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2003 APTA Presidential Address

Making Vision 2020 a Reality

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hree years ago, the APTA House of Delegates adopted Vision 2020. It
is a bold but tangible vision of where the profession of physical
therapy sees itself in just 17 years. Our shared vision has united our
members, focused our attention on the really important issues, and
distinguished our profession among our health care colleagues.

Three years ago, the House of Delegates elected me to serve as your President.
To serve this profession that all of us love so dearly has been a great honor and
a privilege. And to serve as President for the initial years of our quest for
Vision 2020 has been an awesome experience for me. During the past 3 years,
the House has consistently elected officers and members of the Board of
Directors who have brought their talents, tireless commitment, and mature
wisdom to lead this Association, to carry out the mandates of our mem-
bers—to make Vision 2020 a reality. And we have required all their talents for
this monumental task.

At a retreat in the fall of 2000, your Board of Directors determined that if we

are to achieve our Vision—a vision of becoming an autonomous profes-
sion—we must focus our efforts on 5 key areas:

1. Professionalism,

2. Direct Access,

3. The Doctor of Physical Therapy,

4. Evidence-Based Practice, and

5. Practitioner of Choice.

I’d like to take a few minutes to trace our progress and to share with you my
assessment of some of the work yet to be done.

[Massey BF Jr. 2003 APTA Presidential Address: Making Vision 2020 a reality. Phys Ther. 2003;83:1023–
1026.]

Ben F Massey, Jr, PT, MA

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Physical Therapy . Volume 83 . Number 11 . November 2003 1023

1. Professionalism: At a recent
regional caucus of delegates, a vote
was taken as to which of the 5 com-
ponents of the Vision they felt was
the key to achieving our Vision. The
vote was unanimous—professional-
ism. The same professionalism that
our professors and instructors tried to
instill in us from the first days of our
professional education. The quality
that makes us want to learn everything
we can so that we can provide the best
care to our patients. The quality that
makes us stay late or come in early so
that we can see a patient in pain. The
quality that makes us intolerant of
unethical behavior. The quality that
makes us willing to get involved in
politics and advocacy. Professionalism
captures the essence of our Vision.
Are we more professional than we were 3 years ago as a
result of our efforts toward Vision 2020? I don’t know.
How do you measure professionalism? Are we more
focused on the outcomes of our patients? Have we begun
to internalize a greater sense of responsibility for our
patients? My communication with members around the
country suggests to me that we have. I am certain that we
have become stronger advocates and more politically
active.
2. Direct Access: With the addition of Virginia, Pennsyl-
vania, New Jersey, Wyoming, and Louisiana over the past
3 years, 38 states now have some form of direct access—
and direct access legislation is still pending in several
others. In addition, several states have improved their
practice acts to allow less-restricted access.
Nationally, Medicare direct access has been at the top of
our priority list. Who would have dreamed in June 2000
that by today we would have introduced our second direct
access bill; that we would have 78 sponsors in the House
of Representatives and 8 sponsors in the Senate; that we
would have more than 2,000 physical therapists, physical
therapist assistants, and students marching on Capitol
Hill tomorrow; that members of our Association would
have donated more than $1.2 million dollars to the
PT-PAC, so that we would be ranked third among
nonphysician health care PACs in the country; and that
we would have the support and endorsements of
BF Massey Jr, PT, MA, is Executive Director, North Carolina Board of Physical Therapy Examiners, 18 West Colony Place, Ste 140, Durham, NC
27705-5582 (bfmassey@mindspring.com).
Mr Massey’s Presidential Address was presented at the Opening Plenary of PT 2003: The Annual Conference and Exposition of the American
Physical Therapy Association; June 18, 2003; Washington, DC.
1024 . Massey
national consumer organizations.
Direct access is no longer just a
dream. It is becoming a reality!
3. The Doctor of Physical Therapy:
I believe the Doctor of Physical Ther-
apy (DPT) degree has now been
embraced by the majority of our mem-
bers. In the past 3 years, we have
grown from 19 professional [entry-
level] DPT programs to 74 programs.
Within 5 years we expect to be at 150.
In the past 3 years, 35 transitional DPT
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programs have developed, and several
thousands of physical therapists are
enrolling in these programs.
4. Evidence-Based Practice: Evidence-
based practice has been incorporated
into all accredited physical therapist
education programs. Our graduates
are learning the value of research and evidence. Hooked
on Evidence, APTA’s new online database, has had
phenomenal growth, with more than 800 articles cur-
rently available to help us incorporate evidence into the
art and science of our practice.
5. Practitioner of Choice: Increasing awareness among
consumers about physical therapy is an important part of
the Vision 2020 process. We have taken many solid steps
over the years, and most recently we have enhanced our
efforts by providing members with more than 400,000
free copies of the PT Magazine consumer supplement
each October and by developing exciting plans to
enhance the consumer focus on our Web site. These are
worthy and important efforts, but I believe the achieve-
ment of recognition as practitioners of choice must be
based on the quality of our services and our patients’
outcomes. If we achieve the other 4 elements of our
Vision to their fullest extent, then recognition as practi-
tioners of choice will soon follow.
As your President, I have 3 major goals related to Vision
2020 that I would like to see accomplished during the
next 3 years. Number 1, without question, is getting
direct access under Medicare. Number 2 is increasing
our membership (a vision for the profession of physical
therapy must be a vision for all physical therapists and
physical therapist assistants). And number 3, I want to
see more physical therapists assuming positions of lead-
Physical Therapy . Volume 83 . Number 11 . November 2003

