<h2>Alex and Dana explore AI, patient behavior, and the gap between technological innovation and meaningful health outcomes.</h2> <h3>Technology may transform how care is delivered, but therapists' ability to influence human behavior could be their most enduring value.</h3> <h4>Find the <a href="https://futureproofpt.notion.site/Episode-37-Can-Technology-Really-Change-Health-4012cee6a6d980d79388d9812177dc77" rel="noopener noreferrer" target="_blank">full transcript here.</a></h4> Listen in on the conversation about the forces reshaping healthcare and the therapy professions.We begin with the upcoming midterm elections, potential shifts in healthcare policy, and the future of Medicare innovation models under changing political leadership. From there, the conversation turns to a bigger question: Can artificial intelligence, digital health, and robotics fundamentally improve health outcomes, or does meaningful progress still depend on changing human behavior? Dana and Alex explore patient agency, the slow and often underestimated nature of lasting change, and the possibilities technology creates for expanding access to care and reducing human suffering. They close with a challenge to physical, occupational, and speech therapists: Are we placing too much value on hands-on techniques and too little on our greatest strengths and value we provide to the healthcare ecosystem and the population: clinical reasoning, patient engagement, and the ability to help people change their behavior? The episode covers the intersection of policy, technology, and human potential, and what it will take to future-proof the therapy professions. *All ideas and opinions are those of the podcast participants only and not advice. For informational and entertainment purposes only.* (subscribe to our YouTube channel <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">here</a>.) Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> where Dana covers health policy insights and career growth tips for healthcare professionals.

Alex and Dana explore AI, patient behavior, and the gap between technological innovation and meaningful health outcomes.Technology may transform how care is delivered, but therapists' ability to influence human behavior could be their most enduring value.Find the full transcript here.Listen in on the conversation about the forces reshaping healthcare and the therapy professions.We begin with the upcoming midterm elections, potential shifts in healthcare policy, and the future of Medicare innovation models under changing political leadership. From there, the conversation turns to a bigger question: Can artificial intelligence, digital health, and robotics fundamentally improve health outcomes, or does meaningful progress still depend on changing human behavior?Dana and Alex explore patient agency, the slow and often underestimated nature of lasting change, and the possibilities technology creates for expanding access to care and reducing human suffering.They close with a challenge to physical, occupational, and speech therapists: Are we placing too much value on hands-on techniques and too little on our greatest strengths and value we provide to the healthcare ecosystem and the population: clinical reasoning, patient engagement, and the ability to help people change their behavior? The episode covers the intersection of policy, technology, and human potential, and what it will take to future-proof the therapy professions.*All ideas and opinions are those of the podcast participants only and not advice. For informational and entertainment purposes only.*(subscribe to our YouTube channel here.)Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, where Dana covers health policy insights and career growth tips for healthcare professionals.

Future-Proof PT

Episode 37: Can Technology Really Change Health?

<h2>The momentum behind physical therapists, the payers still holding on to an old picture of PT, and what new grads need to stay in the profession.</h2> (subscribe to our YouTube channel <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">here</a>.) Kyle teaches at Duke, spent years in hospital-based care as a board-certified neurologic specialist, and started PT school in 2001, when direct access and the DPT were the new conversation. He's candid about how hard it is to be a clinician right now, and he's optimistic anyway. Here's what you'll hear: You're going to see your physical therapist. When Kyle takes his dog in, he's going to see the veterinarian. He says physical therapists put the "sent for PT" language on ourselves, and it's on us to make clear that patients come to see a clinical expert. He ties it to the century of referral-only, incident-to history the profession is still undoing, even with direct access in every state. Nothing magic happens at minute eight. Dana points out that the eval and re-eval are the only codes for work only a physical therapist can do. The rest of the code set was built for an earlier era of PT education, and it misses the work we do without pay: coordinating care, reassessing, modifying plans, talking with patients between visits, and much more. Kyle's answer is outcomes. The data in your documentation is what moves payment toward value and complexity, and it's why APTA's Value of PT report keeps adding diagnoses as the evidence comes in. Physicians already want their patients to see us. APTA's report on primary care physicians came back positive: they think their patients need physical therapists. They just don't know how to get patients to us. Dana calls it being "aligned with our primary care colleagues," and Kyle says he's stealing the phrase. After decades of turf battles, his message to the profession is "It's got to be a contribution, not a competition." Keep PT in your signature. Kyle names the loan debt and housing costs newer clinicians face that he never did, and Dana gets personal about what it costs to be a PT in northern New Jersey. Kyle wants everyone who moves into other roles like insurance, administration, tech, or city council to introduce themselves as a PT first. Nurses and physicians keep their nursing or physician identity in every leadership role they take, and that's how they get advocates at tables where we're missing. Cash-based practice is evidence. Dana worries that a profession serving only people who can pay out of pocket drifts away from mainstream medicine. Kyle agrees it can't meet society's needs, and he sees something useful in it: proof that people with the means will pay a lot more for what physical therapists do. He wants to use that proof to improve payment in network. PT For Future Me. APTA's consumer campaign pitches physical therapists as the clinicians who keep you active 20 years from now and able to play with your grandkids. Kyle says the public and lawmakers are coming around. Private payers still picture PT as post-surgical care, and he wants a campaign aimed right at them. Tech companies are coming to physical therapists. APTA treats AI as an opportunity and has an AI framework report on the way. Kyle points to the CSM exhibit hall as proof that tech now comes looking for us, and he reminds us the profession has adapted before: when polio disappeared, PTs moved with the technology. Kyle is optimistic, and he backs it up with record years of state advocacy wins, bipartisan standing in Congress, and physicians and tech companies asking for more of us. Keeping that going is everyone's job, member or not. <h3>Chapters:</h3> 00:00 Welcome, APTA President Kyle Covington01:22 Where direct access stands now07:39 The eval, the re-eval, and the work we don't get paid for11:37 "Sent for PT" and the veterinarian test12:55 Nothing magic happens at minute eight16:15 Downstream spend and aligning with primary care21:13 Burnout, loan debt, and what new grads face26:23 Why PTs are leaving the clinic28:20 Cash-based practice and keeping PT in your signature31:20 PTs as experts in behavior change33:08 PT For Future Me and public health34:45 AI and technology37:23 PT first and the case to private payers39:27 Bipartisan support and record state wins41:26 Wrap-up <h4>A few quotes from Kyle to listen for:</h4> "We've known for a long time that nothing magic happens between minute eight and minute nine, or minute fifteen and minute sixteen. The magic that happens is the exercise prescription and the clinical expertise that we apply." "We need to own that you are coming to the expertise of this clinical expert. You're going to see your physical therapist." "They all think that their patients need us. The misdirect is they don't know how to get their patients to us." "It can't be a competition anymore. It's got to be a contribution." "They face a world outside of PT from a loan burden standpoint, from a cost of buying a house standpoint that I didn't face when I was coming out of PT." "What it is doing in a way that we've never had before is showing that society is willing to pay a lot more for our services." "PT is in my signature. PT is what I was trained to do. And it's because of my PT training that I'm so good at this other role." "We're your provider that's going to keep you active two decades from now. We're your provider that's going to make sure you can play with your grandkids." "It's technology saying, you know what we need? We need physical therapists." "You chose this profession, and it's all of our collective responsibility to grow that fire." <h4>Find the full transcript and Kyle's bio <a href="https://futureproofpt.notion.site/Episode-36-with-Kyle-Covington-Nothing-Magic-Happens-at-Minute-Eight-3e72cee6a6d980f0bf2cfa13cfa49b9c?source=copy_link" rel="noopener noreferrer" target="_blank">here.</a></h4> Follow Kyle on LinkedIn <a href="https://www.linkedin.com/in/kyle-covington-pt-dpt-phd-b52339204/" rel="noopener noreferrer" target="_blank">here.</a> <h4>Download the APTA's Report "The Economic Value of Physical Therapy in the United States."<a href="https://www.valueofpt.com/" rel="noopener noreferrer" target="_blank"> Linked here.</a></h4> Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening. Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">How OTs and PTs Get Paid</a> and <a href="https://otpotential.com/continuing-education/course/therapy-and-value-based-care-models" rel="noopener noreferrer" target="_blank">Therapy and Value-Based Care Models.</a>

The momentum behind physical therapists, the payers still holding on to an old picture of PT, and what new grads need to stay in the profession.(subscribe to our YouTube channel here.)Kyle teaches at Duke, spent years in hospital-based care as a board-certified neurologic specialist, and started PT school in 2001, when direct access and the DPT were the new conversation. He's candid about how hard it is to be a clinician right now, and he's optimistic anyway. Here's what you'll hear:You're going to see your physical therapist. When Kyle takes his dog in, he's going to see the veterinarian. He says physical therapists put the "sent for PT" language on ourselves, and it's on us to make clear that patients come to see a clinical expert. He ties it to the century of referral-only, incident-to history the profession is still undoing, even with direct access in every state.Nothing magic happens at minute eight. Dana points out that the eval and re-eval are the only codes for work only a physical therapist can do. The rest of the code set was built for an earlier era of PT education, and it misses the work we do without pay: coordinating care, reassessing, modifying plans, talking with patients between visits, and much more. Kyle's answer is outcomes. The data in your documentation is what moves payment toward value and complexity, and it's why APTA's Value of PT report keeps adding diagnoses as the evidence comes in.Physicians already want their patients to see us. APTA's report on primary care physicians came back positive: they think their patients need physical therapists. They just don't know how to get patients to us. Dana calls it being "aligned with our primary care colleagues," and Kyle says he's stealing the phrase. After decades of turf battles, his message to the profession is "It's got to be a contribution, not a competition."Keep PT in your signature. Kyle names the loan debt and housing costs newer clinicians face that he never did, and Dana gets personal about what it costs to be a PT in northern New Jersey. Kyle wants everyone who moves into other roles like insurance, administration, tech, or city council to introduce themselves as a PT first. Nurses and physicians keep their nursing or physician identity in every leadership role they take, and that's how they get advocates at tables where we're missing.Cash-based practice is evidence. Dana worries that a profession serving only people who can pay out of pocket drifts away from mainstream medicine. Kyle agrees it can't meet society's needs, and he sees something useful in it: proof that people with the means will pay a lot more for what physical therapists do. He wants to use that proof to improve payment in network.PT For Future Me. APTA's consumer campaign pitches physical therapists as the clinicians who keep you active 20 years from now and able to play with your grandkids. Kyle says the public and lawmakers are coming around. Private payers still picture PT as post-surgical care, and he wants a campaign aimed right at them.Tech companies are coming to physical therapists. APTA treats AI as an opportunity and has an AI framework report on the way. Kyle points to the CSM exhibit hall as proof that tech now comes looking for us, and he reminds us the profession has adapted before: when polio disappeared, PTs moved with the technology.Kyle is optimistic, and he backs it up with record years of state advocacy wins, bipartisan standing in Congress, and physicians and tech companies asking for more of us. Keeping that going is everyone's job, member or not.Chapters:00:00 Welcome, APTA President Kyle Covington01:22 Where direct access stands now07:39 The eval, the re-eval, and the work we don't get paid for11:37 "Sent for PT" and the veterinarian test12:55 Nothing magic happens at minute eight16:15 Downstream spend and aligning with primary care21:13 Burnout, loan debt, and what new grads face26:23 Why PTs are leaving the clinic28:20 Cash-based practice and keeping PT in your signature31:20 PTs as experts in behavior change33:08 PT For Future Me and public health34:45 AI and technology37:23 PT first and the case to private payers39:27 Bipartisan support and record state wins41:26 Wrap-upA few quotes from Kyle to listen for:"We've known for a long time that nothing magic happens between minute eight and minute nine, or minute fifteen and minute sixteen. The magic that happens is the exercise prescription and the clinical expertise that we apply.""We need to own that you are coming to the expertise of this clinical expert. You're going to see your physical therapist.""They all think that their patients need us. The misdirect is they don't know how to get their patients to us.""It can't be a competition anymore. It's got to be a contribution.""They face a world outside of PT from a loan burden standpoint, from a cost of buying a house standpoint that I didn't face when I was coming out of PT.""What it is doing in a way that we've never had before is showing that society is willing to pay a lot more for our services.""PT is in my signature. PT is what I was trained to do. And it's because of my PT training that I'm so good at this other role.""We're your provider that's going to keep you active two decades from now. We're your provider that's going to make sure you can play with your grandkids.""It's technology saying, you know what we need? We need physical therapists.""You chose this profession, and it's all of our collective responsibility to grow that fire."Find the full transcript and Kyle's bio here.Follow Kyle on LinkedIn here.Download the APTA's Report "The Economic Value of Physical Therapy in the United States." Linked here.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: How OTs and PTs Get Paid and Therapy and Value-Based Care Models.

