Brainwashed: Change requires starting with a clean slate.

Brainwashed: Change requires starting with a clean slate.

Brainwashed: Change requires starting with a clean slate

This one’s for all the PT’s in the house. Most of the writing I do on my blog is for patients: to provide information, encourage, and teach self-care techniques. Today I’m writing for my peer group.

I would like to preface this post by saying that I am not currently a member of the APTA. Before you leave this website or think that I have no right to have an opinion on an organization that I am not part of, let me explain to you the major reason that I am not a current APTA member: In October 2011, I left a job that was meeting all of my financial needs to pursue my dream of being a self-employed physical therapist. I took a risk, and the reward has been great. I opened my business without a single patient on my books. It was the scariest thing I have ever done; but, I believed that I had a unique service to offer and a community that would value that service enough to become my clients. In eight months, I have gone from zero patients per week to averaging twenty patients a week. Anyone who has ever run a business knows that this is no small feat. And, I did it without a small business loan, without six months of savings in the bank (I wouldn’t recommend anyone do this), without participating with any insurance providers, and without being in any way connected to a physician for referrals. I am proud of my accomplishments, grateful to my patients, forever indebted to my husband and children, and appreciative of the help of the other physical therapists I work in concert with on a daily basis. I believe that I have a unique viewpoint, and I would like to share my thoughts on a few things.

This past week a huge shift occurred. Out of the blue the APTA started interacting on Twitter using the @APTAtweets account. Instead of just posting links and information, they started interacting with several individuals in real time. The interactions were kind of like mini Tweet chats. I was involved in a few which made me realize that I had some thoughts to share that required >140 characters.
See, the fact that APTA was interacting in real time was new (and exciting); but, the problem is that they were saying the same old thing using a new form of communication. The need for change was pointed out several times in the conversations. The response (in my opinion) was something like this, “We know things need to change; but, we’re not sure how to do it, and first we’re going to become defensive, because change is really difficult.”

Now, I applaud APTA for their efforts in trying to engage with physical therapists in real time. This is no small task. Interacting in social media is risky: what you say may easily be taken out of context and upset people, the comments can be re-Tweeted, posted to Facebook and blogs, and live on for eternity. Most of all, you run the risk of people having the ability to say whatever they desire in response to you. There is no moderator on Twitter, no one to screen comments, no ability to delete the Tweets you don’t like. If you are going to engage, you need to be prepared to hear what people really think. And, this is a good thing, because all organizations should be willing to listen to what people think.

Before we go any further, I would like you to read the following article written by Seth Godin:

Seth Godin is an absolute genius, and in this article he describes how we have all been brainwashed into believing that “creating average stuff for average people, again and again, is a safe and easy way to get what you want.” He poses a very important question: “When exactly were we brainwashed into believing that the best way to earn a living is to have a job?”

I think it is vital to ask ourselves this question! Because I don’t just want a job, I want a life filled with passion where I can give my gifts and help others. That is what drew me to the field of physical therapy, and it’s what has kept me here for 14 years. I never set out to be a cog in a machine, and I’m willing to take risks to ensure I don’t end up as one.

If we are honest with ourselves, we can acknowledge that the idea of working a “steady” job to ensure a lifetime of safety and security has flown out the window. In my mind, that’s a good thing, because we have to ask ourselves (as the author did in this article): “do we want the same job, but more work, less pay? Same industry, but less growth, no challenges? Same path, fewer options?” The answer should be a resounding NO! Because right now, if we can be brave, the opportunities are endless! We can start tapping into these opportunities by reinventing the way we are perceived as a profession.

We can’t continue to play by a set of rules that aren’t true anymore. We need to be innovative to thrive. We need to be serious about transformation. As Mr. Godin states, “I’m not talking about polishing yourself, I’m talking about a reset button, a reinvention that changes the game.”

See, I think we need to stop wringing our hands, asking how we can ‘show people we have value’ and just start showing people we have value! Let’s not have committee meetings, and endless discussions about how to do this! Let’s press the reset button and get out there and start showing value!

How do we do this? A complete overhaul of the system. Mr. Godin lists 7 ways to press the reset button that I think can help our profession.