Our shared vision has united our
members, focused our attention on the
really important issues, and
distinguished our profession among
our health care colleagues.
ership and acting as advocates in local, state, and
national arenas.
I believe that we can achieve some form of Medicare
direct access in the next 3 years. I believe that when our
members put their hearts and souls into an initiative,
and that initiative is based on what is in the best interests
of our patients, we can make it happen. We— everyone
in this room—must make it a high priority. We will
achieve direct access in Congress the old-fashioned
way—we’re going to earn it, one member of Congress at
a time.
Why is Medicare direct access the number 1 priority for
our future? There are many reasons. The first, and
always foremost, is that patients need access to our
services and should not be burdened with the require-
ment of a physician prescription. The second is long
overdue professional autonomy. Not professional isola-
tion, but professional autonomy that allows us to become
active collaborators with other health care professionals.
Professional autonomy that recognizes the full extent of
our contributions as members of the health care team.
And, as a practical measure, Medicare direct access is
critical because of the influence that the Medicare
system has on other insurance programs. Direct access
also promotes the patient’s right to choose a physical
therapist, rather than the patient being directed to a
physical therapist of the physician’s choice, an arrange-
ment that frequently allows the physician to benefit
financially from provision of the physical therapist’s
services. Because many provisions of the Stark legislation
have been watered down through regulation, recently we
have been seeing an increase in physician-owned prac-
tices. Vision 2020 does not envision physical therapists as
employees of physicians.
Tomorrow—Thursday, June 19, 2003— each of us has a
unique opportunity to be an active and influential
participant in the democratic process. In the morning,
we will gather for a rally on Capitol Hill. The more of us
who attend, the louder will be our collective voice and,
consequently, the stronger our message. We will rally in
support of the Medicare Patient Access to Physical
Therapists Act. We have strong support from Congress,
but we need even more legislators behind it to make it a
law.
Physical Therapy . Volume 83 . Number 11 . November 2003
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Tomorrow afternoon, more than 900 physical therapists
and physical therapist assistants will flood the halls of
Congress to visit our members of Congress. Legislators
will hear your stories of patients who need our services;
they will benefit from your expert opinions on health
care matters; and they will see your dedication to and
passion for your patients and your profession.
Hill visits, and training for these visits, are a routine part
of APTA’s Federal Government Affairs Forum every
spring. I am so excited to bring this opportunity to our
Annual Conference. I hope that many of you who might
never have tried advocacy in the political arena will step
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forward and take a chance. And even if you haven’t
signed up for Hill visits, I hope that you will join us
tomorrow morning for the rally. Standing together with
your colleagues on Capitol Hill is a once-in-a-lifetime
opportunity. I know that we will make a difference for
our profession, and I guarantee that you will leave
Washington inspired by your participation in that
process.
If we are to achieve our Vision—
a vision of becoming an autonomous
profession—we must focus our efforts
on 5 key areas: Professionalism,
Direct Access, the Doctor of Physical
Therapy, Evidence-Based Practice, and
Practitioner of Choice.
The second major goal that I would like to see us address
in the next 3 years is to increase membership in our
Association. A CEO of a major marketing company once
told me that the most critical measuring stick of the
success of an organization is its membership. In 1997, we
had close to 75,000 members—and times were great.
Then the Balanced Budget Act of 1997 hit. Most health
care associations experienced a significant decrease in
membership. Our numbers dropped to a low of 61,092
in 2002. Enrollment in our schools decreased, and
student membership dropped by nearly 34%. In
response to these declines, we have worked hard to
publicize the value of membership in many different
ways and, with direction from the House of Delegates,
have offered various promotions and incentive pro-
grams. But our real problem is not recruitment, it’s
retention. Members join, stay for a few years, then
leave—for a variety of reasons. Currently, our member-
ship is 63,166. This past year we saw physical therapist
Massey . 1025
membership increase 1.02%. In the next 3 years, I want We make a difference in people’s
to see our physical therapist membership grow by 10%
[4,680 members]. lives—and we do it for the right

