Announcement

Collapse
No announcement yet.

My Break from APTA

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • CT My Break from APTA

    I recently received an appeal letter from a state chapter Governmental Affairs liaison requesting increased involvement in legislative and professional activities in general. It looks like this letter went out to all licensees, so I wasn't targeted for any reason in particular.

    I've been getting letters like these on a more or less regular basis my entire 20-year career, but this is the first time I got one after making the fateful decision to allow my APTA membership to lapse. I've paid my dues to APTA and the Orthopedic Section dutifully for my entire career, so I didn't reach this decision lightly. In fact, I was one of those people who would have strongly criticized others for failing to uphold their professional obligation by joining their professional association. This letter jumped out at me, in part, because it contained the following quote from Teddy Roosevelt:
    Every man owes part of his time and money to the business of the industry in which he is engaged. No man has the moral right to withhold his support from an organization that is trying to improve conditions within his sphere.
    I wrote a fairly lengthy response to this poor guy, and I have yet to receive a response. I told him that I was no longer convinced that APTA is doing much to improve conditions in my professional sphere. I cited the recent defense of cervical manipulation in response to the American Heart and Stroke Associations' position statement against that practice. I also referenced both national and state level efforts to promote dry needling. In my state, the PT board is consulting- and paying- lawyers to fight legal battles to "protect PT scope of practice" so that they can perform this intervention. Frankly, I don't care that much if some individual PT wants to jab people with needles, but I'm not too keen at all on my licensure dues going to a legal effort against "integrative" physicians who either practice acupuncture themselves or hire acupuncturists so that we can wage a turf war against them to see who's better at delivering DNIC+placebo. You know that the guys and gals in the white coats are going to win that battle every time, anyway.

    So, for me, it's a matter of principles and priorities. I think APTA has nearly completely lost track of it's principles, particularly with respect to promoting a firmly science-based profession. The recent and concerted efforts to defend cervical manipulation and dry needling also show that the highest priority right now for APTA is staking out turf, not advancing clinical practice and thereby helping us to better help our patients.

    I've decided to take a break from APTA, and I'd be interested to hear what others think about this issue. Do you agree with my position? Can change only happen by working within an organization? What do you think would happen if dozens or hundreds of PTs sent a letter to APTA opting out of membership until they made an effort to re-establish the profession's science-based heritage and re-aligned their priorities so that quality patient care was once again paramount?
    John Ware, PT
    Fellow of the American Academy of Orthopedic Manual Physical Therapists
    "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
    “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
    be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

  • #2
    Well, in that professional organizations are there for the sole purpose of staking, and being a visible liaison to government/legislation, I think they are probably acting inside the appropriate scope; however one suspects there isn't really anyone with any real piercing vision steering it.
    Diane
    www.dermoneuromodulation.com
    SensibleSolutionsPhysiotherapy
    HumanAntiGravitySuit blog
    Neurotonics PT Teamblog
    Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
    Canadian Physiotherapy Association Pain Science Division Facebook page
    @PainPhysiosCan
    WCPT PhysiotherapyPainNetwork on Facebook
    @WCPTPTPN
    Neuroscience and Pain Science for Manual PTs Facebook page

    @dfjpt
    SomaSimple on Facebook
    @somasimple

    "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

    “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

    “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

    "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

    "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

    Comment


    • #3
      As much as I want to support the APTA it's hard for me to understand initiatives like this which are, at best, tangential to it's stated mission.

      "Cultural competence" is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enable that system, agency, or those professionals to work effectively in cross-cultural situations.
      I understand how someone could rationalize this as a component of the APTA's activities. So I hope the APTA can in-turn understand why some would rationalize it as a component of why we decided not to rejoin this year.
      Last edited by HeadStrongPT; 16-03-2015, 10:10 PM.
      Rod Henderson, PT, ScD, OCS
      It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

      Comment


      • #4
        Rod,
        I thought it was when they came out with that poster of that glowering nun warning the public about their posture that sealed the deal for you.

        Actually, politically-correct trappings like "diversity" campaigns seem to be unavoidable for any organization within a certain radius of the DC Beltway, so I wouldn't expect APTA to be any different in that regard.

