Darwin’s theory says that the fittest are those that survive. In my experience, it’s not just about strength, but about intelligence, and the willingness to adapt. Never was this truer than today in our profession and within PTPN.

Looking back over our 25-year history, we can see that our “species” (independent private practitioners) has survived a number of evolutionary challenges that seemed threatening at the time, but which we collectively turned into opportunities. By sticking together and leveraging our power as a network of dedicated, highly qualified professionals, we’ve been able to survive crisis after crisis.

Viewed from the perspective of our current industry upheavals, these insights from the past can help us now. Here are a few lessons in survival worth revisiting:

Getting a seat at the table
When the concept of managed care took over the healthcare scene in the early 1980s, and California passed legislation allowing the formation of PPOs, we were all fearful that therapists in private practice would be shut out of the contracting frenzy. Instead of going the way of the dinosaur, we found a solution by founding PTPN. As the nation’s first specialty network of private rehab therapists, we secured our seat at the managed care table. Then, by establishing the PTPN Quality Assurance Program, we captured the attention of payers that recognized the value of PTs who were held to the highest quality standards in the industry. Beginning in 1990, we built the PTPN network across the U.S. so that we could offer not only local and regional contracting opportunities, but also national relationships as well.

Keeping independent therapists independent
As managed care increasingly dominated the healthcare landscape in the late 1980s to mid-1990s, our world was rocked by a wave of consolidation. Fearful of the future, many therapists sold their practices to such corporate giants as HealthSouth or NovaCare, or went to work for physicians. During that period, PTPN aggressively spread the word to payers about the negative effects of corporate- or physician-owned PT services (POPTS), including testifying before Congress in 1995. Since then, that advocacy has continued through our involvement in the APTA POPTS Task Force and ongoing discussions with PTPN members on how they can fight physician referral-for-profit. Together, we’ve proven that the therapist-owned private practice model can withstand the pressures of competing models.

Adapting to change is the key to survival
Coping with an ever-changing payer landscape is no easy task. Dealing with the occasional contract cancellation or drastically reduced reimbursement is daunting. Looking at the lessons of the past, we can see that the sky actually didn’t fall with a particular setback. The PTPN network, and the vast majority of our members, those who learned to adapt and not panic in the face of change, bounced back then and continued to do so. For example, early in PTPN’s history, one of our flagship contracts was a large self-insured utility company. After eight years, the contract was terminated when the company decided to change from self-insurance to third-party insurance coverage. It was a tremendous blow at the time, but PTPN was able to bring in other business and provide other value to our members. And now that company is again self-insured, and is again, a PTPN customer. In fact, it has also become an AccessPoint client in which PTPN makes the workers’ comp patient appointments with PTPN member offices. This experience is just one of the lessons that have taught us patience and perseverance.

Click here to take a look at some other cyclical events, and how we’ve banded together succeeded in turning crisis into opportunity.

So what have we learned from these history lessons?

• First, we need to keep our heads when all around us are losing theirs. What looks like today’s crisis can be, and usually is, tomorrow’s opportunity. We must think strategically and long-term about our options, and avoid short-term thinking and reactions that we will later regret.
• Second, we must be flexible. There’s no guarantee that the career path and practice model that we envisioned upon graduation will last a lifetime. The only constant in our profession — and in life — is change.
• Third, there is creativity and power in banding together to find solutions to our dilemmas, whatever they may be.

We’ve seen these truisms work for our benefit over the last 25 years, as we’ve all adjusted to, and survived, the evolutionary cycles in the healthcare world. By staying this course today, we can continue to not just survive, but thrive well into the future.

Michael Weinper, MPH, PT, is president of PTPN. Please contact him with your thoughts on this blog.