Episode 36: | Grown Up and In Demand, with APTA President Kyle Covington

<h2>Chris Hoekstra watched PT's AI panic flip in twelve months at the same annual meeting, and he explains what that reversal says about how this profession actually changes.</h2> Chris has been a PT for about 25 years. He also holds a PhD in clinical informatics, teaches organizational behavior at Oregon Health & Science University, and leads clinical transformation work at Therapeutic Associates. He calls himself a sociotechnologist, and that turned out to be the right word for this conversation. We got into why PT has been slow to adopt technology, why most therapists can't tell you what an RVU is when every physician can, the difference between quality and value, and what Chris thinks leadership actually requires. He also tells the story of a quality dashboard rollout that made therapists call in sick. <h3>What we cover:</h3> → Why the HITECH Act money went to medicine and PT paid its own way → The four levers that decide whether anybody changes anything → The gap between the scope therapists have and the codes they can bill → Quality and value, and why treating them as the same word keeps us stuck → What $800 a day buys in a skilled nursing facility → Why a quality number feels like a verdict on your character → What CMS is signaling in this year's requests for information → The three ingredients that put a clinician in flow <h3>Chapters:</h3> 00:00 Meet Chris Hoekstra 02:15 Why PT lagged on technology 04:05 What actually forces change 07:13 When patients start acting like consumers 10:29 The four levers behind every decision 12:45 The scope we have and the codes we don't 15:41 "I want an hour with my patients" 16:55 Quality and value are not the same 19:16 $800 a day to walk down the hall 22:09 The patient who wants the ultrasound 24:34 The 10 percent echo chamber 25:30 A failure of leadership 29:26 They have to feel it 31:12 Confident humility and one percent better 32:26 Every physician knows what an RVU is 35:06 AI, second brains, and what it's for 37:45 When AI alone outperformed the doctor 38:28 From boogeyman to ChatGPT in one year 41:56 The dashboard that made PTs call in sick 43:46 What quality even means anymore 46:06 What CMS is signaling in the RFIs 48:31 PT as prevention 50:40 Part of the primary care team 53:29 The recipe for flow 54:36 What every PT should understand <h4>A few quotes from Chris during in this episode. Listen for them:</h4> "I had more than one PT, the first day we rolled it out, call in sick, because they thought maybe they would be the lowest performing person on that dashboard. That's the amount of fear we have with people when you start to show these." "Historically we've dumbed down PT to say it's visits plus units." "We went from one year boogeyman to the next year put everything in ChatGPT. It just takes a couple of people getting a good outcome from it. And we're lemmings, so we're gonna follow." "We teach our PTs to look at the efficacy of their care in a frame of one, always. What we rarely do is roll those up into populations to say, how am I doing en masse?" "Be confident, but first be humble. Every day step into it saying, I'm not where I need to be. And if I am, I should probably retire." "MIPS has been a travesty in many respects, with an overfocus on process measures that actually don't change care. Everyone's gonna game the system when you throw money at it." <h3>Find the full transcript and Chris' bio <a href="https://futureproofpt.notion.site/FPPT-Episode-35-AI-Was-The-Boogeyman-A-Year-Later-Everyone-Was-Using-It-3e02cee6a6d98099b7a7c481a4536b5b?source=copy_link" rel="noopener noreferrer" target="_blank">here.</a> </h3>Follow Chris on Linked In <a href="https://www.linkedin.com/in/chrishoekstra-pt/" rel="noopener noreferrer" target="_blank">here.</a> Hosts: Alex Bendersky and Dana Strauss Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening. Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">How OTs and PTs Get Paid</a> and <a href="https://otpotential.com/continuing-education/course/therapy-and-value-based-care-models" rel="noopener noreferrer" target="_blank">Therapy and Value-Based Care Models.</a>

Chris Hoekstra watched PT's AI panic flip in twelve months at the same annual meeting, and he explains what that reversal says about how this profession actually changes.Chris has been a PT for about 25 years. He also holds a PhD in clinical informatics, teaches organizational behavior at Oregon Health & Science University, and leads clinical transformation work at Therapeutic Associates. He calls himself a sociotechnologist, and that turned out to be the right word for this conversation.We got into why PT has been slow to adopt technology, why most therapists can't tell you what an RVU is when every physician can, the difference between quality and value, and what Chris thinks leadership actually requires. He also tells the story of a quality dashboard rollout that made therapists call in sick.What we cover:→ Why the HITECH Act money went to medicine and PT paid its own way → The four levers that decide whether anybody changes anything → The gap between the scope therapists have and the codes they can bill → Quality and value, and why treating them as the same word keeps us stuck → What $800 a day buys in a skilled nursing facility → Why a quality number feels like a verdict on your character → What CMS is signaling in this year's requests for information → The three ingredients that put a clinician in flowChapters:00:00 Meet Chris Hoekstra 02:15 Why PT lagged on technology 04:05 What actually forces change 07:13 When patients start acting like consumers 10:29 The four levers behind every decision 12:45 The scope we have and the codes we don't 15:41 "I want an hour with my patients" 16:55 Quality and value are not the same 19:16 $800 a day to walk down the hall 22:09 The patient who wants the ultrasound 24:34 The 10 percent echo chamber 25:30 A failure of leadership 29:26 They have to feel it 31:12 Confident humility and one percent better 32:26 Every physician knows what an RVU is 35:06 AI, second brains, and what it's for 37:45 When AI alone outperformed the doctor 38:28 From boogeyman to ChatGPT in one year 41:56 The dashboard that made PTs call in sick 43:46 What quality even means anymore 46:06 What CMS is signaling in the RFIs 48:31 PT as prevention 50:40 Part of the primary care team 53:29 The recipe for flow 54:36 What every PT should understandA few quotes from Chris during in this episode. Listen for them:"I had more than one PT, the first day we rolled it out, call in sick, because they thought maybe they would be the lowest performing person on that dashboard. That's the amount of fear we have with people when you start to show these.""Historically we've dumbed down PT to say it's visits plus units.""We went from one year boogeyman to the next year put everything in ChatGPT. It just takes a couple of people getting a good outcome from it. And we're lemmings, so we're gonna follow.""We teach our PTs to look at the efficacy of their care in a frame of one, always. What we rarely do is roll those up into populations to say, how am I doing en masse?""Be confident, but first be humble. Every day step into it saying, I'm not where I need to be. And if I am, I should probably retire.""MIPS has been a travesty in many respects, with an overfocus on process measures that actually don't change care. Everyone's gonna game the system when you throw money at it."Find the full transcript and Chris' bio here. Follow Chris on Linked In here.Hosts: Alex Bendersky and Dana StraussFollow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: How OTs and PTs Get Paid and Therapy and Value-Based Care Models.

Episode 35: AI Was the Boogeyman. A Year Later, Everyone Was Using It.

<h2>Net Health's Ben Barron on the 12,000-therapist shortage, what CMS' proposed RTM changes would mean for rural practices, and how to create access to physical therapists' expertise starting today.</h2> The physical therapy profession is 12,000 therapists short, with no catch-up projected until 2037 at the earliest. Demand is climbing. Filling the schedule is not the problem. We should be focused on how to serve more of the community with the therapists we already have. Ben Barron is a physical therapist, former co-owner of a 23-clinic orthopedic private practice, and an executive at Net Health. He joins Alex and Dana to talk about what therapists can do about capacity right now. Ben said this perfectly: "We're going to be busy. The question is: How do we want to be busy?" The through line is more evaluations, hybrid and tech-supported care paths, remote touchpoints between visits, and care segmented by clinical need rather than by who called first. Besides being ways to address access issues, they're the pre-value-based steps that prepare a practice for what's coming and let therapy meet its physician partners where they already are on their own VBC journey. How? By delivering the thing those partners need most, which is prompt, skilled evaluation and reliable access to care for their patients best managed by physical therapists. In this episode, we cover this and more: • The workforce math that makes hybrid care a necessity rather than a preference • Why the 40-minute one-on-one visit came from the 8-minute rule, not the evidence • Visit frequency dogma, and what the evidence actually supports • Why a wait list is rationing, and why "we're full" isn't a success metric • The eval math: why skewing toward evaluations helps finances and patients • RTM, hybrid visits, and the 166 hours a week you're not with your patient • Why promising cost savings is the argument that loses regulators • What primary care and behavioral health figured out about access first • How to be ready for value-based care before you ever sign a contract Two other quotes from Ben during the episode that we love (listen to hear the context!): "We are incrementally making an imperfect system less imperfect.""We ration care every single day." <h3>Chapters:</h3> 00:11 — Music intro and welcome00:42 — Ben Barron’s background in physical therapy and health tech03:04 — Are technology tools making therapists’ work easier?07:37 — Workforce shortages, demand, and access to care10:51 — RTM: reimbursement changes and remote monitoring18:59 — Why RTM adoption has been slow26:06 — Rethinking one-on-one care and embracing hybrid models39:33 — What prevents practices from changing44:04 — Access, value-based care, and a more sustainable practice model52:30 — Building a future focused on lives impacted54:08 — Closing thoughts and thanks <h4>Find the full transcript and Ben's bio<a href="https://futureproofpt.notion.site/Future-Proof-PT-Episode-34-PT-Has-A-Capacity-Problem-Hybrid-Care-Is-The-Answer-3b12cee6a6d980f887e9db0f817aa05d?source=copy_link" rel="noopener noreferrer" target="_blank"> here.</a> Follow Ben on Linked In <a href="https://www.linkedin.com/in/benjamin-f-barron/" rel="noopener noreferrer" target="_blank">here</a>.</h4> Hosts: Alex Bendersky and Dana Strauss Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid"</a> and <a href="https://otpotential.com/continuing-education/course/therapy-and-value-based-care-models" rel="noopener noreferrer" target="_blank">Therapy and Value-Based Care Models.</a> Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Net Health's Ben Barron on the 12,000-therapist shortage, what CMS' proposed RTM changes would mean for rural practices, and how to create access to physical therapists' expertise starting today.The physical therapy profession is 12,000 therapists short, with no catch-up projected until 2037 at the earliest. Demand is climbing. Filling the schedule is not the problem. We should be focused on how to serve more of the community with the therapists we already have.Ben Barron is a physical therapist, former co-owner of a 23-clinic orthopedic private practice, and an executive at Net Health. He joins Alex and Dana to talk about what therapists can do about capacity right now.Ben said this perfectly: "We're going to be busy. The question is: How do we want to be busy?"The through line is more evaluations, hybrid and tech-supported care paths, remote touchpoints between visits, and care segmented by clinical need rather than by who called first. Besides being ways to address access issues, they're the pre-value-based steps that prepare a practice for what's coming and let therapy meet its physician partners where they already are on their own VBC journey. How? By delivering the thing those partners need most, which is prompt, skilled evaluation and reliable access to care for their patients best managed by physical therapists.In this episode, we cover this and more:• The workforce math that makes hybrid care a necessity rather than a preference • Why the 40-minute one-on-one visit came from the 8-minute rule, not the evidence • Visit frequency dogma, and what the evidence actually supports • Why a wait list is rationing, and why "we're full" isn't a success metric • The eval math: why skewing toward evaluations helps finances and patients • RTM, hybrid visits, and the 166 hours a week you're not with your patient • Why promising cost savings is the argument that loses regulators • What primary care and behavioral health figured out about access first • How to be ready for value-based care before you ever sign a contractTwo other quotes from Ben during the episode that we love (listen to hear the context!):"We are incrementally making an imperfect system less imperfect.""We ration care every single day."Chapters:00:11 — Music intro and welcome00:42 — Ben Barron’s background in physical therapy and health tech03:04 — Are technology tools making therapists’ work easier?07:37 — Workforce shortages, demand, and access to care10:51 — RTM: reimbursement changes and remote monitoring18:59 — Why RTM adoption has been slow26:06 — Rethinking one-on-one care and embracing hybrid models39:33 — What prevents practices from changing44:04 — Access, value-based care, and a more sustainable practice model52:30 — Building a future focused on lives impacted54:08 — Closing thoughts and thanksFind the full transcript and Ben's bio here. Follow Ben on Linked In here.Hosts: Alex Bendersky and Dana StraussWant information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid" and Therapy and Value-Based Care Models.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Episode 34: PT Has a Capacity Problem. Hybrid Care is the Answer