1) Connect – He says that “social media is a crack in the wall between you and the rest of the world.” It offers the “chance to make real connections and gain insights from people you would never have a chance to interact with in any other way.” How true! How easy! Use social media to connect and build relationships with APTA members, non-members, and patients (AKA our customers who will ensure that we have a profession in the years to come). The take home point I would like to make is that APTA members are already connected! The APTA needs to use social media to connect with potential members and the general public. See, just about every time I have clicked on a link put up by @APTAtweets, it takes me to a Members Only page on the APTA website! This prevents me from reading the link, and prevents me from sharing valuable information with my patients who participate in social media. How can an organization increase their influence if they only connect with those who have already ‘bought in?’ It can’t. An organization needs to connect with potential members and support systems to grow. The best way to connect? Allow people to volunteer. I tried to connect with APTA last October when I responded to a call for volunteers to work the Move Forward booth at the Marine Corps Marathon Expo. The venue was not far from my house, and I had just gone into private practice that month. I looked at it as an opportunity to educate athletes about our profession, and to make connections with other local physical therapists, as well as my professional organization. And, since I was just starting my practice, I had plenty of open time during the Expo to volunteer, since my schedule was light. I was told “Sorry, but only APTA members can volunteer.” I was actually shocked that a volunteer for anything would be turned down. It was a completely wasted opportunity to connect. How can the APTA better connect?

2) Be Generous – social media and the internet in general have made it easier than ever to be generous. It doesn’t cost anything to share information that has already been created. Mr. Godin explains that generosity rewards people who create and participate in circles of gifts. This creates a “tribal economy of individuals supporting one another.” Then, “tribes of talented individuals who are connected, mutually trustful, and supported by one another, and in a position to create a movement, deliver items of unique value, and move ideas forward faster than any individual ever could.” How could the APTA be more generous? As an example: provide links to the APTA “White Papers” that state the organization’s position on issues in the profession (I tried to click on the link to the APTA position paper on dry needling, and it led me to a Members only page of the website. As a physical therapist who utilizes dry needling, I really wanted to read the position paper and share it with my patients on my website. I even emailed the APTA to ask if I might be able to have access to just that one position paper, even offering to pay for one time access to it. I was told no. It was a total missed opportunity to be generous, which would have increased connection by allowing me to share that generosity with my patients, which in turn would lead to increased public awareness of what physical therapists do, and why certain techniques are supported by our national organization.) Being generous supports individual therapists as well as the organization, as we all go out into the world to share our gifts by “making art.”

3) Make art – we have a unique opportunity to make a difference in people’s lives and a “platform to create something new.” This is what Mr. Godin calls art. Art is “connecting with another person at a human level. And it’s risky.” Social media is risky, doing things differently is risky, being generous and connecting is risky; but, all lead to great reward. What stops us from ‘making art?’

4) Acknowledging the lizard – As Mr. Godin so eloquently states, the lizard brain – our prehistoric brain – doesn’t like being laughed at. It creates “resistance….which encourages you to follow instructions.” He explains that over time, artists have “figured out that this resistance is the sole barrier between today and their art.” The way to handle the lizard brain? “Acknowledge it so we can ignore it.” Only by acknowledging that we may get laughed at and then ignoring it and producing art anyway, can we truly succeed. Change is often painful; but, without ignoring our fear of criticism, we remain stuck where we are. Being stuck prevents us from shipping.

5) Ship – After we ignore our fear of ridicule, we need to get out there and get things done. We need to create a product or service that meets a need. The need for our services is great (we know this). Now we need to get the message out there that physical therapists are the patient/consumer’s best resource for the treatment of musculoskeletal injuries. We get the message out there by educating the public, making connections, being generous with our time and information, and laughing at the lizard. Which leads us to the next point…?

6) Fail – we need to be willing to fail, because we will. According to Mr. Godin, the “reinvention of the marketplace demands that one have the ability to fail, often and with grace – and in public!” As we try out new ideas, and negotiate new forms of social media, we will fail. People may criticize us, laugh at us, debate us, or worst of all, ignore us. That’s ok. We need to use each failure as an opportunity to do better.

7) Learn – as we try new things, and fail, we need to learn from each experience and keep moving in the right direction. We need to apologize for mistakes, make amends to those we have hurt, pay better attention to those who feel unheard, restructure according to what people are saying they want. There is no place for defensiveness in learning. We can take something positive away from each interaction to do better in the future. The big challenge in modern life is that change happens so rapidly – even a few years ago, an organization would never have had the opportunity to reach such a staggering number of people with a message as Twitter allows today. We need to learn quickly, adapt, and move on. It is difficult for a large organization to change so rapidly; but, APTA must change in order to remain relevant.

So, in a nutshell, what are some things that our organization could do immediately?

