PT Classroom - Think Big or Go Home - Observations from the 2015 Graham Sessions - Private Practice Physical Therapy׀  by Chad Novasic, PT


Chad Novasic is the President and CEO of Alliant Physical Therapy Group. He is a 1988 graduate of Marquette University. His focus has been in the field of outpatient orthopedic rehabilitation and injury prevention. Chad has been an independent Physical Therapist since 1989. He is proud to be active in the community having served as President of the Wisconsin Independent Physical Therapists, and on the Board of the Racine Founders Rotary and the Wisconsin Physical Therapy Association. Over the years, Chad's passion for physical therapy and helping others has complimented his capacity to help fellow physical therapists open and run successful private physical therapy practices.  

On January 16th and 17th I had the pleasure to be invited to the 8th annual Graham Sessions sponsored by the Institute for Private Practice Physical Therapy. The purpose of these meetings are to openly, safely and vigorously discuss and debate issues facing Physical Therapy, where the profession is, and where it is going. The function also serves as a conduit for future leaders within the profession. The overall mix is a quite impressive list of practitioners, educators, a few students, and APTA leadership including the President and CEO of the APTA.

The structure of the event is to explore relevant topics with a brief presentation of the issues followed by healthy discussion. There are a couple of ground rules. First, titles do not apply. If you were invited to this event it is assumed that you have something to contribute. Second, What is said in the room is welcome to be shared, but the name of the person who shared their thoughts is to remain confidential. And Finally, there is a moderator to keep discussion on track, and assure that time is respected for everyone who has something to contribute.

This was my first time attending the Graham Sessions and I was very impressed. The collection of people who were there was impressive. The people were engaging and inviting. The general discourse and discussions were stimulating and thought provoking. And the freedom to say what was on your mind was clear.

There were several highlights for me, and I will narrow down my thoughts to what I observed to be the most interesting.

Transformational Thinking
We are in the era of health care reform. Change is occurring whether we like it or not. Many people are reactionary in their approach. However transformational thinking is not about reacting, it is about transforming. True innovation in our field may be disruptive. Transformation may look different. However it is, once it happens you don’t go back. It is time to think about what would Physical Therapy look like if we stripped away all our current thoughts about insurance, marketing, CPT codes, ICD-9 codes, the 8 minute rule… everything? How would we as Physical Therapists define our role in the health care paradigm? Would we be rehabilitating injuries? Would we be personal Trainers? Would we be athletic trainers? Would we be primary musculoskeletal care providers? What would a Physical Therapist be? What would a PT do? And how would a PT benefit society?

Defining a Physical Therapist?
Are Physical Therapists Defined by what we do? Or, Who we are? Are Physical Therapists from the “neck down” workers who need to do everything physically to our patients? Or, Are we “neck up” providers who use our unique knowledge to team up with the health care community and direct the care of our patients? I found the discussion about the term “Autonomy” to be fascinating. Apparently many Physical Therapists have taken this to mean that they are “independent” and as such, can do everything on their own. This was not the intent of the term Autonomy when used in vision 2020. However since the terms inception PT’s have been given the improper reputation for net being “team” players. There several ways that this as hurt us as a profession. The bigger picture, is that Physical Therapists have done a poor job of defining who we are to the public and the Health care community.

We are in the era of technology. Electronic communication has made great advances, however communication is not up to speed with our technology. Many hospitals use Epic, many major provider groups are using NextGen. However most Private Practice Physical Therapists are using industry specific software such as Web PT, Clinicient, or in my case Practice Perfect. All of these Physical Software programs are excellent for managing our practices, but how do we seamlessly communicate our patient information and data with providers using the larger software? There are evolving cloud based locations for patient information. Some on the local state wide level, and evolving personal medical records that are available nationally. Even with all of this one of the most widely used piece of equipment in a hospital is the fax machine. There continues to evolve a need for seamlessness in patient data access while protecting patient privacy and security.

Big Data
With all of the advances in technology, we are able to produce large amounts of data. However is this data useful? Meaningless data is useless data. However meaningful data can be useful data. How do we capture effective patient outcome data? Currently there are approximately 300 outcomes tools for use in Physical Therapy. This variability leads to good data that is not standardized and therefore not reliable in predicting outcomes. The APTA has worked on some standardization of data in the inpatient setting, however the outpatient setting requires much more work on reliability and validity of the data we collect. This is all good and well, however the evolution of healthcare is happening rapidly. We need to keep up with this to keep Physical Therapists relevant in the scope of Health Care as a whole.

Big Opportunity
We, as Physical Therapists are at a crossroads in our profession. We are uniquely positioned with our education and skills to be play a vital role in the Health Care system. Physical Therapists have the ability to promote and deliver health and wellness programs as well as help people recover from injury and functional limitations. The Physical Therapist is primed to play a role in daily care of the population regardless of diagnosis or condition. Our services can save the system millions of dollars and enhance the quality of life to all individuals in our community. We have the potential to enhance our value to the health care system. It is up to us to do this.

Physical Therapists have many opportunities facing them now and in the near future. The challenge is to think big! Who will evolve as the visionary to transform our profession. We need to get out of our 8 minute rule thinking, and consider what we really have to offer.

If you are thinking about starting a private practice, NOW is a great time to go into private practice! For more information on starting up a private practice you can visit the Private Practice Section of the APTA or contact Chad at


Other Private Physical Therapy Practice related articles by Chad
- Starting a Private Physical Therapy Practice
- Basic Equipment for Starting a Private Physical Therapy Practice
- Physical Therapy Private Practice Tips - Red Flag Rules


Last revised: February 15, 2015
by Chad Novasic, PT

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