<h3>VA Leader Brian Westlake, PT, DPT, Cert MDT on how to impact total cost of care, what it means to control healthcare spending in a fixed budget and how primary care is crucial, outcomes-accountable care, and MSK triage in primary care.</h3> After 25 years leading inside the Veterans Administration, Brian Westlake came away certain that future of the physical therapy profession depends on moving upstream, into the primary care team. He saw it firsthand. As an executive overseeing a ~$400 million budget in the Bronx, Brian watched primary care teams do what fragmented, downstream care couldn't do. They keep budgets viable and get patients the right care as early as possible. He has a high conviction that this is a better model for PT and that it's the only way the profession secures its future, steps fully into its role in the healthcare system, and has a bigger impact on patients. He starts off with the story of four patients, all sent to him for evaluations for shoulder pain. Two actually had a neck, not shoulder impairment, and some had already gotten injections and an MRI of the shoulder before anyone screened the spine. It's exactly the wasted downstream spend that earlier PT contact is built to prevent. Dana, Alex, and Brian get into: – Why PTs belong at the front of the system as the MSK triage point of contact– The VA's PACT model, and why MSK should follow behavioral health into primary care– Outcomes-accountable care and the IMC model (25% MSK cost reduction, at risk)– The Choice Act and Mission Act, and how community-care spend exploded– Telehealth that actually scales: e-consults, store-and-forward, video-to-home– Why weak outcomes collection is the thing holding PT back– Speaking the language payers reward: total cost of care and "days at home" Brian's message to the profession: We've earned a seat in the broader healthcare arena, we underestimate our own impact, and we can't afford to wait. We have to demonstrate the impact we can have so it becomes the norm for primary care providers and patients alike. Tune in for the rest of the conversation! <h3>Chapters</h3> <ul><li>00:09 — Introduction: Brian Westlake’s VA career and virtual PT practice</li><li>03:35 — What it means for physical therapy to move “upstream”</li><li>10:47 — The value of early MSK assessment in primary care</li><li>13:37 — Building primary-care teams with embedded PT support</li><li>17:23 — The need for standardized, outcomes-driven PT care</li><li>18:42 — Integrated MSK Care: accountability, outcomes, and lower downstream costs</li><li>23:17 — How the VA evolved: outpatient care, the Choice Act, and the Mission Act</li><li>29:56 — E-consults and telehealth as tools for access and triage</li><li>36:25 — Why outcomes data matters for PT’s future and AI</li><li>39:09 — Proving value through total cost of care</li><li>44:41 — The practical barriers facing independent practices</li><li>47:28 — Primary care as the path to innovation and scale</li><li>48:46 — Advocacy, interoperability, and avoiding professional stagnation</li><li>51:06 — Why Brian is optimistic about PT’s future</li><li>54:54 — Closing: start small, pilot partnerships, and move forward</li></ul> <h4>Find the full transcript and Brian's Bio <a href="https://futureproofpt.notion.site/Transcript-and-Guest-Bio-for-Episode-33-How-Physical-Therapists-Prove-Their-Value-in-Value-Based-Ca-3a82cee6a6d98073b4b8cfeee7151ce1?source=copy_link" rel="noopener noreferrer" target="_blank">here.</a> Follow Brian on<a href="https://www.linkedin.com/in/brian-westlake-pt-dpt-cert-mdt-146a08183/" rel="noopener noreferrer" target="_blank"> Linked In</a>.</h4><h4> </h4>About the show: Future Proof PT is a podcast for physical therapists, physical therapists assistants, and others who want to think beyond the clinic, about policy, payment, identity, and the future of the profession. Hosts: Alex Bendersky and Dana Strauss Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid"</a> and <a href="https://otpotential.com/continuing-education/course/therapy-and-value-based-care-models" rel="noopener noreferrer" target="_blank">Therapy and Value-Based Care Models.</a> Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

VA Leader Brian Westlake, PT, DPT, Cert MDT on how to impact total cost of care, what it means to control healthcare spending in a fixed budget and how primary care is crucial, outcomes-accountable care, and MSK triage in primary care.After 25 years leading inside the Veterans Administration, Brian Westlake came away certain that future of the physical therapy profession depends on moving upstream, into the primary care team.He saw it firsthand. As an executive overseeing a ~$400 million budget in the Bronx, Brian watched primary care teams do what fragmented, downstream care couldn't do. They keep budgets viable and get patients the right care as early as possible. He has a high conviction that this is a better model for PT and that it's the only way the profession secures its future, steps fully into its role in the healthcare system, and has a bigger impact on patients.He starts off with the story of four patients, all sent to him for evaluations for shoulder pain. Two actually had a neck, not shoulder impairment, and some had already gotten injections and an MRI of the shoulder before anyone screened the spine. It's exactly the wasted downstream spend that earlier PT contact is built to prevent.Dana, Alex, and Brian get into:– Why PTs belong at the front of the system as the MSK triage point of contact– The VA's PACT model, and why MSK should follow behavioral health into primary care– Outcomes-accountable care and the IMC model (25% MSK cost reduction, at risk)– The Choice Act and Mission Act, and how community-care spend exploded– Telehealth that actually scales: e-consults, store-and-forward, video-to-home– Why weak outcomes collection is the thing holding PT back– Speaking the language payers reward: total cost of care and "days at home"Brian's message to the profession: We've earned a seat in the broader healthcare arena, we underestimate our own impact, and we can't afford to wait. We have to demonstrate the impact we can have so it becomes the norm for primary care providers and patients alike.Tune in for the rest of the conversation!Chapters00:09 — Introduction: Brian Westlake’s VA career and virtual PT practice03:35 — What it means for physical therapy to move “upstream”10:47 — The value of early MSK assessment in primary care13:37 — Building primary-care teams with embedded PT support17:23 — The need for standardized, outcomes-driven PT care18:42 — Integrated MSK Care: accountability, outcomes, and lower downstream costs23:17 — How the VA evolved: outpatient care, the Choice Act, and the Mission Act29:56 — E-consults and telehealth as tools for access and triage36:25 — Why outcomes data matters for PT’s future and AI39:09 — Proving value through total cost of care44:41 — The practical barriers facing independent practices47:28 — Primary care as the path to innovation and scale48:46 — Advocacy, interoperability, and avoiding professional stagnation51:06 — Why Brian is optimistic about PT’s future54:54 — Closing: start small, pilot partnerships, and move forwardFind the full transcript and Brian's Bio here. Follow Brian on Linked In.About the show: Future Proof PT is a podcast for physical therapists, physical therapists assistants, and others who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid" and Therapy and Value-Based Care Models.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Episode 33: How Physical Therapists Prove Their Value in Value-Based Care