• Provide links to articles, position papers, etc. that can be accessed by anyone (achieves the goals of connecting, being generous, ignoring the lizard, and shipping)
• Allow all licensed physical therapists to volunteer for APTA events (achieves the goal of connecting, provides the ability to bring in new members, allows those physical therapists who work part time or are self-employed (and have difficulty paying dues) to give to the organization and stay connected.
• Offer different levels of membership to meet the needs of every physical therapist, offer “temporary/trial” memberships, or offer the ability to “pay for what you want.” Full membership can still offer the full complement of perks, while less expensive memberships could offer less in return. A concierge service can be offered where therapists pay for access to specific resources (position papers, news flashes, journal articles, etc.) The work has already been done, and the extra income to the organization would be a bonus. The organization (and its members) need to keep in mind that we are not a homogenous group – some therapists work full time, some work part-time due to family obligations, some are self-employed and don’t have extra financial resources. Rather than judging each other (as has happened in recent Twitter interactions, where members judged the “priorities” of non-members), let’s work as a profession to support ALL physical therapists in reaching their personal goals WHILE meeting the overall goals of the organization.
• Have a consistent social media policy – identify who is Tweeting for the account, have a goal of excellent customer service in every interaction, keep in mind the infinite (virtual) life of Tweets and ensure that each and every one adds to the overall goal of the organization.

These are just some of the thoughts that have been formulating in my mind this week. I believe there is room for all of us in this profession, and room for all to be part of the organization. We just need to realize that the rules have changed, and we can’t keep playing the same game.

  1. Sometimes as organizations grow, they become so big that they lose the interconnectedness of being familiar with all the various departments. Each department has a highly focused role and may not be paying attention to all the other components. And in the highly focused state, sometimes the focus is on meeting certain measures or certain targets. The social media department will have certain numbers to hit… you know, followers on Twitter, likes on facebook, number of video views in YouTube, number of hits on MoveForwardPT. That’s all fine and well, but meeting these kind of goals doesn’t mean the audience is really engaged or truly paying attention. Other metrics, such as number of emails sent to connect others, number of thank you’s, number of retweets, number of introductions or even number of hours spent sharing specific information, measure the detailed component of interactions. With metrics like that the focus changes begins to include the customer-service type aspect of using social media to help members and reach out to non-members.

    I agree, there could be different levels of membership – pay for what you want. I also like the idea of a trial period. A free one month membership in the association and with desired sections to see if one finds value. This would lead to better tracking – the conversion rate from a trial to a membership. It changes the whole attitude from “professional duty” to one where a potential member has his/her foot in the door with no initial obligation except to learn the value of the association. The APTA and sections would need to potentially implement some type of nice introductory information and multiple little short emails with information to links and what not throughout that trial period, along with maybe a phone call at the halfway point. The goal would be retention…

    What you haven’t experienced is a focused customer-service attitude where every physical therapist or assistant is viewed as a potential customer. The engrained attitude is we should all just be members… well, times are changing. Before we part with our dollars, we want to feel as though we matter and we want to know the value for our dollars. The same thing is happening in healthcare.

    Hang in there. You know a lot of us physical therapists who are members and we’ll help you. We understand that sometimes potential members just want to test the waters. We don’t want you to feel frigid water… we definitely want you to continue to grow, learn and impact this profession at a level greater than your community. That’s what the APTA is supposed to help us achieve.

    • Selena,
      Thanks for the nice comments. You are correct that people want to know what they are getting before they part with their dollars. As a cash-based business owner, I know that I need to provide the highest level of customer service and the most highly skilled care possible. Knowing that people are “voting with their dollars” keeps me on my toes at all times. And, when clients offer constructive feedback to me, I listen. I also agree with you that it is important for us all to want to impact the profession at a level greater than our communities. We start locally and hopefully the ripples spread out. That’s the beauty of social media – we can connect with anyone at any time. I look forward to more discussions through #solvept!

  2. Interesting blog. Triggers a few comments:

    1. The APTA has several venues to connect to “outsiders” (see for example), but the organization should also have inside links for members only. There are many organizations who attempt to undermine the efforts of physical therapists and the APTA.

    2. The dry needling position statement has been available for all on the APTA website after it was initially (for less than 2 weeks) posted on the “members only”. See

    3. The APTA is very active in working toward acceptance of dry needling. As a member of two different APTA committees on dry needling, I assure you that only with active members (who pay their dues and participate in the organization) is it possible to achieve what has already been accomplished. Dry needling will be in the next edition of the Guide to PT Practice, which will help state boards approve dry needling, and which will help insurance companies to erase policies against dry needling and actually reimburse patients and clinicians for dry needling.

    4. Become a member and work from within the organization to implement the excellent ideas you brought forward.

    • Jan,

      Good to hear from you! Thanks for participating. In response:

      1) I do agree that any organization should have inside links for members only – after all, that’s a benefit of membership/paying dues. There are many ways that APTA provides “Members Only” benefits (from what I can tell) including the opportunity to be listed as a practitioner on the APTA’s “Find a Physical Therapist” page, and access to other important information.

