The momentum behind physical therapists, the payers still holding on to an old picture of PT, and what new grads need to stay in the profession.

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Kyle teaches at Duke, spent years in hospital-based care as a board-certified neurologic specialist, and started PT school in 2001, when direct access and the DPT were the new conversation. He's candid about how hard it is to be a clinician right now, and he's optimistic anyway. Here's what you'll hear:

You're going to see your physical therapist. When Kyle takes his dog in, he's going to see the veterinarian. He says physical therapists put the "sent for PT" language on ourselves, and it's on us to make clear that patients come to see a clinical expert. He ties it to the century of referral-only, incident-to history the profession is still undoing, even with direct access in every state.

Nothing magic happens at minute eight. Dana points out that the eval and re-eval are the only codes for work only a physical therapist can do. The rest of the code set was built for an earlier era of PT education, and it misses the work we do without pay: coordinating care, reassessing, modifying plans, talking with patients between visits, and much more. Kyle's answer is outcomes. The data in your documentation is what moves payment toward value and complexity, and it's why APTA's Value of PT report keeps adding diagnoses as the evidence comes in.

Physicians already want their patients to see us. APTA's report on primary care physicians came back positive: they think their patients need physical therapists. They just don't know how to get patients to us. Dana calls it being "aligned with our primary care colleagues," and Kyle says he's stealing the phrase. After decades of turf battles, his message to the profession is "It's got to be a contribution, not a competition."

Keep PT in your signature. Kyle names the loan debt and housing costs newer clinicians face that he never did, and Dana gets personal about what it costs to be a PT in northern New Jersey. Kyle wants everyone who moves into other roles like insurance, administration, tech, or city council to introduce themselves as a PT first. Nurses and physicians keep their nursing or physician identity in every leadership role they take, and that's how they get advocates at tables where we're missing.

Cash-based practice is evidence. Dana worries that a profession serving only people who can pay out of pocket drifts away from mainstream medicine. Kyle agrees it can't meet society's needs, and he sees something useful in it: proof that people with the means will pay a lot more for what physical therapists do. He wants to use that proof to improve payment in network.

PT For Future Me. APTA's consumer campaign pitches physical therapists as the clinicians who keep you active 20 years from now and able to play with your grandkids. Kyle says the public and lawmakers are coming around. Private payers still picture PT as post-surgical care, and he wants a campaign aimed right at them.

Tech companies are coming to physical therapists. APTA treats AI as an opportunity and has an AI framework report on the way. Kyle points to the CSM exhibit hall as proof that tech now comes looking for us, and he reminds us the profession has adapted before: when polio disappeared, PTs moved with the technology.

Kyle is optimistic, and he backs it up with record years of state advocacy wins, bipartisan standing in Congress, and physicians and tech companies asking for more of us. Keeping that going is everyone's job, member or not.

Chapters:

00:00 Welcome, APTA President Kyle Covington

01:22 Where direct access stands now

07:39 The eval, the re-eval, and the work we don't get paid for

11:37 "Sent for PT" and the veterinarian test

12:55 Nothing magic happens at minute eight

16:15 Downstream spend and aligning with primary care

21:13 Burnout, loan debt, and what new grads face

26:23 Why PTs are leaving the clinic

28:20 Cash-based practice and keeping PT in your signature

31:20 PTs as experts in behavior change

33:08 PT For Future Me and public health

34:45 AI and technology

37:23 PT first and the case to private payers

39:27 Bipartisan support and record state wins

41:26 Wrap-up

A few quotes from Kyle to listen for:

"We've known for a long time that nothing magic happens between minute eight and minute nine, or minute fifteen and minute sixteen. The magic that happens is the exercise prescription and the clinical expertise that we apply."

"We need to own that you are coming to the expertise of this clinical expert. You're going to see your physical therapist."

"They all think that their patients need us. The misdirect is they don't know how to get their patients to us."

"It can't be a competition anymore. It's got to be a contribution."

"They face a world outside of PT from a loan burden standpoint, from a cost of buying a house standpoint that I didn't face when I was coming out of PT."

"What it is doing in a way that we've never had before is showing that society is willing to pay a lot more for our services."

"PT is in my signature. PT is what I was trained to do. And it's because of my PT training that I'm so good at this other role."

"We're your provider that's going to keep you active two decades from now. We're your provider that's going to make sure you can play with your grandkids."

"It's technology saying, you know what we need? We need physical therapists."

"You chose this profession, and it's all of our collective responsibility to grow that fire."

Find the full transcript and Kyle's bio here.

Follow Kyle on LinkedIn here.

Download the APTA's Report "The Economic Value of Physical Therapy in the United States." Linked here.

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Want information on PT and OT reimbursement and opportunities in policy and advocacy? Read Dana's guest post series for OT Potential here: How OTs and PTs Get Paid and Therapy and Value-Based Care Models.