Face Into the Storm

Abstract

America is about to experience a demographic shift of enormous magnitude: increasing longevity, declining fertility, and the aging of the baby boomers, which are triggering an enormous “age wave.” We are facing the challenge of limited access to health care services by millions of our citizens, and unsustainable cost escalation. In response, health care is changing fundamentally. In the 2012 McMillan Lecture, Jette discusses 3 critical “system skills” that physical therapists must develop to practice successfully in a changing health care environment. First, therapists must become interested in data. Second, they must become skilled in the ability to devise solutions for the system problems that data and experience uncover. Third, the physical therapy profession must develop the ability to implement at scale—the ability to get therapists along the entire chain of care functioning in concert, in collaboration. Jette discusses the American Physical Therapy Association's Vision 2020 as it relates to these challenges and the degree to which he believes physical therapists are equipped with the system skills needed to function within effective health care systems to identify what works in physical therapy, for what conditions, under what circumstances, and at what cost. Jette articulates a revised vision for physical therapy that includes being a leader in teaching systems skills to practice successfully in interconnected heath care teams; being a recognized national leader in implementing evidence-based strategies; using standardized collection, analysis, and dissemination of intervention and outcomes data as a regular part of practice to determine what interventions best improve the health of individuals and society; and being a profession that is a central player in devising, evaluating, and implementing cost-effective health care innovations for communities as well as for individuals.