<h2>Plus, Ray Dalio's framework for how systems break, applied to the profession's financial reckoning and its AI future</h2> (note: this episode was published before the CMS 2027 Physician Fee Schedule Proposed Rule was published) Is physical therapy heading toward its own financial reckoning? In Episode 32, Dana and Alex run MSK care through the same systems logic Ray Dalio uses to explain how countries go broke. Here's what you'll hear: <ul><li>How physical therapy goes broke. Large systems are already taking write-offs and defaulting as payers stop feeding operations that don't return what they promised. Alex makes the case that these are the first signs of a two-to-three year restructuring, and that it's predictable if you know the cycle.</li><li>Your evaluation pays $90. Your treatment pays $30. The system is already telling you where your value is. We get into why that gap exists and what it should change about how you design your day, your team, and your top-of-license time.</li><li>Your patients are already grading your plan of care with ChatGPT. A time-constrained patient can drop their symptoms and your plan into AI and ask "is this any good?" in thirty seconds. We talk through what that means for how defensible your plans need to be, starting now.</li><li>The money is moving to primary care (even in fee-for-service), and PT is sitting in the specialty bucket. Advanced Primary Care Management codes, capitation tests in ACO models, and a closed-system reality where dollars flowing to primary care flow away from the rest of us. Dana lays out a four-to-six year forecast and why PTs need to fight into that definition before it hardens.</li><li>Your discharges might be creating your own return visits. Tissue remodels over months and years. An episode of care runs days and weeks. We unpack that mismatch and why treating to symptom relief (often with unnecessarily high visit frequency) keeps sending patients back through the door.</li><li>AI is safer than your intuition wants to believe. Iatrogenesis is one of the largest preventable costs in medicine. Bring in the Waymo that has never had a fatality, add the difference between training and tuning these models, and you get a real role for clinicians as the people who tune them.</li><li>The optimistic close. Done right, AI plus interoperability finally plugs PT into the rest of the medical system and makes the work more individualized, more rewarding, and more visible. Or you can keep your paper charts and your goniometer.</li></ul><h4> </h4><h4>Chapters:</h4> 00:10 Introduction to Payment Stressors in Healthcare01:43 The Evolution of Physical Therapy and Payment Reform05:30 The Impact of AI on Healthcare Delivery09:53 Revolution vs. Evolution in Healthcare Systems14:01 The Future of Payment Models and AI Integration19:30 AI's Role in Healthcare Precision and Transparency21:05 Access Challenges in Urban vs. Rural Healthcare22:52 Understanding Access Problems in Healthcare25:02 AI's Impact on Healthcare Access26:51 Network Adequacy and AI's Potential29:08 AI Safety and Bias in Healthcare31:16 The Future of Physical Therapy with AI33:48 Embracing Change in Healthcare Delivery <h3>Find the full transcript<a href=" https://futureproofpt.notion.site/Transcript-for-Future-Proof-PT-Episode-32-The-Physical-Therapist-The-Big-Cycle-and-The-Age-of-AI-3942cee6a6d9802eaafbc57a6aeb85f3?source=copy_link" rel="noopener noreferrer" target="_blank"> here.</a></h3> <h3>Referenced in the episode:</h3> <a href="https://www.linkedin.com/in/chad-cook-22150510/" rel="noopener noreferrer" target="_blank">Dr. Chad Cook</a> <a href="https://www.linkedin.com/in/trevor-lentz-20647757/" rel="noopener noreferrer" target="_blank">Dr. Trevor Lentz</a> <a href="https://www.principles.com/" rel="noopener noreferrer" target="_blank">Ray Dalio's books</a> <a href="https://www.cms.gov/medicare/payment/fee-schedules/physician" rel="noopener noreferrer" target="_blank">CMS Physician Fee Schedule home page</a> <a href="https://www.cms.gov/medicare/payment/shared-savings-program" rel="noopener noreferrer" target="_blank">Medicare Shared Savings Program</a> <a href="https://www.cms.gov/priorities/innovation/innovation-models/aco-reach" rel="noopener noreferrer" target="_blank">ACO REACH Model</a> <a href="https://www.cms.gov/priorities/innovation/innovation-models/lead" rel="noopener noreferrer" target="_blank">LEAD Model</a> <a href="https://www.cms.gov/priorities/innovation/innovation-models/access" rel="noopener noreferrer" target="_blank">ACCESS Model</a> ACCESS Model: <a href="https://www.cms.gov/priorities/innovation/access-primary-care-providers-referring-clinicians" rel="noopener noreferrer" target="_blank">landing page for referring and co-managing clinicians (including PTs and OTs)</a> <a href="https://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/advanced-primary-care-management-services" rel="noopener noreferrer" target="_blank">Advanced Primary Care Management services and codes </a>under the Physical Fee Schedule <a href="https://ortho.duke.edu/news/early-access-physical-therapy-reduces-costly-interventions-musculoskeletal-care" rel="noopener noreferrer" target="_blank">Duke research</a> finding removing financial barriers to physical therapy led to more evidence-based care and cut unnecessary healthcare utilization. <a href="https://www.healthcaredive.com/news/hinge-health-goes-public-digital-health-IPO-signal/748931/" rel="noopener noreferrer" target="_blank">"Healthcare Dive's" coverage of the Hinge Health IPO</a> <a href="https://www.healthcaredive.com/news/hinge-health-goes-public-digital-health-IPO-signal/748931/" rel="noopener noreferrer" target="_blank">Waymo's March 2026 landing page</a> covering their safety data About the show: Future Proof PT is a podcast for physical therapists, physical therapists assistants, and others who want to think beyond the clinic, about policy, payment, identity, and the future of the profession. Hosts: Alex Bendersky and Dana Strauss Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid"</a> and <a href="https://otpotential.com/continuing-education/course/therapy-and-value-based-care-models" rel="noopener noreferrer" target="_blank">Therapy and Value-Based Care Models.</a> Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Plus, Ray Dalio's framework for how systems break, applied to the profession's financial reckoning and its AI future(note: this episode was published before the CMS 2027 Physician Fee Schedule Proposed Rule was published)Is physical therapy heading toward its own financial reckoning?In Episode 32, Dana and Alex run MSK care through the same systems logic Ray Dalio uses to explain how countries go broke. Here's what you'll hear:How physical therapy goes broke. Large systems are already taking write-offs and defaulting as payers stop feeding operations that don't return what they promised. Alex makes the case that these are the first signs of a two-to-three year restructuring, and that it's predictable if you know the cycle.Your evaluation pays $90. Your treatment pays $30. The system is already telling you where your value is. We get into why that gap exists and what it should change about how you design your day, your team, and your top-of-license time.Your patients are already grading your plan of care with ChatGPT. A time-constrained patient can drop their symptoms and your plan into AI and ask "is this any good?" in thirty seconds. We talk through what that means for how defensible your plans need to be, starting now.The money is moving to primary care (even in fee-for-service), and PT is sitting in the specialty bucket. Advanced Primary Care Management codes, capitation tests in ACO models, and a closed-system reality where dollars flowing to primary care flow away from the rest of us. Dana lays out a four-to-six year forecast and why PTs need to fight into that definition before it hardens.Your discharges might be creating your own return visits. Tissue remodels over months and years. An episode of care runs days and weeks. We unpack that mismatch and why treating to symptom relief (often with unnecessarily high visit frequency) keeps sending patients back through the door.AI is safer than your intuition wants to believe. Iatrogenesis is one of the largest preventable costs in medicine. Bring in the Waymo that has never had a fatality, add the difference between training and tuning these models, and you get a real role for clinicians as the people who tune them.The optimistic close. Done right, AI plus interoperability finally plugs PT into the rest of the medical system and makes the work more individualized, more rewarding, and more visible. Or you can keep your paper charts and your goniometer.Chapters:00:10 Introduction to Payment Stressors in Healthcare01:43 The Evolution of Physical Therapy and Payment Reform05:30 The Impact of AI on Healthcare Delivery09:53 Revolution vs. Evolution in Healthcare Systems14:01 The Future of Payment Models and AI Integration19:30 AI's Role in Healthcare Precision and Transparency21:05 Access Challenges in Urban vs. Rural Healthcare22:52 Understanding Access Problems in Healthcare25:02 AI's Impact on Healthcare Access26:51 Network Adequacy and AI's Potential29:08 AI Safety and Bias in Healthcare31:16 The Future of Physical Therapy with AI33:48 Embracing Change in Healthcare DeliveryFind the full transcript here.Referenced in the episode:Dr. Chad CookDr. Trevor LentzRay Dalio's booksCMS Physician Fee Schedule home pageMedicare Shared Savings ProgramACO REACH ModelLEAD ModelACCESS ModelACCESS Model: landing page for referring and co-managing clinicians (including PTs and OTs)Advanced Primary Care Management services and codes under the Physical Fee ScheduleDuke research finding removing financial barriers to physical therapy led to more evidence-based care and cut unnecessary healthcare utilization."Healthcare Dive's" coverage of the Hinge Health IPOWaymo's March 2026 landing page covering their safety dataAbout the show: Future Proof PT is a podcast for physical therapists, physical therapists assistants, and others who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid" and Therapy and Value-Based Care Models.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Episode 32: The Physical Therapist, The Big Cycle, and The Age of AI

<h3>Duke's Dr. Chad Cook on the 5 things MSK therapists obsess over, and what we should be doing instead</h3> A VA physician once told a colleague of Dr. Chad Cook's that physical therapy isn't really the movement profession, it's the Swiss Army knife profession, because PTs do a little bit of everything. Whenever no one else knows what to do, the patient gets sent to PT to "get it sorted out." Chad isn't sure he disagrees. In this episode, Chad joins Alex and Dana to walk through five sacred cows in MSK physical therapy. These are the things clinicians treat as essential that, in his view, matter far less than the profession believes, and the skills we should be leaning into instead. Chad is a tenured professor at Duke University with appointments in Orthopaedics, Population Health Sciences, and the Duke Clinical Research Institute. He's been a PT for 36 years, a health services researcher for 27, and is one of the most cited voices in our field. What we cover: <ul><li>Why the "movement expert" identity has limited what PT can become, and the cost of letting ourselves be bucketed as specialists when so much of what we do is primary care</li><li>Where tissue-specific diagnosis still matters (red-flag screening) and where it really doesn't (the 56 SIJ tests, the rotator cuff special-test rabbit hole)</li><li>Why treatment specificity often doesn't drive outcomes, and what therapeutic ritual, contextual packaging, and alliance actually do</li><li>How the top 10% of clinicians handle session-by-session symptom fluctuation without losing the long-term trajectory</li><li>Why social media arguments about exercise intensity and volume miss the point, and what behavior change should look like instead</li></ul> Plus three threads that emerged outside the five-things framework: <ul><li>The case for training prognosis communication with the same rigor as diagnosis, and why patients are really looking for someone who can tell them what to expect</li><li>What top US psychologists told Chad about the power of physical touch: "You're lucky. You can put your hands on your patients. We don't have that." — and why it's a privilege PTs underuse</li><li>The phrase from one of Chad's fibromyalgia patients that frames what he thinks PT actually is: "negotiated behavior change"</li></ul> Dr. Cook shares some uncomfortable numbers that we need to face to address.-75% of PT referrals never initiate,-30% drop off after the first visit,-and MSK patient outcomes have actually gotten worse over the last two decades Plus, where Chad sees AI, digital-first care, and lifestyle medicine fitting in. Chapters 00:00 Introduction to Dr. Chad Cook02:56 The Identity Crisis in Physical Therapy05:47 The Role of Physical Therapists in Primary Care08:33 The Precision Paradox in Treatment10:51 The Emotional Aspect of Diagnosis13:29 The Transition to Self-Management15:41 The Impact of Digital Health Solutions18:20 The Future of Physical Therapy28:45 Navigating Uncertainty in Healthcare30:45 The Digital Transformation of Health Systems32:08 The Role of AI in Patient Care36:51 Understanding Patient Recovery Trajectories39:36 The Importance of Prognosis in Therapy46:04 Redefining Exercise and Patient Engagement50:48 The Power of Touch in Therapy55:22 Negotiating Behavioral Change in Healthcare59:09 The Future of Physical Therapy Find the full transcript <a href="https://www.notion.so/Transcript-for-Episode-31-with-Dr-Chad-Cook-AI-Generated-by-Riverside-36b2cee6a6d980078379dbfe3dcb5ba9?pvs=21" rel="noopener noreferrer" target="_blank">here.</a> Related: <a href="https://listen.hubhopper.com/episode/episode-30-one-bad-experience-with-pt-loses-patients-forever-with-dr-trevor-lentz-pt-phd-mph/33004593" rel="noopener noreferrer" target="_blank">Episode 30</a> with Dr. Trevor Lentz About our Guest: <a href="https://www.linkedin.com/in/chad-cook-22150510/" rel="noopener noreferrer" target="_blank">Dr. Chad Cook</a> is a tenured professor at Duke University with appointments in the Department of Orthopaedics, the Duke Clinical Research Institute, and the Department of Population Health Sciences. He is a physical therapist with more than 36 years of clinical experience, an active health services researcher, and a clinical board member for multiple healthcare organizations. Dr. Cook has been involved in securing over $16 million in external funding and has authored more than 450 peer reviewed manuscripts, 46 book chapters, and four textbooks. He has delivered over 100 keynote lectures across 40 countries. Chad’s recent article in Journal of Orthopaedic and Sports Physical Therapy: <a href="https://www.jospt.org/doi/abs/10.2519/jospt.2026.13992" rel="noopener noreferrer" target="_blank">Many Paths to Recovery: The Case for Treatment Pluralism.</a> About the show: Future Proof PT is a podcast for physical therapists who want to think beyond the clinic, about policy, payment, identity, and the future of the profession. Hosts: Alex Bendersky and Dana Strauss Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid."</a> Follow <a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank">Dana Strauss</a> on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In.Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page. Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Duke's Dr. Chad Cook on the 5 things MSK therapists obsess over, and what we should be doing insteadA VA physician once told a colleague of Dr. Chad Cook's that physical therapy isn't really the movement profession, it's the Swiss Army knife profession, because PTs do a little bit of everything. Whenever no one else knows what to do, the patient gets sent to PT to "get it sorted out."Chad isn't sure he disagrees. In this episode, Chad joins Alex and Dana to walk through five sacred cows in MSK physical therapy. These are the things clinicians treat as essential that, in his view, matter far less than the profession believes, and the skills we should be leaning into instead. Chad is a tenured professor at Duke University with appointments in Orthopaedics, Population Health Sciences, and the Duke Clinical Research Institute. He's been a PT for 36 years, a health services researcher for 27, and is one of the most cited voices in our field.What we cover:Why the "movement expert" identity has limited what PT can become, and the cost of letting ourselves be bucketed as specialists when so much of what we do is primary careWhere tissue-specific diagnosis still matters (red-flag screening) and where it really doesn't (the 56 SIJ tests, the rotator cuff special-test rabbit hole)Why treatment specificity often doesn't drive outcomes, and what therapeutic ritual, contextual packaging, and alliance actually doHow the top 10% of clinicians handle session-by-session symptom fluctuation without losing the long-term trajectoryWhy social media arguments about exercise intensity and volume miss the point, and what behavior change should look like insteadPlus three threads that emerged outside the five-things framework:The case for training prognosis communication with the same rigor as diagnosis, and why patients are really looking for someone who can tell them what to expectWhat top US psychologists told Chad about the power of physical touch: "You're lucky. You can put your hands on your patients. We don't have that." — and why it's a privilege PTs underuseThe phrase from one of Chad's fibromyalgia patients that frames what he thinks PT actually is: "negotiated behavior change"Dr. Cook shares some uncomfortable numbers that we need to face to address.-75% of PT referrals never initiate,-30% drop off after the first visit,-and MSK patient outcomes have actually gotten worse over the last two decadesPlus, where Chad sees AI, digital-first care, and lifestyle medicine fitting in.Chapters00:00 Introduction to Dr. Chad Cook02:56 The Identity Crisis in Physical Therapy05:47 The Role of Physical Therapists in Primary Care08:33 The Precision Paradox in Treatment10:51 The Emotional Aspect of Diagnosis13:29 The Transition to Self-Management15:41 The Impact of Digital Health Solutions18:20 The Future of Physical Therapy28:45 Navigating Uncertainty in Healthcare30:45 The Digital Transformation of Health Systems32:08 The Role of AI in Patient Care36:51 Understanding Patient Recovery Trajectories39:36 The Importance of Prognosis in Therapy46:04 Redefining Exercise and Patient Engagement50:48 The Power of Touch in Therapy55:22 Negotiating Behavioral Change in Healthcare59:09 The Future of Physical TherapyFind the full transcript here.Related: Episode 30 with Dr. Trevor LentzAbout our Guest:Dr. Chad Cook is a tenured professor at Duke University with appointments in the Department of Orthopaedics, the Duke Clinical Research Institute, and the Department of Population Health Sciences. He is a physical therapist with more than 36 years of clinical experience, an active health services researcher, and a clinical board member for multiple healthcare organizations. Dr. Cook has been involved in securing over $16 million in external funding and has authored more than 450 peer reviewed manuscripts, 46 book chapters, and four textbooks. He has delivered over 100 keynote lectures across 40 countries.Chad’s recent article in Journal of Orthopaedic and Sports Physical Therapy: Many Paths to Recovery: The Case for Treatment Pluralism.About the show: Future Proof PT is a podcast for physical therapists who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid."Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Episode 31: Physical Therapy is the Swiss Army Knife Profession