        It sure would be refreshing if for once APTA took a stand on something important, like, oh, I don't know...the scientific method.
        Attached Files
        John Ware, PT
        Fellow of the American Academy of Orthopedic Manual Physical Therapists
        "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
        “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
        be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

        Comment


        • #5
          Oh, by the way, folks, you can still get your hands on one of those eye-catching posters of the mean nun for a mere $7.95- $4.95 if you're an APTA member. That's a nearly 40% savings for the privilege of membership!
          John Ware, PT
          Fellow of the American Academy of Orthopedic Manual Physical Therapists
          "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
          “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
          be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

          Comment


          • #6
            You are not alone, John.

            I allowed my membership to lapse 2 years ago and now only contribute to the state PAC, which continues to work to ease direct-access restrictions in my state. I would rather spend that money to go to a cont ed class instead.

            I am sure that there are others on the boards who may think that we need to change things from the inside (as you mention) but I don't have the stomach or time for it - so I remain mostly silent with regards to the APTA as I also appreciate that I have little to complain about if I am not actively involved, myself.

            Respectfully,
            Keith
            Blog: Keith's Korner
            Twitter: @18mmPT

            Comment


            • #7
              John,
              Let's discuss this:
              I've decided to take a break from APTA, and I'd be interested to hear what others think about this issue. Do you agree with my position? Can change only happen by working within an organization? What do you think would happen if dozens or hundreds of PTs sent a letter to APTA opting out of membership until they made an effort to re-establish the profession's science-based heritage and re-aligned their priorities so that quality patient care was once again paramount?
              Obviously you have outlined some reasons about how the APTA has not worked for you. What would change your mind?
              Joseph Brence, DPT, FAAOMPT, COMT, DAC
              "Great spirits have always encountered violent opposition from mediocre minds" - Albert Einstein
              Blog: www.forwardthinkingpt.com

              Comment


              • #8
                Joe,

                I am not sure if these items are at all changeable by the APTA or not, but here are a few things I see needing change.

                1. State licensing exams are out of day
                2. Based on #1, the material and curriculum in PT schools is lacking a true evidence and based on outdated information that is more PT history vs current practice.
                3. Promotion of continuing education courses that are sketchy at best

                Comment


                • #9
                  Frankly, I don't care that much if some individual PT wants to jab people with needles, but I'm not too keen at all on my licensure dues going to a legal effort against "integrative" physicians who either practice acupuncture themselves or hire acupuncturists so that we can wage a turf war against them to see who's better at delivering DNIC+placebo.
                  https://www.facebook.com/80628138606...type=1&theater

                  Comment


                  • #10
                    Here in NY we're going to be making a push toward TPDN legislation for PTs, adding yet another confusing layer to our public identity. I've expressed my concern at our winter Board meeting, but could sense the private practitioners disdain that anyone would want to "limit our practice act." Meanwhile, another billable modal....er, "tool" will be added to the box, and the turf war with the acupuncturists will ensue.

                    It's a sad day when we're engaged in a defensible argument with acupuncturists. Scientific method be damned.
                    Nate Mosher, PT, DPT, SCS, CSCS
                    Board-Certified Clinical Specialist in Sports Physical Therapy

                    Comment


                    • #11
                      Obviously we all have to make individual decisions. But to me I am APTA. If APTA messes up I need to get more active to try and prevent it in the future. I realize this is a very minority opinion as only 30% of PTs are actual members and less then 5% are actively involved in the association. I get that it's political and politics seems to push many people away, welcome to the American democratic way. With the US government when they do things I don't agree with I realize the people voted them in place. Government by the people for the people. I realize this ideal at times seems lost. But APTA is not much different, it is a professional volunteer organization run by its members. It's a diverse profession with almost 200,000 PTs that it represents and 80,000 PTAs, meeting everyone's needs considering the diversity of practice is impossible, yet best efforts are made. I ask myself would the profession of PT be better if there were no members of APTA and it did not exist at all?

                      sent from my phone using tapatalk, mistakes possible
                      Kory Zimney, PT, DPT

                      http://koryzimney.blogspot.com

                      "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill

                      "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

                      Comment


                      • #12
                        Kory,
                        As I've heard Barrett say many times: I didn't leave the profession, the profession left me.

                        At least 15 of the 20 years of my APTA membership, I paid the dues out of my own pocket. In addition to that, I also remain a member of the AAOMPT since 1998. So, altogether, I've shelled out nearly $10K in professional dues, and that doesn't count all the PT-PAC and Foundation for PT contributions I've made over the years. Yet, the profession continues to drift away from me and it's commitment to science.