Increasing membership requires a joint effort at reasons.

national, state, district, local, and individual levels. The
Board recently appointed a Membership Task Force,
Carolina, Randy Stewart, is serving as county commis-
and the first meeting is scheduled for July. For the past
sioner. Patrice Winter is a member of the Fairfax, Va, city
3 years, staff have been working with several states that
council. Unfortunately, these are rare exceptions, and
have struggled with membership, and we have had some
we need them to be a more common occurrence. And
success. But you, as individual members, can be more
we, as a profession, need to support our colleagues
effective recruiting members one-on-one. Three years
across the country who seek appointments or election to
ago I promised to make communication one of the 3

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office. Whenever a physical therapist gets a key appoint-
“C’s” of my term as President. I have had e-mail, voice,
ment or is elected to a local or state office, it elevates the
and face-to-face communication with thousands of mem-
entire profession of physical therapy, and our patients
bers and nonmembers these past 3 years. What they want
are better served because of the unique perspective that
most is to be heard. Now I challenge you to make every
physical therapists bring to these arenas.
interaction with a nonmember an interaction that
inspires the nonmember to become part of who we
We need a physical therapy culture that cultivates and
are—part of the American Physical Therapy Association.
promotes activism. Thomas Jefferson said:

We do not have a government by the majority, we have a

We need a physical therapy culture government by the majority who get involved.

that cultivates and promotes activism. And Abraham Lincoln said:

My third goal is to increase our sphere of influence by Those who choose not to participate in government are
doomed to be controlled by those who do.
networking with and becoming involved in other orga-
nizations. We must be community leaders and advocates
Not only is it our right as members of a free society to
for our patients. Professional activism is a key compo-
become involved in the social and political process, but,
nent of professionalism. We must all be advocates for
I would argue, it is our responsibility and a vital part of
our profession in our own innovative, courageous, pas-
professionalism. Our responsibility as true professionals
sionate way. We need physical therapists— our patients
is to become advocates for our patients. My expectation
need physical therapists—to be involved in policy deci-
this week is that many first-time activists will emerge in
sions and to be decision makers. When I look at the
our profession. The more of us who become involved,
boards of trustees of organizations such as the United
the more we can accomplish. It’s that simple.
Way and the American Heart Association, when I look at
the National Institutes of Health panels, I hope to see
In closing, I stand before you today full of optimism. I
physical therapists in decision-making positions. When I
am optimistic that we will see the 5 elements of our
look at the lists of officials elected to our state legisla-
Vision 2020 become a reality and that we will be recog-
tures, county commissions, and city councils, I see other
nized as a doctoring profession. I am optimistic that our
professionals, but rarely do I see physical therapists.
membership numbers will grow because our colleagues
will see our accomplishments and realize their value to
We have some very notable exceptions of whom we are
them as individuals and to the future of the profession.
most proud. Commander Penny Royal, US Public
Lastly and most importantly, I am optimistic because our
Health Service, a physical therapist, is acting Executive
Association is made up of members and staff who are the
Director of the President’s Council on Physical Fitness.
most committed, the most dedicated, the most talented,
Jack Close of Nevada, Rebecca Cohn of California, and
and the most passionate professionals in the world. We
Greg Wynn of Arkansas have served as state legislators.
make a difference in people’s lives—and we do it for the
Beth Coulson is currently serving as a member of the
right reasons.
Illinois General Assembly. My good friend from North

1026 . Massey Physical Therapy . Volume 83 . Number 11 . November 2003