<h3>And the active ingredients in PT often aren't even physical</h3> "We have the capacity to provide a level of care that nobody else in the healthcare system does. But we're being hamstrung by the payment models." — Dr. Trevor Lentz Dr. Trevor Lentz of Duke University on why patients write off physical therapy after one failed attempt, what the profession is actually selling, and the payment models keeping PT from delivering its real value. In this episode, Alex Bendersky and Dana Strauss sit down with Dr. Trevor Lentz, physical therapist, researcher, and faculty at Duke University, to unpack the structural and identity challenges facing the profession. The conversation moves across patient defection, language and labeling, payment reform, phenotyping, and what it would take to build longitudinal care models that finally pay therapists for outcomes rather than volume. What you'll hear: <ul><li>Why a single bad round of PT loses patients for life, and why the same isn't true for dentistry or primary care.</li><li>The challenge of fostering critical thinking and comfort with uncertainty in clinical education.</li><li>Trevor's research on removing copays, what it actually did to costs, and what payers misunderstand about long-term value.</li><li>The case that PT's active ingredients aren't physical, and why the language we use, from "assistant" to "exercise" to "blown disc," is quietly damaging the profession.</li><li>How <a href="https://www.dukehealth.org/treatments/orthopaedics/joint-health-program" rel="noopener noreferrer" target="_blank">Duke's Joint Health Program</a> built a longitudinal care model before the payment model existed.</li><li>Phenotyping, tiered care, and what it means for therapists to be the quarterback of a patient's care journey.</li><li>The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847237" rel="noopener noreferrer" target="_blank">AIM-Back trial </a>and the Pain Navigator program, recently published in JAMA Network Open, and what it teaches about scaling non-pharmacologic care.</li></ul> <h4>Find the complete transcript and outline <a href="https://www.notion.so/dsuzanne/Episode-30-Future-Proof-PT-Outline-and-Full-Transcript-3542cee6a6d980f99214e2c4b2638dc2?source=copy_link" rel="noopener noreferrer" target="_blank">here.</a></h4> Chapters: 00:00 Introduction00:23 Trevor's background and path to research03:00 Day-to-day at Duke03:54 Inductive vs. deductive reasoning in clinical practice05:39 The No-Copay Revolution study09:30 Horizontal vs. vertical value and the time-horizon problem12:44 Rethinking incentives and longitudinal care17:28 Why one bad PT experience ends the relationship forever20:53 The identity crisis and language problem26:57 Phenotyping and tiered, personalized care39:32 The Pain Navigator program and AIMBAC trial46:23 Navigators in the commercial space48:14 Closing: the whole-person argument About the guest: <a href="https://ortho.duke.edu/personnel/trevor-lentz-pt-phd-mph" rel="noopener noreferrer" target="_blank" style="color: rgb(34, 34, 34);">Trevor Lentz, PT, PhD, MPH</a> is an Associate Professor in Orthopaedic Surgery at Duke University and a licensed physical therapist. His work focuses on improving outcomes in musculoskeletal care by integrating behavioral and psychological factors, patient-reported outcomes, and real-world data into clinical decision-making. He leads and collaborates on pragmatic and hybrid effectiveness-implementation studies aimed at translating evidence into routine surgical and non-surgical musculoskeletal care. About the show: Future Proof PT is a podcast for physical therapists who want to think beyond the clinic, about policy, payment, identity, and the future of the profession. Hosts: Alex Bendersky and Dana Strauss Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid."</a> Follow<a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank"> Dana Strauss </a>on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In. Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page.Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a>. Subscribe to our sister newsletter, <a href="https://studio.hubhopper.com/podcasts/459285/episodes/32994044/www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

And the active ingredients in PT often aren't even physical"We have the capacity to provide a level of care that nobody else in the healthcare system does. But we're being hamstrung by the payment models." — Dr. Trevor LentzDr. Trevor Lentz of Duke University on why patients write off physical therapy after one failed attempt, what the profession is actually selling, and the payment models keeping PT from delivering its real value.In this episode, Alex Bendersky and Dana Strauss sit down with Dr. Trevor Lentz, physical therapist, researcher, and faculty at Duke University, to unpack the structural and identity challenges facing the profession.The conversation moves across patient defection, language and labeling, payment reform, phenotyping, and what it would take to build longitudinal care models that finally pay therapists for outcomes rather than volume.What you'll hear:Why a single bad round of PT loses patients for life, and why the same isn't true for dentistry or primary care.The challenge of fostering critical thinking and comfort with uncertainty in clinical education.Trevor's research on removing copays, what it actually did to costs, and what payers misunderstand about long-term value.The case that PT's active ingredients aren't physical, and why the language we use, from "assistant" to "exercise" to "blown disc," is quietly damaging the profession.How Duke's Joint Health Program built a longitudinal care model before the payment model existed.Phenotyping, tiered care, and what it means for therapists to be the quarterback of a patient's care journey.The AIM-Back trial and the Pain Navigator program, recently published in JAMA Network Open, and what it teaches about scaling non-pharmacologic care.Find the complete transcript and outline here.Chapters:00:00 Introduction00:23 Trevor's background and path to research03:00 Day-to-day at Duke03:54 Inductive vs. deductive reasoning in clinical practice05:39 The No-Copay Revolution study09:30 Horizontal vs. vertical value and the time-horizon problem12:44 Rethinking incentives and longitudinal care17:28 Why one bad PT experience ends the relationship forever20:53 The identity crisis and language problem26:57 Phenotyping and tiered, personalized care39:32 The Pain Navigator program and AIMBAC trial46:23 Navigators in the commercial space48:14 Closing: the whole-person argumentAbout the guest:Trevor Lentz, PT, PhD, MPH is an Associate Professor in Orthopaedic Surgery at Duke University and a licensed physical therapist. His work focuses on improving outcomes in musculoskeletal care by integrating behavioral and psychological factors, patient-reported outcomes, and real-world data into clinical decision-making. He leads and collaborates on pragmatic and hybrid effectiveness-implementation studies aimed at translating evidence into routine surgical and non-surgical musculoskeletal care.About the show: Future Proof PT is a podcast for physical therapists who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid."Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.

Episode 30: One Bad Experience with PT Loses Patients Forever with Dr. Trevor Lentz, PT, PhD, MPH

<h2>Why content follows culture, and practical actions clinic owners can implement within the next 3 months.</h2> Find the full episode transcript <a href="https://futureproofpt.notion.site/Episode-29-Transcript-with-Kylie-Williams-3462cee6a6d98070b6c6d286228ec861" rel="noopener noreferrer" target="_blank">here.</a> Posting more isn’t a growth strategy. Kylie Williams joins us to break down why “marketing to patients” on social media is getting harder, and why the clinics that win are the ones building culture that therapists actually want to be part of. We talk retention, autonomy, flexibility, benefits that matter, and a simple “side quest” approach to content that does not derail clinical excellence. Kylie is a healthcare professional with 8+ years of experience in physical therapy as a PTA. Now in a non-clinical role, she focuses on industry market analysis and storytelling to help private practices grow, adapt, and stay strong in a change healthcare landscape. Key Topics: -Social media's impact on private practice growth-Creating a strong clinic culture to reduce turnover-Innovative marketing strategies for healthcare providers Chapters: 00:00 Introduction to Kylie Williams01:36 The Importance of Culture in Physical Therapy05:05 Defining and Building a Positive Work Culture09:29 Targeting the Right Audience for Recruitment18:15 First Principles for Engaging New Clinicians23:07 The Impact of Social Media on Attention Spans23:40 Balancing Attention and Depth in Learning25:20 Navigating the Attention Economy26:10 Attracting Talent in a Digital Age27:04 Creating Value in Social Media Content28:27 The Challenge of Teaching Value in Social Media30:18 Connecting Social Media to Business Success32:12 Investing in Marketing Education for Therapists34:03 Finding Balance in Clinical and Promotional Roles37:15 The Role of Influencers in Modern Careers39:07 Empowering Clinicians to Pursue Side Projects40:47 The Importance of Agency in Clinical Roles42:36 Shifting Paradigms in Therapy Business Models44:40 Embracing Creativity and Optimism in Therapy Want information on PT and OT reimbursement and opportunities in policy and advocacy?Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid."</a> Follow<a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank"> Dana Strauss </a>on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In. Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page.Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a> for exclusive content. Subscribe to our sister newsletter, <a href="https://studio.hubhopper.com/podcasts/459285/episodes/32994044/www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter every Sunday evening.