      As you mentioned (and as you and I have discussed before) there are many groups who attempt to undermine the efforts of PT’s and the APTA. Are you saying that making pages only accessible to Members is done to protect information from these groups? That’s an interesting idea that I have not really considered. Thank you for bringing that to my attention. I suppose that one way to avoid non-PT’s from accessing that information on the website is to require people to enter their PT License number in order to be verified to gain access to those pages. (Before people say this can’t be done, it can – the technology exists; and, it’s no less “safe” than having someone who is a PT and …(insert name of other healthcare professional) fill out an APTA Membership Application online, become a Member, and then sharing all of the Members Only information with colleagues who may attempt to undermine PT’s.)

      2) Interesting to know that the dry needling position statement is now available to the public. I had no idea. There was no follow up from my conversations with the APTA for them to let me know that they changed the document from Members Only to open to the public. How did this change occur? Was it a result of your work with the APTA and at your suggestion? If so, thank you – I appreciate all of the hard work you do on a daily basis with the APTA.

      I clicked on the link to access the position paper and was able to do so….although the position paper on Health, Wellness, and Fitness in State Practice Acts is still Members Only, and since I provide Wellness Services in my practice, I would love to be able to read that one as well. Again, why can’t all of the position papers be accessible not only by all PT’s but also by the public. What is the use of the APTA going through the trouble of having a task force and coming up with a position, only to keep the information under lock and key?

      3) Again, I know how hard you work on the topic of dry needling, and how many hours you devote to having it included in the state practice act of each state. Obviously, it requires money to lobby for these things, and that’s part of what membership dues go toward. I totally appreciate that.

      4) As my business grows, and I am bringing in more of a steady weekly income, I do look forward to joining the organization. I wholeheartedly support the idea of an organization which is working to bring our profession to the forefront of healthcare. My point in writing the blog post was to say that there are many different reasons why some PT’s are not members, and that finances are often a big factor. The idea I was getting at is that many PT’s who are not yet members can work WITH the APTA by volunteering, having access to important documents, and feeling like they are a part of something bigger. I hope that the APTA is willing to look at some of the suggestions I made in order to think about how they may reach many, many more non-members.

      As always, good to hear from you, and thank you for all the work you do to promote our profession from within!


  3. Hi Ann! What a great post! I think you have some great ideas!

    I have been an APTA member my entire career (8 yrs as a work benefit & the past 6 yrs out of my own pocket.) I do admit that I have grudgingly paid my dues out of professional duty & often ask what am I getting out of being a member?

    I recently attended a PT professionalism conference and Dr. Jody Frost, who is on staff at APTA, was one of the speakers. Someone asked her about APTA membership & its cost and here was her response

    ‘Think about what it would be like if there was NO APTA. There would be NO presence in Washington with one unified voice; NO coordinated support & resources for advocacy at the chapter level; NO governing body to create its own professional positions and policies, & NO board specialties and certifications among many other things.’

    Dr. Frost’s nuanced reframing of the benefits of membership with her ‘imagine if there was no APTA’ made the light bulb illuminate in my brain and caused me to see the true benefit and importance of being an APTA member. For me, that was the “one, unified voice in Washington.”

    I agree that those APTA members that would not let you volunteer beside them missed a golden opportunity. If the goal is to increase membership, then it seems silly to be exclusive instead of inclusive at that point.

    APTA is working on “inter disciplinary” collaboration among different healthcare professions which is great, but I also think they need to focus on “intra disciplinary” collaboration as well. Your point about the articles and research speak to that. Even as a member I’m a bit frustrated when I cannot access certain links just because I’m not a member of that specific section!

    I agree with you on the different levels of memberships, perhaps as simple as a “full” member & a “junior” member.

    I guess this is the way I view the APTA, it is a good Organization, but NOT a perfect organization. But at the end of the day our profession is better because of the work they do and I’m glad they are around!

    I encourage you to send in some of your ideas to APTA. I have recently done that. The more input they get, perhaps some changes may be made!


  4. Mike,
    Thank you for connecting! I agree with your thoughts – being inclusive and collaborative is in everyone’s best interest. I also agree that the APTA does a lot of work advocating for physical therapists, and it is only through membership dues that they are able to accomplish what they do. I look forward to sharing my ideas with APTA.

  5. Hi Ann,

    Wow what a refreshing point of view!

    I love that you quote Seth Godin. He is amazing!

    Thanks for offering a solution to the problem. Many PT’s only complain about the APTA, but I like that you also made healthy suggestions.

    As stated in some comments, yes the APTA is active, but is it active enough to stay current with the times? Is it able to defend and grow our position as PT’s?

    Time have changed, the APTA needs to evolve.

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