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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In this episode of Future Proof PT, we dive deep into two game-changing models of care provision that could reshape physical therapy practice:

First, we explore the TEAM model (Transforming Episode Accountability Model), a Medicare acute episodes of care affecting about 740 hospitals nationwide. Learn how this model creates opportunities for outpatient PT (and OT) practices and why rethinking post-acute care transitions could lead to better patient outcomes.

Then, we uncover the proven success of PTs as primary care providers (PCPs) in the military model - a system that's been delivering results since 1974! Discover the four key domains that validate PT effectiveness as PCPs:

• Clinical effectiveness in musculoskeletal care
• Outstanding safety profile
• Cost effectiveness
• Reduced downstream healthcare utilization

For clinicians feeling burnt out: This episode offers a fresh perspective on elevating your practice and embracing new opportunities in team-based care.

Don't miss this crucial conversation about the future of our profession and how we can deliver more value to our healthcare system!

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Summary:

In this episode of the Future Proof PT podcast, Dana and Alex delve into the economic implications of healthcare with a focus on musculoskeletal disorders. They discuss the concepts of QALY and DALY, emphasizing the importance of understanding these metrics in evaluating the effectiveness of interventions. The hosts highlight the value of physical therapy as an investment in health, the impact of productivity loss due to days away from work, and the need for therapists to embrace technology. They also explore the distinction between patient needs and wants, the importance of patient autonomy, and the role of therapists in the healthcare ecosystem. They conclude with a call to action for therapists to advocate for their profession and build trust within the healthcare community.

Takeaways:

• Physical therapist care is an investment in overall health.
• Understanding QALY and DALY is crucial for evaluating interventions.
• The economic burden of musculoskeletal disorders is significant.
• Days away from work reflects productivity loss and impacts healthcare economics.
• Therapists need to embrace technology to enhance patient care.
• Therapists need to move beyond filling prescriptions and establish themselves as primary care providers for musculoskeletal health
• There is a need to differentiate between patient needs and wants in therapy.
• Building trust in the healthcare ecosystem is essential for therapists.
• Agency in physical therapy is vital for professional satisfaction.
• The future of physical therapy lies in value-based care models.
• Therapists must advocate for their profession by better quantifying and communicating its value to improve public perception, including that of payers, at-risk providers, and healthcare systems.

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Thank you for listening!

Alex and Dana

Below by Notion AI from the transcript:

A detailed discussion exploring the complex dynamics of value-based care in the musculoskeletal health sector. The conversation covers patient-reported outcome measures, healthcare system challenges, and the future of healthcare delivery in the United States.

Takeaways from Riverside AI:

Takeaways and Chapters by Riverside AI

• The role of clinicians is multifaceted and influenced by various factors.
• Transitioning to value-based care requires a shift in mindset and practice.
• Markers of success in healthcare are often arbitrary and need reevaluation.
• Clarity and alignment in professional roles are crucial for effective care delivery.
• Autonomy in clinical practice is essential for personal and professional growth.
• Critical thinking is vital for therapists to navigate complex patient needs.
• Adaptability is key to thriving in value-based care models.
• Patient engagement is a critical component of successful healthcare delivery.
• Accountability in healthcare extends beyond individual patient interactions.
• Quality metrics and patient outcomes are essential for evaluating care effectiveness.

AI Show Notes by Riverside FM:

Summary

In this episode, Dana and Alex discuss the complexities of budget resolutions, government spending, and their implications for healthcare, particularly telehealth and physical therapy. They explore the challenges posed by the physician fee schedule, the underutilization of physical therapy, and the importance of alternative payment models in transitioning to value-based care. The conversation emphasizes the need for quality metrics and the potential for a paradigm shift in healthcare funding.

Takeaways

• Budget resolutions involve complex negotiations and cuts.
• Telehealth expansion is dependent on congressional action.
• The physician fee schedule and impacts on therapist reimbursement
• Physical therapy is underutilized in treating musculoskeletal issues.
• Correct dosing in therapy is crucial
• Alternative payment models can provide financial stability for providers.
• Value-based care links reimbursement to patient outcomes.
• Quality and outcomes are essential in value-based care models.
• Government actions can directly affect healthcare delivery.
• The future of healthcare may require significant restructuring.

Chapters

00:00 Navigating Congressional Changes

01:56 Understanding Alternative Payment Models

04:00 The Impact of Budget Resolutions on Healthcare

06:19 Telehealth and Its Future

08:24 The Physician Fee Schedule and Its Implications

10:02 The Role of Physical Therapy in Primary Care

12:03 Challenges in Establishing Optimal Therapy Practices

14:40 The Future of Physical Therapy in Healthcare

17:56 Understanding CMS and Conversion Factor Cuts

20:18 The Budget Dilemma in Healthcare

22:49 Reimagining the Healthcare System

25:28 Alternative Payment Models Explained

33:44 The Future of Value-Based Care

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Riverside AI was used to generate the below:

Summary

In this episode of Future Proof PT, Dana and Alex delve into the complexities of the physical therapy referral continuum, discussing the challenges and opportunities within the healthcare supply chain. They emphasize the importance of understanding the roles of physical therapists, the need for primary care generalists as well as specialization, and the significance of building trust with primary care providers. The conversation also highlights the shift towards value-based care and the potential for physical therapists to engage in the Medicare Shared Savings Programs, ultimately advocating for better patient outcomes and healthcare efficiency.

Takeaways

• The physical therapy referral continuum is crucial for optimizing patient outcomes.
• Understanding the referral process and new opportunities can enhance care delivery.
• Physical therapists must recognize their limitations and refer patients appropriately.
• Building trust with primary care providers is essential for effective referrals.
• Specialization within physical therapy can improve patient care.
• Value-based care models reward effective management of conditions.
• Engaging in Medicare Shared Savings Programs can benefit physical therapists and patients alike.
• Collaboration among healthcare providers leads to better patient outcomes.
• Healthcare Value Week offers valuable insights into value-based care.
• Knowledge sharing and adaptation are key to improving physical therapy practices.

Sound Bites

"We need to advocate for our patients' needs."

"We need a matchmaker to connect providers."

"Knowledge is out there; we just need to find it."

Chapters

00:00 Introduction to the Future Proof PT Podcast

00:50 Exploring the Physical Therapy Supply Chain

04:17 Understanding Referral Continuity and Challenges

08:42 The Role of Physical Therapists in Patient Care

11:22 Navigating the Referral Process and Patient Advocacy

15:35 Building Collaborative Care Networks

19:46 Value-Based Care and Its Implications

23:44 Conclusion and Future Directions

25:57 Building Trust in Healthcare Relationships

27:59 The Importance of Patient Engagement

30:52 The Future of Primary Care

33:25 Creating a Community Resource

35:29 Navigating Medicare Shared Savings Programs

38:32 The Role of Matchmakers in Healthcare

43:49 Learning from Supply Chain Efficiency

47:47 Healthcare Value Week and Community Engagement