Why content follows culture, and practical actions clinic owners can implement within the next 3 months.Find the full episode transcript here.Posting more isn’t a growth strategy. Kylie Williams joins us to break down why “marketing to patients” on social media is getting harder, and why the clinics that win are the ones building culture that therapists actually want to be part of. We talk retention, autonomy, flexibility, benefits that matter, and a simple “side quest” approach to content that does not derail clinical excellence.Kylie is a healthcare professional with 8+ years of experience in physical therapy as a PTA. Now in a non-clinical role, she focuses on industry market analysis and storytelling to help private practices grow, adapt, and stay strong in a change healthcare landscape.Key Topics:-Social media's impact on private practice growth-Creating a strong clinic culture to reduce turnover-Innovative marketing strategies for healthcare providersChapters:00:00 Introduction to Kylie Williams01:36 The Importance of Culture in Physical Therapy05:05 Defining and Building a Positive Work Culture09:29 Targeting the Right Audience for Recruitment18:15 First Principles for Engaging New Clinicians23:07 The Impact of Social Media on Attention Spans23:40 Balancing Attention and Depth in Learning25:20 Navigating the Attention Economy26:10 Attracting Talent in a Digital Age27:04 Creating Value in Social Media Content28:27 The Challenge of Teaching Value in Social Media30:18 Connecting Social Media to Business Success32:12 Investing in Marketing Education for Therapists34:03 Finding Balance in Clinical and Promotional Roles37:15 The Role of Influencers in Modern Careers39:07 Empowering Clinicians to Pursue Side Projects40:47 The Importance of Agency in Clinical Roles42:36 Shifting Paradigms in Therapy Business Models44:40 Embracing Creativity and Optimism in TherapyWant information on PT and OT reimbursement and opportunities in policy and advocacy?Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid."Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list for exclusive content.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter every Sunday evening.

Episode 29: Build a PT and OT Clinic Where Therapists Want to Work

<h3>How RVUs (Not the Conversion Factor) Quietly Squeeze PT and OT and the Practical Blueprint to Shift From "Minutes" to ACO-Ready Value</h3> <a href="https://futureproofpt.notion.site/Future-Proof-PT-Episode-28-Transcript-3312cee6a6d98065896fd565ff9aa62f?source=copy_link" rel="noopener noreferrer" target="_blank">(read the full transcript here)</a> In this episode, Alex and Dana discuss the CMMI ACCESS Model and what it could unlock for MSK care inside ACOs. They debate digital enablement reality and explain how aligned incentives can reshape referral pathways. They make a direct case the that the physical therapy profession's future depends on understanding payment mechanics. A core theme of this episode is that if PT stays positioned as specialty care based on "treatment minutes" as the primary service, it will keep losing in a system shifting relative value units (RVUs) toward primary care and behavioral health. If PT repositions around evaluation-driven expertise and ACO partnership, the profession can move from survival to influence. <h4>Here's what else you'll learn:</h4> <ul><li>Why the ACCESS Model payments are intentionally low, and why that is not the point.</li><li>How ACOs think about total cost of care and why MSK spend is hard for primary care to manage.</li><li>What “aligned incentives” can look like in a PCP + ACO + ACCESS org + PT partnership.</li><li>Why engagement is often 3–5% for digital MSK programs, and what that means in context.</li><li>A practical “go do this tomorrow” play for clinics: identify local ACO participants and pursue Preferred Provider relationships.</li><li>The RVU basics most therapists never learned, and why it changes your advocacy strategy.</li><li>Why PTs should prioritize evaluation, differential diagnosis, and plan-setting, with PTAs executing more follow-up care.</li><li>How waitlists and access challenges become non-starters if PT wants to play in ACO-aligned care.</li><li>A potential new productivity mindset: RVU-based expectations instead of “visits per week.”</li></ul> Want more information on PT and OT reimbursement and opportunities in policy and advocacy?Read Dana's guest post series for <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">OT Potential</a> here: <a href="https://otpotential.com/ceu-podcast-courses/how-ots-and-pts-get-paid" rel="noopener noreferrer" target="_blank">"How OTs and PTs Get Paid."</a> Follow<a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank"> Dana Strauss </a>on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In. Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page.Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a> for exclusive content. Subscribe to our sister newsletter, <a href="https://studio.hubhopper.com/podcasts/459285/episodes/32994044/www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy,</a> Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter every Sunday evening.

How RVUs (Not the Conversion Factor) Quietly Squeeze PT and OT and the Practical Blueprint to Shift From "Minutes" to ACO-Ready Value(read the full transcript here)In this episode, Alex and Dana discuss the CMMI ACCESS Model and what it could unlock for MSK care inside ACOs. They debate digital enablement reality and explain how aligned incentives can reshape referral pathways. They make a direct case the that the physical therapy profession's future depends on understanding payment mechanics.A core theme of this episode is that if PT stays positioned as specialty care based on "treatment minutes" as the primary service, it will keep losing in a system shifting relative value units (RVUs) toward primary care and behavioral health. If PT repositions around evaluation-driven expertise and ACO partnership, the profession can move from survival to influence.Here's what else you'll learn:Why the ACCESS Model payments are intentionally low, and why that is not the point.How ACOs think about total cost of care and why MSK spend is hard for primary care to manage.What “aligned incentives” can look like in a PCP + ACO + ACCESS org + PT partnership.Why engagement is often 3–5% for digital MSK programs, and what that means in context.A practical “go do this tomorrow” play for clinics: identify local ACO participants and pursue Preferred Provider relationships.The RVU basics most therapists never learned, and why it changes your advocacy strategy.Why PTs should prioritize evaluation, differential diagnosis, and plan-setting, with PTAs executing more follow-up care.How waitlists and access challenges become non-starters if PT wants to play in ACO-aligned care.A potential new productivity mindset: RVU-based expectations instead of “visits per week.”Want more information on PT and OT reimbursement and opportunities in policy and advocacy?Read Dana's guest post series for OT Potential here: "How OTs and PTs Get Paid."Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list for exclusive content.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter every Sunday evening.

Episode 28: Skin in the Game: How PT Wins in the ACCESS Model

<h2>A reality-check on what works today, what is hype, and what must improve before digital-first MSK care earns trust</h2> We sit down today with <a href="https://www.linkedin.com/in/sergeiai/" rel="noopener noreferrer" target="_blank">Sergei Polevikov</a> (<a href="http://FixHealth.ai" rel="noopener noreferrer" target="_blank">FixHealth.ai</a>, <a href="http://Well.AI" rel="noopener noreferrer" target="_blank">Well.AI</a> / Chart2Chart) for a reality-check conversation on what AI in healthcare actually is, where it genuinely helps today, and where the hype can cause harm. Sergei breaks down AI’s evolution from early machine learning to modern transformer models, then moves from definitions into the real stakes: transparency, validation, and workflow fit. Then we discuss with him the risk of overpromising in musculoskeletal care. The conversation zooms in on a massive, under-discussed shift: Medicare’s growing interest in digitally enabled care models that can substitute for traditional services, and what that could mean for PTs, patients, and outcomes. Sergei explains why digital-first triage is likely the future, while also outlining the biggest watch-outs right now, including hallucinations, automation bias, incomplete data, and the lack of real-time interoperability that healthcare needs most. We also cover a PT and OT relevant rubric for separating hype from real clinical value: does the tool augment PT judgment and continuity of care, or is it being positioned (and reimbursed) to substitute for PT, especially in emerging Medicare digital-first models? Takeaways from the episode should help outline what to pressure-test before adoption or referral: safety guardrails and hallucination risk, transparency and validation in real-world MSK populations, EHR/workflow fit (not “more clicks”), and whether the vendor’s incentives align with outcomes vs. billing. Clinicians are concerned about AI "replacing clinicians tomorrow," but that's not reality and it distracts from the real issue. The biggest threat is poorly governed digital care pathways that can bypass PT and OT, fragment care, and dilute instead of improve accountability unless the evidence and oversight are truly there. Follow<a href="https://www.linkedin.com/in/danastraussdpt/" rel="noopener noreferrer" target="_blank"> Dana Strauss </a>on Linked In.Follow <a href="https://www.linkedin.com/in/alexbenderskydpt/" rel="noopener noreferrer" target="_blank">Alex Bendersky</a> on Linked In. Subscribe to the <a href="https://www.linkedin.com/search/results/all/?keywords=future%20proof%20pt&origin=RICH_QUERY_SUGGESTION&heroEntityKey=urn%3Ali%3Aorganization%3A105894611&position=0" rel="noopener noreferrer" target="_blank">Future Proof PT</a> Linked In page.Subscribe to the <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Future Proof PT</a> YouTube Channel.Subscribe to our <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">newsletter and email list</a> for exclusive content.

A reality-check on what works today, what is hype, and what must improve before digital-first MSK care earns trustWe sit down today with Sergei Polevikov (FixHealth.ai, Well.AI / Chart2Chart) for a reality-check conversation on what AI in healthcare actually is, where it genuinely helps today, and where the hype can cause harm.Sergei breaks down AI’s evolution from early machine learning to modern transformer models, then moves from definitions into the real stakes: transparency, validation, and workflow fit. Then we discuss with him the risk of overpromising in musculoskeletal care.The conversation zooms in on a massive, under-discussed shift: Medicare’s growing interest in digitally enabled care models that can substitute for traditional services, and what that could mean for PTs, patients, and outcomes. Sergei explains why digital-first triage is likely the future, while also outlining the biggest watch-outs right now, including hallucinations, automation bias, incomplete data, and the lack of real-time interoperability that healthcare needs most.We also cover a PT and OT relevant rubric for separating hype from real clinical value: does the tool augment PT judgment and continuity of care, or is it being positioned (and reimbursed) to substitute for PT, especially in emerging Medicare digital-first models?Takeaways from the episode should help outline what to pressure-test before adoption or referral: safety guardrails and hallucination risk, transparency and validation in real-world MSK populations, EHR/workflow fit (not “more clicks”), and whether the vendor’s incentives align with outcomes vs. billing.Clinicians are concerned about AI "replacing clinicians tomorrow," but that's not reality and it distracts from the real issue. The biggest threat is poorly governed digital care pathways that can bypass PT and OT, fragment care, and dilute instead of improve accountability unless the evidence and oversight are truly there.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list for exclusive content.

Episode 27: The $900 Billion Problem | Can AI Actually Fix Musculoskeletal Care?

