimbursements every year, and if passed and signed into law, HR 2474 would reverse that pattern. The bill is also supported by the American Physical Therapy Association (APTA).

Facing the Biggest Issues Together

Beaulieu is a big advocate of physical therapists joining a state, regional or nationwide PT advocacy group for the industry.

Participation allows PTs to stay plugged into important legislation and other industry trends that will impact them and their practices directly.

"If you’re not in the room to offer feedback, you’re not part of the solution or part of the decisions that eventually get made."

So let’s talk about some options for PT leaders and practice owners to help tackle the biggest issues facing physical therapists in 2024.

Advocacy Tips for Physical Therapist Leaders and Practice Owners

For many PTs and practice leaders, the everyday challenges of patient care, practice management, and growing your practice can draw attention away from the larger efforts in the physical therapy industry.

“It starts for most of us in PT school, where [we’re] given extra credit to join an organization, like the local APTA or APTQI [chapter],” he says, “Most people tend to drift away from it as they get busy with day-to-day life and work—not maintaining a membership in those organizations.”

But in doing so, PT professionals may be losing out on an major advantage in facing today’s most pressing challenges: the power of collective voices to create regulatory change.

1. Stay Informed

For practice leaders or owners, the most important thing is to stay informed.

Awareness of the issues and legislation surrounding physical therapy as a profession is the first step. “I know the political arena is not for everyone, but just being armed with that information” is important, Beaulieu says.

Staying informed can help leaders stay creative and engaged in solving real problems facing physical therapy private practices. It’s certainly a part of Beaulieu’s role. “At Athletico, I’m part of going out and advocating directly with federal legislators in DC on the Hill,” says Beaulieu. “So it’s been an evolution. I think people need to look at it as an evolution.”

2. Get Involved

Of course, advocating in-person at the capitol isn’t for everyone. Beaulieu says the journey to the point where he’s now lobbying members of Congress has been a long one—and there are many simple steps that advocates can take, from wherever they are.

For instance, he points out that there are many political action committees (PACs) that advocate on behalf of physical therapy, which can be supported financially from anywhere.

Additionally, he points out that organizations like the APTA make it easier than ever to participate in advocacy efforts. For example, they’ll often send out updates on current issues and legislative efforts.

Sending an email to your representative is one simple step toward solving the biggest issues in physical therapy: “It doesn’t take long. You have to join the many voices that are out there so that, collectively, we can make some change.”

Four Illustrated People Climbing A Stairway

3. Educate New PTs

Leaders in the field should take the responsibility to educate new professionals about the importance of advocacy. 

Continuous dialogue at regional and local meetings is necessary to instill a sense of responsibility and understanding among new physical therapy graduates. “It’s incumbent on us to make sure our new entrants into the profession understand the importance of [advocacy] and that you bring it up your regional and local meetings.”

Beaulieu says many PTs join professional organizations when they’re still in training, but then let their memberships lapse once their careers take off. More experienced PT staff may be feeling the high cost of burnout, and have a tendency to think that their one vote won’t matter.

“You feel a little helpless in the clinic when you’re busy and you’re one voice,” says Beaulieu. “But, you know, collectively we have made things happen throughout the history of therapy.”

4. Guide Patients Toward PT Advocacy

Patients of physical therapists are some of our strongest and greatest assets.

With that in mind, Beaulieu says that patients of physical therapy can help lobby state and federal lawmakers on behalf of the industry.

“It can be very powerful messaging when a patient goes to a Representative or Senators and says, ‘My PT was the best thing that ever happened to me, and I need you to support this legislation,'” Beaulieu says. “So we need to wrap our patients in that blanket and use them to help us get what we need.”

Hot Topics and Takeaways

The Therapy Matters podcast has brought several thought leaders and physical therapy advocates to discuss the top challenges facing physical therapists in the coming year (among other hot topics!). Recurring themes have included:

The takeaway from our conversation with Brian Beaulieu, Senior Vice President of Clinical Operations at Athletico: Collective action can make a difference!

From staying informed to getting patients involved in advocacy, there are many actionable steps that leaders can implement in their professional life and instill in their practice culture.

Continuing the Conversation

Want to stay on top of changes in the physical therapy and rehabilitation field? You’re in the right place. Keep reading expert advice in practice management and more, listen to the Therapy Matters podcast, or join peers at TherapyCon ’24 in Las Vegas.

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