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The Importance of Advocacy

Written by Erin Kinneen, PT, MS, DMT, CLT, OCS, a Physical Therapist at our Kirkland Clinic. 

As a physical therapist practicing in Washington for 18 years, I have witnessed the profound impact of advocacy on patient care and the provider experience. The hard work of therapists who banded together to advocate for concerns has significantly advanced patient care and improved the provider experience. Below I’ve highlighted two ways physical therapists in Washington have advocated for our field. 

Spinal Manipulation 

In Washington, 18 years ago, providers were not allowed to perform spinal manipulation, an important part of our practice. This was very frustrating to our providers for a few important reasons. First, spinal manipulation is a highly efficacious treatment that can significantly impact patient outcomes.  

We were restricted for reasons not based on science but instead on politics. The treatment type is very safe, and our providers are well-trained to provide it. At the time, Washington and Arkansas were the only states that couldn’t perform this part of patient care. It’s concerning when two states in the country are the only ones unable to perform a treatment. Washington is known for its esteemed role in entrepreneurship and providing high-quality research initiatives that advance science and technology; it was frustrating to be relocated to the bottom of the barrel by law. 

However, the goal-setting abilities of physical therapists helped us create a tabulated plan to approach our legislators regularly with factual information about: 

  • The importance of this technique. 
  • The impact on state taxpayers’ wellness and days worked after symptom improvement. 
  • The impact on our ability to recruit talented therapists who sought to practice at the top of their license. 

Our success in advocacy can be largely attributed to the strong relationships we’ve built with providers, legislators, and constituents. These relationships have been instrumental in our conquests and highlight the importance of networking and collaboration in advocacy efforts.   

Additionally, our advocacy helped advance access to care. Previously, prior authorization demands may have precluded some individuals from pursuing care when it mattered the most: when we are in pain and need it acutely. Providers in Washington worked hard to allow access to at least six visits prior to the need for additional authorization. This move was really helpful in improving health care expenses and days out from work for those in pain.  

Dry Needling 

Approximately ten years ago, physical therapists were restricted from practicing dry needling, another highly efficacious part of our practice. Dry needling is a tool used to help manage musculoskeletal conditions like 

  • Increased muscle tone  
  • Muscle pain 
  • Advance tissue healing to structures. 

In dry needling care, a trained provider with an established review of their skills uses a rounded filament to change the musculoskeletal system. This technique can improve 

  • Muscle fiber structure 
  • Local muscle stiffness 
  • Nerve irritability 
  • Muscle recruitment 
  • Concentrations of chemicals in the tissue that can cause pain 

Our previous advocacy work helped us as we used those relationships to explain why dry needling is essential. After a decade of advocacy, our providers recently added the ability to perform dry needling to our practice act. While a decade is a long time, the turnaround was much shorter than that of our manipulation concerns. It demonstrated that our relationships with our community are critical in helping us advance important patient concerns.   

Reimbursements for Providers 

Right now, your providers and lobbyists are working hard to improve reimbursement for providers. Physical therapists have not had a cost-of-living-related increase in payment for services in some time, despite the increased expenses of providing care in a post-COVID world.   

RET Physical Therapy and Healthcare Specialists (RET PT) has played an essential role in some of our state’s advocacy work. We often sponsor important days like our Legislative Impact Day, where providers meet in Olympia with their representatives to review pressing concerns. The group is also very supportive of our state’s Political Action Committee. This non-partisan group helps elect candidates running for the Washington State Legislature who support the physical therapy profession. The PAC is vital in helping direct the physical therapy profession’s future by increasing our voice in the political process, advocating for policies that benefit our profession and the patients we serve. Several RET PT employees are members and leaders of this group.   

It is rare that a physical therapy practice like RET PT supports important measures. It has been meaningful to observe the extent of the impact political advocacy in physical therapy has had on the scope of the profession in a relatively short time. In working together, our providers adapted to changing healthcare landscapes and advanced a strong voice in the legislative process. Who knew that was an important part of healthcare?   

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