We are tackling physical therapy's brand crisis head-on. From pop culture portrayals (yes, we're talking about that "Land Man" stripper scene) to CMS policy that treats PT as "substitute spend" for MSK digital health solutions, the evidence is clear: we have a public perception problem. We explore why professional identity matters, how specialization creates internal dissonance, and why evidence-based practice sometimes conflicts with how we want to be perceived. We talk about the importance of communicating our actual skill set, and why we need to stop being terrible at telling people what we do and why it matters. Why this matters right now: Value-based care and episode/bundled payment models are framed as the future: fewer visits, higher impact per encounter. But remaining the PT who serves as the primary provider for managing their patients' longitudinal spend. In those models, PTs “win” by preventing downstream costs (imaging, opioids, injections, surgery, prolonged disability). But that only works if we can show it. Key topics: professional branding, healthcare policy, payment models, public perception, advocacy, and the path forward for elevating the profession. Mentioned in the episode: <a href="https://read.amazon.com/kp/embed?linkCode=kpd&ref_=k4w_oembed_BQlFux8mQZjBCY&asin=042528462X&tag=danaprommelst-20&amazonDeviceType=A2CLFWBIMVSE9N&from=Bookcard&preview=inline" rel="noopener noreferrer" target="_blank">Nassim Taleb | "Skin in the Game" Hidden Asymmetries in Daily Life</a> <a href="https://hscrc.maryland.gov/Pages/Episode-Quality-Improvement-Program.aspx" rel="noopener noreferrer" target="_blank">Episode Quality Improvement Plan (EQIP)</a> <a href="https://www.cms.gov/priorities/innovation/innovation-models/access" rel="noopener noreferrer" target="_blank">ACCESS Model</a> <a href="https://www.cms.gov/priorities/innovation/access-technical-frequently-asked-questions" rel="noopener noreferrer" target="_blank">ACCESS Technical FAQs</a>

We are tackling physical therapy's brand crisis head-on. From pop culture portrayals (yes, we're talking about that "Land Man" stripper scene) to CMS policy that treats PT as "substitute spend" for MSK digital health solutions, the evidence is clear: we have a public perception problem.We explore why professional identity matters, how specialization creates internal dissonance, and why evidence-based practice sometimes conflicts with how we want to be perceived. We talk about the importance of communicating our actual skill set, and why we need to stop being terrible at telling people what we do and why it matters.Why this matters right now:Value-based care and episode/bundled payment models are framed as the future: fewer visits, higher impact per encounter. But remaining the PT who serves as the primary provider for managing their patients' longitudinal spend. In those models, PTs “win” by preventing downstream costs (imaging, opioids, injections, surgery, prolonged disability). But that only works if we can show it.Key topics: professional branding, healthcare policy, payment models, public perception, advocacy, and the path forward for elevating the profession.Mentioned in the episode:Nassim Taleb | "Skin in the Game" Hidden Asymmetries in Daily LifeEpisode Quality Improvement Plan (EQIP)ACCESS ModelACCESS Technical FAQs

Episode 26: The PT Identity Project | The Problems Causing PTs Patients, Pay, and Progress

<h2>Explore the intersection of evidence-based practice, healthcare economics, and pseudoscience in rehab, plus practical strategies for clinicians who want to do better without going broke</h2> <h4>Is your physical therapy practice built on evidence, or just what pays? In this episode, we sit down with Paul Ingraham, science writer and founder of<a href="https://www.painscience.com/" rel="noopener noreferrer" target="_blank" style="color: rgb(44, 44, 43);"> </a><a href="https://www.painscience.com/" rel="noopener noreferrer" target="_blank" style="color: inherit;">painscience.com</a>, to challenge the line between evidence-based practice and pseudoscience in rehab. </h4><h4> </h4><h4>We explore why manual therapy needs a serious reframe, how economic pressures push clinicians toward uncertain treatments, and whether honest patient communication can coexist with running a profitable practice. </h4><h4> </h4><h4>Paul doesn't hold back: he argues that most PTs operate in a gray zone where research is weak, outcomes are unpredictable, and informed consent is virtually nonexistent. You might not agree with everything he says—but you'll hopefully question what you do and why you do it. Maybe you'll look into the scientific evidence behind your current common care plans.</h4> <h3>Topics include:</h3> <ul><li>Evidence-based practice vs. pseudoscience: where's the line? </li><li>Why manual therapy should be reframed as an experimental intervention in many cases</li><li>The role of informed consent in uncertain treatments (not unlike what we hope physicians do when prescribing a treatment plan whose results are uncertain)</li><li>How value-based care incentives better outcomes and discourages pseudoscience</li><li>The economics of PT: balancing integrity with income</li><li>Why strength training and exercise therapy are still key ingredients in PT treatment plans</li><li>Teaching intellectual humility and critical thinking in healthcare education</li><li>Practical strategies for clinicians who want to practice honestly without going broke</li></ul> Paul Ingraham is a Vancouver science writer and a former Registered Massage Therapist, a profession he left in 2010 over concerns about its pseudoscientific nonsense. Since then, he has been publishing PainScience.com full-time, a website about the science of pain and injury, known for its rich footnotes and anti-quackery activism. The site offers hundreds of articles and ten books, all based on a huge bibliography. Paul was an active amateur athlete for decades, especially in ultimate (the Frisbee sport), but has now retired from competitive intensity and “just” does a lot of running and cycling, despite grappling with his own chronic pain/illness problems since 2015. <h3>Here's where you can find Paul! </h3> <a href="https://www.painscience.com/subscribe" rel="noopener noreferrer" target="_blank" style="color: rgb(17, 85, 204);">https://www.painscience.com/subscribe</a> [free newsletter]<a href="https://www.painscience.com/ebooks" rel="noopener noreferrer" target="_blank" style="color: rgb(17, 85, 204);">https://www.painscience.com/ebooks</a><a href="https://www.facebook.com/painscience" rel="noopener noreferrer" target="_blank" style="color: rgb(17, 85, 204);">https://www.facebook.com/painscience</a><a href="https://www.threads.net/@painsci" rel="noopener noreferrer" target="_blank" style="color: rgb(17, 85, 204);">https://www.threads.net/@painsci</a><a href="https://bsky.app/profile/painsci.bsky.social" rel="noopener noreferrer" target="_blank" style="color: rgb(17, 85, 204);">https://bsky.app/profile/painsci.bsky.social</a><a href="https://x.com/painsci" rel="noopener noreferrer" target="_blank" style="color: rgb(17, 85, 204);">https://x.com/painsci</a> Sign up for <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">our newsletter</a>, where Alex shares weekly literature summaries and links relevant to therapy. Sign up for our sister publication, authored by Dana, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy.</a> Dana covers weekly health policy insights and tips on career growth for clinicians. <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Subscribe to our YouTube Channel</a>

Explore the intersection of evidence-based practice, healthcare economics, and pseudoscience in rehab, plus practical strategies for clinicians who want to do better without going brokeIs your physical therapy practice built on evidence, or just what pays? In this episode, we sit down with Paul Ingraham, science writer and founder of painscience.com, to challenge the line between evidence-based practice and pseudoscience in rehab. We explore why manual therapy needs a serious reframe, how economic pressures push clinicians toward uncertain treatments, and whether honest patient communication can coexist with running a profitable practice. Paul doesn't hold back: he argues that most PTs operate in a gray zone where research is weak, outcomes are unpredictable, and informed consent is virtually nonexistent. You might not agree with everything he says—but you'll hopefully question what you do and why you do it. Maybe you'll look into the scientific evidence behind your current common care plans.Topics include:Evidence-based practice vs. pseudoscience: where's the line? Why manual therapy should be reframed as an experimental intervention in many casesThe role of informed consent in uncertain treatments (not unlike what we hope physicians do when prescribing a treatment plan whose results are uncertain)How value-based care incentives better outcomes and discourages pseudoscienceThe economics of PT: balancing integrity with incomeWhy strength training and exercise therapy are still key ingredients in PT treatment plansTeaching intellectual humility and critical thinking in healthcare educationPractical strategies for clinicians who want to practice honestly without going brokePaul Ingraham is a Vancouver science writer and a former Registered Massage Therapist, a profession he left in 2010 over concerns about its pseudoscientific nonsense. Since then, he has been publishing PainScience.com full-time, a website about the science of pain and injury, known for its rich footnotes and anti-quackery activism. The site offers hundreds of articles and ten books, all based on a huge bibliography. Paul was an active amateur athlete for decades, especially in ultimate (the Frisbee sport), but has now retired from competitive intensity and “just” does a lot of running and cycling, despite grappling with his own chronic pain/illness problems since 2015.Here's where you can find Paul! https://www.painscience.com/subscribe [free newsletter]https://www.painscience.com/ebookshttps://www.facebook.com/painsciencehttps://www.threads.net/@painscihttps://bsky.app/profile/painsci.bsky.socialhttps://x.com/painsciSign up for our newsletter, where Alex shares weekly literature summaries and links relevant to therapy.Sign up for our sister publication, authored by Dana, Timeless Autonomy. Dana covers weekly health policy insights and tips on career growth for clinicians.Subscribe to our YouTube Channel

Episode 25 | Pain Science, Manual Therapy, and the Economics of PT with Paul Ingraham

<h2>How crazy is it that proven interventions in healthcare take so long to spread, even when they show clear economic and clinical benefits?</h2> Innovation in healthcare is painfully difficult to get into widespread adoption, even after proven successful. This episode discusses the results of a nine year-old study at Geisinger Health System on a PT-First "bundle" that's just as relevant today. But the disturbing part about it is it's not common to find a structure like this one, where a shift in incentives changed the care pathway for patients.<h4> </h4><h4>Here are major takeaways from the episode:</h4> <ul><li>PT-First Models Are Economically Proven: When properly structured with the right incentives, physical therapy as a first-line intervention for musculoskeletal conditions reduces costs and improves outcomes. This has been demonstrated at scale.</li><li>Risk Stratification Is Your Friend: Implementing tools that identify high-risk patients (for joint replacement, high utilization, poor psychosocial factors) helps you target PT-first interventions where they'll have the most impact.</li><li>Understand the Regulatory Landscape: Know the difference between what commercial plans can do versus Medicare constraints. This helps you understand why some innovations work in certain settings but not others, and where to focus your advocacy efforts. And don't forget to explore CMS Innovation Center Models! They are a key opportunity for Medicare to offer flexibilities outside of statute and PTs and OTs can 100% benefit from this!</li><li>Patient Incentives Matter as Much as Provider Incentives: Waiving or reducing copays for PT-first approaches changes patient behavior. Consider how your practice can work with payers to create these incentives.</li><li>Think Beyond Traditional Treatment: The food-as-medicine example challenges PTs to consider all drivers of health outcomes, not just manual therapy and exercise. What are the non-medical factors affecting your patients' success?</li><li>Health Systems with Their Own Plans Are Innovation Leaders: These integrated systems have the most flexibility and motivation to try new models. Consider targeting these organizations for partnerships or employment.</li><li>The "Why Not Everywhere?" Question: Just because something works doesn't mean it spreads quickly in healthcare. Understanding the barriers to adoption (regulatory constraints, organizational inertia, population mix) helps you be more strategic about implementing change.</li><li>Keep It Simple: As Alex notes - "kiss things" "(keep it simple, stupid"). The most successful innovations have clear, straightforward incentive structures that are easy for patients and providers to understand and act on.</li></ul> Find the article we discuss in this episode on a <a href="https://www.dovepress.com/impact-of-a-value-based-insurance-design-for-physical-therapy-to-treat-peer-reviewed-fulltext-article-JPR" rel="noopener noreferrer" target="_blank">PT-First payment model here.</a> Sign up for <a href="https://future-proof-pt.beehiiv.com/subscribe" rel="noopener noreferrer" target="_blank">our newsletter</a>, where Alex shares weekly literature summaries and links relevant to therapy. Sign up for our sister publication, authored by Dana, <a href="https://www.timelessautonomy.com/subscribe" rel="noopener noreferrer" target="_blank">Timeless Autonomy.</a> Dana covers weekly health policy insights and tips on career growth for clinicians. <a href="https://www.youtube.com/@FutureProofPT" rel="noopener noreferrer" target="_blank">Subscribe to our YouTube Channel</a> We also discussed in this episode the<a href="https://clinicaltrials.gov/study/NCT03718832?utm_source=copilot.com" rel="noopener noreferrer" target="_blank"> </a><a href="https://journals.sagepub.com/doi/10.1177/1559827620915425" rel="noopener noreferrer" target="_blank">"Geisinger Fresh Food Farmacy"</a> research. The pilot evaluated whether providing free, healthy food for the entire household of a food-insecure adult with Type 2 diabetes improves health outcomes and reduces healthcare use. In the podcast, Dana described what she recalled from memory. The study is found <a href="https://journals.sagepub.com/doi/10.1177/1559827620915425" rel="noopener noreferrer" target="_blank">here</a> but we can't find access to the article unlocked. Asking "Claude.AI," it said in this observational pilot study with 37 participants showed a 2.1% average drop in HbA1c levels and an 80% reduction in healthcare costs (from $240,000 to $48,000 per member per year). Additional research has recently been published put we can't locate it unlocked online. It looks like funding was from the 2018 Farm Bill.

