Wednesday, April 27, 2011

Disrupting something sacred

Tim Richardson has done a nice job of introducing aspects of disruptive innovation to the PT blogsphere.  I read Christensen's book in 2009 and think back to it often.  A big question for me has always been, "How can we do the work we are setting out to do smarter?"

Without a doubt, the need and demand for our services will increase in the coming years.  If we don't seek to disrupt ourselves, someone else will.

Innovation is about capitalizing on areas in which newer, quicker, cheaper, and better options exist.  In many ways, PT evolved to disrupt the western medical model in place for the hundred or so years prior.

If we fail to see that as part of our pedigree, it's a sad state of affairs.  Sad for us because we will lose ground in the next shake up. But it would be great for the next generation of lower cost, more consumer-savvy providers.

If we want to stay on top, here are my suggestions:

Step one: Acknowledge that not every problem requires a PT.  

We have a diverse and widely applicable skill set but we can't be everywhere all the time.  There are some jobs that ATCs, exercise physiologists, health coaches, and nutritionists may do better.  If you can't handle hearing that, okay, but be ready to have our association spread too thin across too many uphill battles...  This means looking at PT-PTA relationships and PT-XYZ relationships as well.  As a profession, and rightly so, we are anti-kick back.  But as demand increases we will need to put the lab back in collaboration.  Which brings me to-

Step two: Forge alliances with the individuals next in line to "disrupt" the system.  

This is no small list. Point of care is moving out of the hospital and out of the Doctor's office.  For us, it's moving out of the clinic...  Nurses were set up to be big winners in Health Care Reform.  That is certainly a strategic alliance that needs our attention.  PTAs, ATCs, SPTs, Massage therapists, and a laundry list of others deserve constructive consideration as well.

Step three: Re-evaluate which jobs we set out to do.  

If an ATC proves they can rehab an ACL better than we can, sigh, maybe we should get out of that business.  Do I expect that to happen? No.  Is it possible?  Perhaps??  If we aren't asking ourselves the question, we open ourselves to being blindsided by unexpected answers.  As I've said in the past, comparative effectiveness studies are exciting opportunities to prove our expertise and rally public support behind endeavors in which we choose to take on a leadership role.  Could the APTA registry in the works be used for the greater good? I certainly hope so.  Why not fund it and fast track it?

Step four: Innovate.  Move "to where the puck is going to be."  

If PTs seek to 'own' just two major areas in the health care arena, they should be obesity and aging related neuromusculoskeletal deterioration.  Soon 80% of Americans would qualify for PT intervention based on one, the other, or both categories. Where are our community based intervention courses for aging and physical therapist interventions?  Where is the hot bed at which PT and Public Health intersect?

  As always, thanks for reading!  There's been a brief hiatus as I've been managing some family issues and gearing up for APTA elections.  This is a cross post with the EIM Blog.  But there will be some Move It exclusives up soon.

            Cheers,
                          Ben