                        Joe,
                        I appreciate you chiming in. I realize that you have become more involved with APTA, and I hope the next time you get a chance, you'll relate to the leadership the growing discontent out here among former dues-paying members. The fact that Keith and Rod have bailed out- two highly dedicated, quality professionals- in fact, just the kind of PTs that APTA should be recruiting for more involvement- should be very concerning to the leadership at APTA. I don't know about Nate and Gary, and I wouldn't expect anyone here to disclose their current membership status, but I have to wonder not just about the quantity of APTA membership, but also the quality of its membership. If they're losing people of this caliber, then that should be very concerning to APTA leadership.

                        What might change my mind? It might be time for APTA to reconvene a summit of sorts, as it did in 1984 when it held the Pathokinesiology Symposium. The profession seems to be languishing in this protracted identity crisis, where, as Jules Rothstein said nearly 30 years ago: "We, as a profession, may be doing more things, but in no way have we developed a true sense of who and what we are." With the expansion of the "toolbox" into dry needling and skin scraping, and lame defenses of cervical manipulation, it's 30 years later and the profession still lacks the fortitude to stake out its own unique destiny. It seems to have just capitulated in so many ways to a dysfunctional health care delivery structure- one that is so focused on following processes of care, that it has completely lost sight of helping patients achieve a positive outcome. We've become so enamored with our ability to not only comply with, but assist the government in developing silly things like G-codes, which have turned out to be totally worthless in terms of translating to meaningful outcomes, that it almost seems like an industry has developed around the next process of care strategy. No one seems to give a damn about whether or not patients actually improve, nor do they care how much it costs.

                        Exhibit 1 at such a summit could be that Educational Resource paper on dry needling that was published by APTA in 2012. This is a prime example of exuberantly defending an intervention despite the lack of evidence that it works. The paper cites several reviews, including the 2011 Cochrane Review by Furlan, which concluded:
                        The data do not allow firm conclusions regarding the effectiveness of acupuncture for acute low back pain. For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the short-term only. Acupuncture is not more effective than other conventional and "alternative" treatments. The data suggest that acupuncture and dry-needling may be useful adjuncts to other therapies for chronic low back pain. Because most of the studies were of lower methodologic quality, there is a clear need for higher quality trials in this area.
                        If needling has only short-term benefits AND it's no better than other treatments, then why in the world would APTA want to so strongly defend it with a 140 page "educational resource paper" prefaced on the dubious existence of trigger points? I can't think of any other explanation than providing PTs a claim to another modality for which they can charge the patient and market their services. It's entirely based on commercial motives, not a value-based result for the patient.

                        That attitude summarizes why I've become so disgusted with APTA. It's become rudderless and unprincipled its professional advocacy.
                        John Ware, PT
                        Fellow of the American Academy of Orthopedic Manual Physical Therapists
                        "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                        “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                        be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                        Comment


                        • #13
                          I have discontinued my membership as well.
                          I struggle because we are already the most over-educated underpaid profession in America, maybe second place to a clergy member. The dues are way too much, with little to no visible return on investment. I don't think the organization really tries to reach out to its membership and truly act for them. A few political agendas seem to get the attention and I don't support them, so I am not offering my monetary support at this time.

                          Comment


                          • #14
                            The concerns expressed here are valid.

                            I have contacted APTA leadership to observe the concerns listed here (which they did) and we are currently in communications in the development of a strategy to discuss these further (will notify you guys when this is ready). They need and want to hear this.
                            Last edited by joebrence9; 17-03-2015, 06:59 PM.
                            Joseph Brence, DPT, FAAOMPT, COMT, DAC
                            "Great spirits have always encountered violent opposition from mediocre minds" - Albert Einstein
                            Blog: www.forwardthinkingpt.com

                            Comment


                            • #15
                              Thanks Joe.

                              I left the APTA many years ago. Though I was an invited speaker at many of their conferences and a whole lot of State Chapter Meetings, I left for a multitude of reasons, several of which have been mentioned here.
                              Last edited by Barrett Dorko; 17-03-2015, 06:39 PM.
                              Barrett L. Dorko

                              Comment

                              Working...
                              X