How crazy is it that proven interventions in healthcare take so long to spread, even when they show clear economic and clinical benefits?Innovation in healthcare is painfully difficult to get into widespread adoption, even after proven successful.This episode discusses the results of a nine year-old study at Geisinger Health System on a PT-First "bundle" that's just as relevant today. But the disturbing part about it is it's not common to find a structure like this one, where a shift in incentives changed the care pathway for patients.Here are major takeaways from the episode:PT-First Models Are Economically Proven: When properly structured with the right incentives, physical therapy as a first-line intervention for musculoskeletal conditions reduces costs and improves outcomes. This has been demonstrated at scale.Risk Stratification Is Your Friend: Implementing tools that identify high-risk patients (for joint replacement, high utilization, poor psychosocial factors) helps you target PT-first interventions where they'll have the most impact.Understand the Regulatory Landscape: Know the difference between what commercial plans can do versus Medicare constraints. This helps you understand why some innovations work in certain settings but not others, and where to focus your advocacy efforts. And don't forget to explore CMS Innovation Center Models! They are a key opportunity for Medicare to offer flexibilities outside of statute and PTs and OTs can 100% benefit from this!Patient Incentives Matter as Much as Provider Incentives: Waiving or reducing copays for PT-first approaches changes patient behavior. Consider how your practice can work with payers to create these incentives.Think Beyond Traditional Treatment: The food-as-medicine example challenges PTs to consider all drivers of health outcomes, not just manual therapy and exercise. What are the non-medical factors affecting your patients' success?Health Systems with Their Own Plans Are Innovation Leaders: These integrated systems have the most flexibility and motivation to try new models. Consider targeting these organizations for partnerships or employment.The "Why Not Everywhere?" Question: Just because something works doesn't mean it spreads quickly in healthcare. Understanding the barriers to adoption (regulatory constraints, organizational inertia, population mix) helps you be more strategic about implementing change.Keep It Simple: As Alex notes - "kiss things" "(keep it simple, stupid"). The most successful innovations have clear, straightforward incentive structures that are easy for patients and providers to understand and act on.Find the article we discuss in this episode on a PT-First payment model here.Sign up for our newsletter, where Alex shares weekly literature summaries and links relevant to therapy.Sign up for our sister publication, authored by Dana, Timeless Autonomy. Dana covers weekly health policy insights and tips on career growth for clinicians.Subscribe to our YouTube ChannelWe also discussed in this episode the "Geisinger Fresh Food Farmacy" research. The pilot evaluated whether providing free, healthy food for the entire household of a food-insecure adult with Type 2 diabetes improves health outcomes and reduces healthcare use. In the podcast, Dana described what she recalled from memory. The study is found here but we can't find access to the article unlocked. Asking "Claude.AI," it said in this observational pilot study with 37 participants showed a 2.1% average drop in HbA1c levels and an 80% reduction in healthcare costs (from $240,000 to $48,000 per member per year). Additional research has recently been published put we can't locate it unlocked online. It looks like funding was from the 2018 Farm Bill.

Episode 24: The Economics of PT-First | Real Data on Cost Savings and Outcomes

Check out the <a href="https://youtu.be/148T540tyis?si=ZtcORILUOjT72eq8" rel="noopener noreferrer" target="_blank">You Tube version </a>of the podcast here. In this episode, Dana and Alex review the research articles Alex shared with Future Proof PT newsletter subscribers on January 4th, 2025, exploring what these studies reveal about healthcare transformation and what PTs can learn from them. They dive into the 4% screening tool study that dramatically improved outcomes by simply asking patients about their needs—a small intervention that created massive value. This leads to a bigger discussion: why are PTs starving on a shrinking fee-for-service diet when alternative models exist? The answer isn't that value-based care doesn't work—it's that most clinicians haven't tested it yet. We explore <a href="https://en.wikipedia.org/wiki/Richard_Feynman" rel="noopener noreferrer" target="_blank">Richard Feynman</a>'s principles of honest self-evaluation and scientific integrity, applying them to healthcare's reluctance to experiment. Alex shares that he recently reread The Alchemist by Paulo Coelho and that the story's message resonated with him differently this time around. He focuses on a key moment in the book where the shepherd's father gives him money to pursue his journey—not because the father expects his son to find treasure, but because the father himself never took that journey and wants something better for his son. Alex connects this to his own mindset as a parent: he wants his children to have opportunities and experiences he didn't have. This parallels the healthcare discussion because leaders and early adopters in value-based care are essentially doing the same thing—investing in a journey they may not fully benefit from themselves, but paving the way for the next generation of clinicians. The core insight Alex draws is that the treasure in The Alchemist wasn't the gold the shepherd was seeking, but the transformation and self-discovery he experienced along the way. Similarly, PTs who experiment with value-based care aren't just chasing financial models—they're undergoing professional transformation that makes them more valuable, regardless of whether any single model succeeds. This reframing positions the journey itself as the reward, and encourages clinicians to stop waiting for value-based care to be "proven" before they engage. Like the shepherd's father investing in his son's journey, today's leaders are investing in the profession's future. Other key points include: why you need a lottery ticket to win (you have to participate to benefit), how to A-B test your way into value-based care leadership, why leadership starts with one person taking action, and how systems thinking can help PTs break free from fee-for-service heuristics. Stop waiting for permission. Start leading from your clinic. The R&D phase of healthcare needs you. Key Topics in Episode 23: <ul><li>Reviewing research articles from Future Proof PT newsletter (Jan 4, 2025)</li><li>The 4% screening tool study and its implications for value creation</li><li>Why "it doesn't work" is invalid if you never tested it</li><li>The sheep analogy: surviving vs. thriving in healthcare</li><li>Richard Feynman's lesson on honest self-evaluation and scientific integrity</li><li>A-B testing your way into value-based care leadership</li><li>Why small experiments and lottery tickets matter in healthcare transformation</li><li>How the journey of experimentation IS the treasure (lessons from The Alchemist)</li><li>Systems thinking and recognizing our own fallibility in healthcare decision-making</li></ul> <a href="https://amzn.to/3YnACIf" rel="noopener noreferrer" target="_blank">"The Alchemist"</a>* <a href="https://amzn.to/49G6D4u" rel="noopener noreferrer" target="_blank">"Thinking Fast and Slow"</a>* <a href="https://amzn.to/3Z4Q24d" rel="noopener noreferrer" target="_blank">"The Almanac of Naval Ravikant"</a>* <a href="https://future-proof-pt.beehiiv.com/p/weekly-literature-review-starting-2026-on-the-right-footing" rel="noopener noreferrer" target="_blank">Alex's summary and takeaways of the five research articles we discuss on the episode.</a> <a href="https://www.cms.gov/priorities/innovation/data-and-reports/2024/ahc-3rd-eval-report-aag?utm_source=copilot.com" rel="noopener noreferrer" target="_blank">Accountable Health Communities Model Findings at a Glance</a> <h5>*affiliate link</h5>

Check out the You Tube version of the podcast here.In this episode, Dana and Alex review the research articles Alex shared with Future Proof PT newsletter subscribers on January 4th, 2025, exploring what these studies reveal about healthcare transformation and what PTs can learn from them.They dive into the 4% screening tool study that dramatically improved outcomes by simply asking patients about their needs—a small intervention that created massive value. This leads to a bigger discussion: why are PTs starving on a shrinking fee-for-service diet when alternative models exist? The answer isn't that value-based care doesn't work—it's that most clinicians haven't tested it yet.We explore Richard Feynman's principles of honest self-evaluation and scientific integrity, applying them to healthcare's reluctance to experiment. Alex shares that he recently reread The Alchemist by Paulo Coelho and that the story's message resonated with him differently this time around. He focuses on a key moment in the book where the shepherd's father gives him money to pursue his journey—not because the father expects his son to find treasure, but because the father himself never took that journey and wants something better for his son.Alex connects this to his own mindset as a parent: he wants his children to have opportunities and experiences he didn't have. This parallels the healthcare discussion because leaders and early adopters in value-based care are essentially doing the same thing—investing in a journey they may not fully benefit from themselves, but paving the way for the next generation of clinicians.The core insight Alex draws is that the treasure in The Alchemist wasn't the gold the shepherd was seeking, but the transformation and self-discovery he experienced along the way. Similarly, PTs who experiment with value-based care aren't just chasing financial models—they're undergoing professional transformation that makes them more valuable, regardless of whether any single model succeeds.This reframing positions the journey itself as the reward, and encourages clinicians to stop waiting for value-based care to be "proven" before they engage. Like the shepherd's father investing in his son's journey, today's leaders are investing in the profession's future.Other key points include: why you need a lottery ticket to win (you have to participate to benefit), how to A-B test your way into value-based care leadership, why leadership starts with one person taking action, and how systems thinking can help PTs break free from fee-for-service heuristics. Stop waiting for permission. Start leading from your clinic. The R&D phase of healthcare needs you.Key Topics in Episode 23:Reviewing research articles from Future Proof PT newsletter (Jan 4, 2025)The 4% screening tool study and its implications for value creationWhy "it doesn't work" is invalid if you never tested itThe sheep analogy: surviving vs. thriving in healthcareRichard Feynman's lesson on honest self-evaluation and scientific integrityA-B testing your way into value-based care leadershipWhy small experiments and lottery tickets matter in healthcare transformationHow the journey of experimentation IS the treasure (lessons from The Alchemist)Systems thinking and recognizing our own fallibility in healthcare decision-making"The Alchemist"*"Thinking Fast and Slow"*"The Almanac of Naval Ravikant"*Alex's summary and takeaways of the five research articles we discuss on the episode.Accountable Health Communities Model Findings at a Glance*affiliate link

Episode 23: The Alchemist and Healthcare | Why Your Journey is the Treasure

Want to stay ahead of the curve in physical therapy? Future Proof PT brings you straight-talking, no-nonsense conversations about what really matters in healthcare today. From dissecting policy risks and opportunities to exploring innovative practice and payment models to practical ways to accelerate your career growth, we're your go-to source for understanding the forces reshaping our profession and the healthcare industry at large. Through candid dialogue and real-world perspectives, we're building a community of forward-thinking professionals working both in and out of direct patient care. They aren't just adapting to change – they're shaping it. Whether you're looking to understand market dynamics or seeking professional growth, each episode delivers actionable insights that will transform how you view the future of healthcare. Come join the conversation!

Want to stay ahead of the curve in physical therapy? Future Proof PT brings you straight-talking, no-nonsense conversations about what really matters in healthcare today. From dissecting policy risks and opportunities to exploring innovative practice and payment models to practical ways to accelerate your career growth, we're your go-to source for understanding the forces reshaping our profession and the healthcare industry at large.Through candid dialogue and real-world perspectives, we're building a community of forward-thinking professionals working both in and out of direct patient care. They aren't just adapting to change – they're shaping it.Whether you're looking to understand market dynamics or seeking professional growth, each episode delivers actionable insights that will transform how you view the future of healthcare. Come join the conversation!