PT Without Walls

Dana will be teaching a live webinar after business hours Eastern Time on September 25, 2025 on the Transforming Episode Accountability Model (TEAM). It’s for PTs, OTs, and case managers for CEUs, but it can be attended by anyone, of course. I’d love to see you! And if you are reading this after September 25, 2025, it will be available to attend later as an asynchronous CEU choice.

If you aren’t a Medbridge subscriber but want to be, use Dana’s link* and code DanaStraussDPT for $101 off your annual subscription. These live webinars meet in-person CEU requirements in many states, including my state of NJ. I’m so happy Medbridge is an expert at getting them approved! 😄 

The Future Is Already Here: Reflections from Three Veteran Doctors of Physical Therapy

Since recording, we’ve been reflecting on the insights shared between three middle-aged PTs with winding, diverse career paths. We covered a lot of ground in this episode, and we were delighted to see how much Dr. Contreras’ perspective aligned with ours. Dr. Contreras is a PT who has pursued a career path where he could make a big impact and literally make history! He was the first White House physical therapist, first stepping into that role serving President Barack Obama.

He is wise, and he has surely earned that wisdom. He now wants to see the profession of physical therapy step into the role that the “old guard” has prepared it for. He also makes a very relatable case for why you would consider being a member of the APTA if you aren’t already, and makes a great case for what you will get out of engaging with the Association. Here’s a one minute snip of that:

Here are Five Main Topics We Cover in Episode 17 and a Few Suggested Action Steps👇️ 

1. Embracing Our Primary Care Provider Identity

Dr. Contreras strongly agrees with us that physical therapists are already equipped to serve as primary care providers. We've all seen firsthand how our diagnostic reasoning and clinical expertise position us perfectly for this role. For perspective, we graduated decades ago. The level of education for PTs in the years since has grown dramatically. But old ways of thinking have a dampening affect on the profession’s growth. The three of us have leveled up our education and have grown our knowledge and experience so we all feel comfortable and prepared for primary care practice. And we know you all can do it, too.

The barrier truly isn't our capability in the vast majority of cases. It’s a hesitation to step confidently into this “version two” PT identity. When we consistently demonstrate our diagnostic expertise and take ownership of patient management beyond just treatment, we will affirm and re-affirm our place in healthcare's front line.

And any PT without a doctoral degree but still practicing, please, for the sake of the profession, get your transitional DPT before there are no longer universities offering it. Many employers, especially health systems, will reimburse for graduate school in a related area. When I (Dana) took that step, I was not even practicing PT as my full time job. I was forty-three years old and had been a practicing PT for twenty years, and my degree was the MPT. I did it because I felt a duty to my profession to level up to the terminal degree, and I felt I was privileged to qualify for a chance to earn a clinical doctorate. (I was also a single mom of pre-teens working full-time. I finished it during the early months of COVID and had started a new job that year. If I could do it, many of you can, too. 😃)

Action Step: This week, document two or three instances where you functioned as a primary contact provider. Note how your diagnostic reasoning, referral decisions, or management approach directly influenced the patient's care pathway. Share these examples with colleagues to normalize this professional identity. (If you are a PT without a DPT, consider looking into transitional DPT programs and whether your employer would help fund your education.)

2. Transitioning from Service Provider to Value Creator

Drew's "tree cutting" analogy resonated deeply us (listen to the pod to hear the story!) Traditional fee-for-service models reward volume of billable units, but healthcare is rapidly shifting toward compensating for outcomes and value creation.

As three PTs who've practiced across decades of healthcare evolution, we've witnessed how clinicians who focus solely on treatment delivery get left behind, while those who demonstrate and articulate their value thrive. The future belongs to therapists who can quantify and communicate their value beyond billable units.

Action Step: Implement one objective outcome measure with every patient and track improvements over time. Create a simple one-page report showing your aggregate outcomes data, and share it with referring providers and your network. Position yourself as someone who delivers measurable results, not just services.

3. Building a Netflix Model of Care Delivery

What we've learned in our careers is that accessibility and flexibility in care delivery is transformative for outcomes. It expands access, builds trust with patients and other providers, and shows adaptability to what we all want now. If it’s possible to offer a wide variety of access points to your expertise, you should be doing it. And it’s definitely possible!

The most successful PTs aren't waiting for patients to find them in traditional settings. They're creating Netflix-like models, per Dr. Contreras’ analogy, where care is available when and where patients need it. This might mean hybrid in-person/virtual models, workplace integration, or innovative delivery systems that meet patients in their daily environments.

Action Step: Experiment with one new delivery model this month. This could be as simple as offering one virtual follow-up session for every in-person evaluation, creating brief video exercise progressions patients can access between visits, or piloting workplace interventions for local employers. Offer local referring providers evaluations in their patients’ homes when they prefer that. Document what works and what doesn't—and give your tests a chance.

4. Expanding Beyond Technical Skills to Behavioral Expertise

We also discussed how technical expertise alone doesn't create lasting change or an evolution of the profession. As we discussed with Drew, the ability to facilitate behavior change is a cornerstone of effective physical therapy. It sets us apart from the top skills of other providers, such as physicians. Without helping create behavior change, patients often have limited benefit from the care of a physical therapist. That’s not good for everyone.

So while manual skills and exercise prescription remain important, our greatest impact comes from systematically guiding patients through sustainable behavior modification. This skill becomes particularly valuable in value-based care models where long-term outcomes matter more than short-term interventions for reimbursement.

Action Step: Dedicate a few hours to studying one formal behavior change methodology like Motivational Interviewing. Implement this framework with five patients and document differences in adherence and outcomes. Create a simple one-page reference guide for your practice that integrates behavior change principles into your standard approach.

5. Becoming a True Medical Professional: Beyond PT Knowledge

Drew emphasized the imperative to expand our knowledge beyond traditional PT domains. All three of us acknowledged how understanding imaging, lab values, and broader medical diagnostics has transformed our practice over the years.

As Drew pointed out, patients don't want a referral to another provider—they want solutions. When PTs can confidently interpret medical information, discuss findings with physicians as peers, and integrate this knowledge into comprehensive care plans, we truly embody our role as doctoring professionals.

Working at the top of scope is sometimes perceiving by therapists as “overstepping boundaries.” We hope that thought becomes extinct. What it really means is fulfilling our full potential as movement system experts within the broader healthcare ecosystem. And as value-based care accelerates, this medical knowledge becomes economically essential.

Action Step: Commit to enhancing your medical knowledge by selecting one area (imaging, lab values, pharmacology) and dedicating 30 minutes weekly to structured learning. Create a reference document for common findings relevant to your patient population. Schedule one lunch meeting with a physician colleague to discuss how your enhanced understanding can improve collaborative care.

Final Thoughts

As three PTs with many decades of combined experience across diverse clinical and non-clinical settings, we've certainly witnessed changes in our profession. What strikes us most is that those who thrive aren't necessarily the most technically skilled. Instead, they're the most adaptable, forward-thinking, and willing to evolve. Many have become proficient in knowledge about other healthcare areas, which compounds their value.

The future of physical therapy is already here for those willing to embrace it. Our conversation with Dr. Contreras reinforced that the opportunities for our profession have never been greater.

What's one step you're taking this week to future-proof your PT career? Share with us on social media or email us directly!