For Episode Nine, we welcome back guest Ben Galin, PT, DPT, for a deep dive into the evolving landscape of physical and occupational therapy, using the role of PTAs and COTAs as a springboard for broader industry discussion.

The conversation begins with examining how PTAs and COTAs are utilized in various healthcare settings, challenging the cookie-cutter approach to their deployment. The discussion reveals that PTAs often demonstrate exceptional career mobility, with many advancing into management positions and finding success in digital health platforms.

A significant portion delves into critical policy issues affecting the profession, including:

• The need to reclassify PTs as "practitioners" alongside other healthcare providers like dietitians and behavioral health specialists
• The importance of shifting focus from fighting Medicare cuts to pursuing more achievable policy goals that could fundamentally change the profession
• The complexities of state-level versus federal-level advocacy, highlighting how state-level changes can often be achieved more quickly and effectively
• The hosts and guest examine how digital health is reshaping traditional supervision ratios and practice models, while also addressing the profession's ongoing challenges with direct access and professional autonomy.

This episode provides valuable insights for physical therapy professionals at all levels, offering a strategic vision for advancing the profession through targeted policy changes and adaptation to emerging healthcare delivery models.

Chapters

00:00 The Role of PTAs and COTAs in Therapy

06:08 Challenges in Career Advancement for Assistants

10:42 Operational Models and Supervision in Therapy

16:11 State Regulations and the Future of PTAs

22:19 Advocacy and Legislative Challenges in Healthcare

27:59 Understanding the Role of Professional Associations

29:50 Navigating Changes in Healthcare Policy

32:26 The Importance of Practitioner Recognition

35:22 Addressing Friction Points in Healthcare

39:04 The Need for Change in Perception and Policy

41:56 Identifying Actionable Wins for the Profession

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In Episode 8 of Future Proof PT, hosts Dana Strauss and Alex Bendersky engage in a deep discussion with veteran physical therapist Ben Galin about the critical evolution of physical therapy practice. With 25 years of diverse clinical experience, Galin shares valuable insights on the transition from traditional fee-for-service models to value-based care.

The conversation delves into several key themes:

• The "51% substance" principle - emphasizing the importance of delivering meaningful, evidence-based care while acknowledging the role of patient engagement techniques
• How this ratio often becomes distorted in traditional fee-for-service models, potentially leading to only 25% substantive care
• The challenge of maintaining clinical value while meeting patient expectations
• Treatment modalities and their true value
• Critical examination of common interventions like cupping, needling, and manual therapy
• The role of placebo effects and their ethical implementation in treatment
• Breaking away from historical expectations of passive modalities
• Digital health transformation
• Benefits of removing non-substantive elements in virtual care delivery
• Focus on evidence-based therapeutic exercise and education
• Collaborative care model
• Horizontal integration with other healthcare providers
• Importance of timely referrals and professional networks
• Recognition of treatment limitations and appropriate escalation of care
• The episode concludes with a compelling vision for the future of physical therapy, emphasizing the need for evidence-based practice, strategic collaboration, and a commitment to meaningful patient outcomes rather than traditional treatment metrics.

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