Better Together – Internationally


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The message sent on July 22, 2021, was brief, “Third wave in Malawi, situation rapidly becoming critical.” I was two months into my appointment as APTA Private Practice’s Member Organization Representative to the International Private Physiotherapy Association (IPPTA) and immediately remembered the panic of the first six months of the COVID-19 pandemic, watching order after order of personal protective equipment (PPE) be canceled or delayed. By the summer of 2021, our supply chain had improved enough that I no longer lost sleep over protecting my staff and patients. Still, the memory was vivid enough to understand exactly what this physical therapist in Malawi was experiencing. Several members stepped up with offers of help, including APTA Private Practice. Shipping supplies to Malawi was no easy task, but APTA Private Practice generous donation of thousands of gloves and hundreds of masks were finally delivered.

Over the course of the last three years, I have observed many lessons shared and friendships made while representing APTA Private Practice to IPPTA.


The recently released “Economic Value of Physical Therapy in the United States” ( is a report that was inspired by the work of the Australian Physiotherapy Association a few years ago. This foundational paper analyzed the net benefit of physical therapist services per episode of care for eight conditions and will drive advocacy and education efforts for years to come. Comparing the value of physical therapy between the US and Australia has also been fascinating, with care for some conditions providing similar net benefit and others with a dramatic gap.


Physical therapy and private practice physical therapy vary widely around the world, but commonalities can be found. We are not alone in our staffing challenges, with all countries report shortages of physical therapists. While some countries have full and unrestricted direct access, others are prohibited from establishing or changing the plan of care. Privileges such as ordering radiographs or performing injections are rare but do exist. In some cases, the expansion of privileges has stratified the profession with physical therapists in hospitals enjoying greater practice scope than private practice physical therapists. In general, associations around the world are shifting advocacy messaging from “all about us” to “all about the patient,” recognizing that our patients’ successes provide powerful stories to promote the advancement of the profession.


The National Health System in the United Kingdom has designated physical therapists as First Contact Providers, allowing patients to see a physical therapist as a point of entry to their health care system. While exciting to see a nation elevate physical therapists, we can learn from the unintended consequences of these changes. Hiring physical therapists for this role has seen high demand from primary care physicians who can improve their quality scores by decreasing the wait times for patients to see a provider, further exacerbating labor shortages in other areas of the profession. Ultimately, patients may be frustrated by their first interaction with a physical therapist in this role since these providers are limited solely to triaging patients to see a specialist, have imaging, or be referred to a physical therapist for treatment — for whom they will wait weeks to see due to labor shortages.


In my role representing APTA Private Practice, I was invited to join a panel presentation on the benefits and challenges of outcomes data collection at the conference of the Australian Physiotherapy Association in Melbourne, Australia, in September 2022. While some countries have been successful in utilizing outcomes measures to demonstrate value, they have typically had significant government financial support in establishing and supporting their data collection systems.


Many associations face similar challenges in promoting engagement with the next generation of members and messaging member value and relevance. This year’s IPPTA meeting focused on positioning your association for the future, and success stories from around the world have been shared with the APTA Private Practice Board of Directors.

In Dublin, Ireland, in September, I was elected to the IPPTA Board of Directors as Secretary and look forward to promoting excellence in and financial independence for physical therapist businesses around the world.

As I reflect on helplessly monitoring the tracking information for APTA Private Practice’s PPE shipment to Malawi just two years ago, I remind myself that while supplies may not be enough or may not be as timely as we would like, supporting each other and knowing that none of us is alone is sometimes exactly the boost that we need. 


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