Our profession operates within a complex financial system, and many of us feel the constant squeeze of lower reimbursements. We talk about the challenges of Medicare, the rising costs of doing business, and the relentless pressure to see more patients just to keep the lights on.
But what if all of that is an illusion?
We often view money as a finite resource, a fixed pie that we're fighting over. We believe the system simply doesn't have enough to pay us fairly. The truth is, money is just an agreement—a collective perception of value. When we look at national spending, we see that trillions of dollars are allocated every year. Yet, where that money goes tells a story about our societal priorities.
Consider for a moment the vast sums of money spent on military hardware, on bullets, and fuel. These are seen as essential for our security, and the budgets reflect that perception of value. Meanwhile, an equally crucial part of our society—healthcare, and specifically physical therapy—is often treated as a cost to be minimized, a budget line item to be cut.
The real battle we face isn't against a lack of money; it's a battle against the invisible.
The Invisible Value of Physical Therapy
The core of our problem is that the value we provide is often unseen. We are the masters of prevention, of restoring function, and of improving quality of life, but the current system doesn't have a way to measure these triumphs adequately.
A patient with benign paroxysmal positional vertigo (BPPV) comes to me dizzy and unable to function. I perform an Epley Maneuver for their posterior semicircular canal BPPV, and their vertigo resolves. The value of that intervention isn't just the few minutes it takes; it's the restored independence, the avoided fall, and the prevention of a costly emergency room visit. The system sees the low reimbursement for the treatment but remains blind to the immense downstream savings.
A patient who comes to me with a somatosensory-vestibular mismatch (SVM) learns to trust their vestibular system again. They regain their confidence and can navigate their environment safely. The value lies in their ability to walk their grandchildren to the park, to enjoy social events without fear of falling, and to escape a life of isolation. These are priceless outcomes that a reimbursement code cannot capture.
The value we bring is a silent, powerful force. We reduce long-term disability, we help people avoid surgery, and we keep them active and engaged in their lives. But until we force the system to see this value, we will continue fighting a battle against an invisible enemy.
Making the Invisible, Visible
So, how do we fix this? The solution isn't just about raising rates. It's about changing the collective perception of our profession.
We must become experts in quantifying our value. We need to use outcome measures and robust data to prove that our interventions are not just effective, but also cost-effective. We must make the invisible visible.
We must also continue to advocate. This means supporting our professional organizations that lobby on our behalf to ensure that physical therapy is seen as a primary and essential part of the healthcare continuum, not as an optional add-on. Our role is not just important, it's integral. We must share our stories, both our successes and our struggles, with our patients and our communities so they can become our most powerful advocates.
Our fight isn't for more money; it's for recognition. It's a fight to show the world that a physical therapist's skill is just as vital as a military's might. And it's a fight we can win. By shining a light on the profound, life-changing value that we bring to our patients every single day, we can bring about the change we seek.
Brian K. Werner, PT, MPT, has been a physical therapist specializing in vestibular and balance disorders for over a quarter of a century. He is the National Director of Vestibular Education & Training at FYZICAL and a Substack article writer. His work, and the work of all physical therapists, is invaluable and deserves recognition.