Certain experiences we engage in have the ability to impact us in multiple and sometimes strangely conflicting ways. For white water enthusiasts, it can be the emotions you experience just before you slide into a big rapid, especially one you have never gone down before. There is this sense of nervousness brought on by the roar of big, strange, chaotic water. The feeling of anxiety is heightened because you don’t know exactly how it will all play out. There is risk. Will you be able to follow your line? Do you have a good crew that will work as a team to help you through? Are you prepared to deal with the expected and more importantly, the unexpected? At the same time, there is excitement. You are thrilled to be there and engaged. Not participating is really not an option you would prefer. Smiling, gritting, it goes back and forth and sometimes the thrill and anxiety weirdly overlay each other. Uneasy exhilaration. Riding big roller coasters used to affect me this way too. What we face with health care is starting to give me a similar feeling.
I recently attended APTA’s Private Practice Section’s Annual Conference, held in Seattle, WA, November 3-5. While there, I soon began to experience that same sort of strange mix of emotions. Discussions with private practice PT colleagues all over the country paint a similar view of an uncertain future that is quickly approaching, like that entrance into a big river canyon rapid, with pandemonium and potential disaster looming. But getting out is not an option. So what will it take to avoid failure and maximize the chance of a successful ride?
I heard from many attendees and presenters that were at this meeting, who were looking for and sharing ideas for navigating these troubled waters. Themes included the need for a frank and thoughtful assessment of the circumstances that we face. Appropriate planning and creative, far reaching, systems thinking is required. Making sure we have the right people with the right training and attitude on the team. The discussions made for a great meeting.
The key note speaker for the conference, Joe Flower, laid this all out in his very informative and thought provoking presentation. In a phrase, Mr. Flower is a health care futurist. He described the looming dangers and challenges for our nation related to health care. But he also explained some of the strategies that can guide PTs and other health care providers through the coming years, allowing us to steer clear of the disasters, finding more friendly waters. He argued that our profession is particularly suited to take advantage of some of the opportunities in our current and future situation. A few points he made included:
Those that can show efficient outcomes for managing chronic diseases (diabetes, metabolic syndrome, Alzheimers, COPD, etc.) and related secondary problems will be positioned well.
Given the demographic numbers for the baby boomer generation and that this cohort is not very accepting of what happens to the body as it ages, those providers that can demonstrate effectiveness in slowing down the impact of aging and keeping people active will have great opportunity.
Any business model that helps reduce the actual total cost of healthcare should thrive.
Mr. Flowers spent a good portion of his presentation outlining the abundant waste that exists in our so called health care system. He laid out a pretty good, data driven argument that a 50% reduction in expenditures is achievable. He made the case that well practiced physical therapy, especially operating as part of a comprehensive team of providers, can be a part of the solution for the elimination of waste, and maximizing value.
There is much more to his vision for our nation and health care. If you are interested, you can learn more from his web site: http://www.imaginewhatif.com/ . Mr. Flower also has a new book on the subject, Health care beyond reform: Doing it right for half the cost. It seems pretty clear though that we are on an unsustainable path and that change related action is required. Pretty exciting stuff. Hold on, as we are in for a wild ride.