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Future-Proof PT

Future-Proof PT

Von: Dana Strauss PT DPT and Alex Bendersky PT DPT
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Want to stay ahead of the curve in physical therapy? Future Proof PT brings you straight-talking, no-nonsense conversations about what really matters in healthcare today. From dissecting policy risks and opportunities to exploring innovative practice and payment models to practical ways to accelerate your career growth, we're your go-to source for understanding the forces reshaping our profession and the healthcare industry at large.


Through candid dialogue and real-world perspectives, we're building a community of forward-thinking professionals working both in and out of direct patient care. They aren't just adapting to change – they're shaping it.


Whether you're looking to understand market dynamics or seeking professional growth, each episode delivers actionable insights that will transform how you view the future of healthcare. Come join the conversation!

Copyright 2025 Dana Strauss, PT, DPT and Alex Bendersky, PT, DPT Hygiene & gesundes Leben Politik & Regierungen Ökonomie
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  • Episode 33: How Physical Therapists Prove Their Value in Value-Based Care

    Episode 33: How Physical Therapists Prove Their Value in Value-Based Care
    Jul 25 2026
    VA Leader Brian Westlake, PT, DPT, Cert MDT on how to impact total cost of care, what it means to control healthcare spending in a fixed budget and how primary care is crucial, outcomes-accountable care, and MSK triage in primary care.After 25 years leading inside the Veterans Administration, Brian Westlake came away certain that future of the physical therapy profession depends on moving upstream, into the primary care team.He saw it firsthand. As an executive overseeing a ~$400 million budget in the Bronx, Brian watched primary care teams do what fragmented, downstream care couldn't do. They keep budgets viable and get patients the right care as early as possible. He has a high conviction that this is a better model for PT and that it's the only way the profession secures its future, steps fully into its role in the healthcare system, and has a bigger impact on patients.He starts off with the story of four patients, all sent to him for evaluations for shoulder pain. Two actually had a neck, not shoulder impairment, and some had already gotten injections and an MRI of the shoulder before anyone screened the spine. It's exactly the wasted downstream spend that earlier PT contact is built to prevent.Dana, Alex, and Brian get into:– Why PTs belong at the front of the system as the MSK triage point of contact– The VA's PACT model, and why MSK should follow behavioral health into primary care– Outcomes-accountable care and the IMC model (25% MSK cost reduction, at risk)– The Choice Act and Mission Act, and how community-care spend exploded– Telehealth that actually scales: e-consults, store-and-forward, video-to-home– Why weak outcomes collection is the thing holding PT back– Speaking the language payers reward: total cost of care and "days at home"Brian's message to the profession: We've earned a seat in the broader healthcare arena, we underestimate our own impact, and we can't afford to wait. We have to demonstrate the impact we can have so it becomes the norm for primary care providers and patients alike.Tune in for the rest of the conversation!Chapters00:09 — Introduction: Brian Westlake’s VA career and virtual PT practice03:35 — What it means for physical therapy to move “upstream”10:47 — The value of early MSK assessment in primary care13:37 — Building primary-care teams with embedded PT support17:23 — The need for standardized, outcomes-driven PT care18:42 — Integrated MSK Care: accountability, outcomes, and lower downstream costs23:17 — How the VA evolved: outpatient care, the Choice Act, and the Mission Act29:56 — E-consults and telehealth as tools for access and triage36:25 — Why outcomes data matters for PT’s future and AI39:09 — Proving value through total cost of care44:41 — The practical barriers facing independent practices47:28 — Primary care as the path to innovation and scale48:46 — Advocacy, interoperability, and avoiding professional stagnation51:06 — Why Brian is optimistic about PT’s future54:54 — Closing: start small, pilot partnerships, and move forwardFind the full transcript and Brian's Bio here. Follow Brian on Linked In.About the show: Future Proof PT is a podcast for physical therapists, physical therapists assistants, and others who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant 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.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.
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    55 Min.
  • Episode 32: The Physical Therapist, The Big Cycle, and The Age of AI

    Episode 32: The Physical Therapist, The Big Cycle, and The Age of AI
    Jul 4 2026
    Plus, Ray Dalio's framework for how systems break, applied to the profession's financial reckoning and its AI future(note: this episode was published before the CMS 2027 Physician Fee Schedule Proposed Rule was published)Is physical therapy heading toward its own financial reckoning?In Episode 32, Dana and Alex run MSK care through the same systems logic Ray Dalio uses to explain how countries go broke. Here's what you'll hear:How physical therapy goes broke. Large systems are already taking write-offs and defaulting as payers stop feeding operations that don't return what they promised. Alex makes the case that these are the first signs of a two-to-three year restructuring, and that it's predictable if you know the cycle.Your evaluation pays $90. Your treatment pays $30. The system is already telling you where your value is. We get into why that gap exists and what it should change about how you design your day, your team, and your top-of-license time.Your patients are already grading your plan of care with ChatGPT. A time-constrained patient can drop their symptoms and your plan into AI and ask "is this any good?" in thirty seconds. We talk through what that means for how defensible your plans need to be, starting now.The money is moving to primary care (even in fee-for-service), and PT is sitting in the specialty bucket. Advanced Primary Care Management codes, capitation tests in ACO models, and a closed-system reality where dollars flowing to primary care flow away from the rest of us. Dana lays out a four-to-six year forecast and why PTs need to fight into that definition before it hardens.Your discharges might be creating your own return visits. Tissue remodels over months and years. An episode of care runs days and weeks. We unpack that mismatch and why treating to symptom relief (often with unnecessarily high visit frequency) keeps sending patients back through the door.AI is safer than your intuition wants to believe. Iatrogenesis is one of the largest preventable costs in medicine. Bring in the Waymo that has never had a fatality, add the difference between training and tuning these models, and you get a real role for clinicians as the people who tune them.The optimistic close. Done right, AI plus interoperability finally plugs PT into the rest of the medical system and makes the work more individualized, more rewarding, and more visible. Or you can keep your paper charts and your goniometer.Chapters:00:10 Introduction to Payment Stressors in Healthcare01:43 The Evolution of Physical Therapy and Payment Reform05:30 The Impact of AI on Healthcare Delivery09:53 Revolution vs. Evolution in Healthcare Systems14:01 The Future of Payment Models and AI Integration19:30 AI's Role in Healthcare Precision and Transparency21:05 Access Challenges in Urban vs. Rural Healthcare22:52 Understanding Access Problems in Healthcare25:02 AI's Impact on Healthcare Access26:51 Network Adequacy and AI's Potential29:08 AI Safety and Bias in Healthcare31:16 The Future of Physical Therapy with AI33:48 Embracing Change in Healthcare DeliveryFind the full transcript here.Referenced in the episode:Dr. Chad CookDr. Trevor LentzRay Dalio's booksCMS Physician Fee Schedule home pageMedicare Shared Savings ProgramACO REACH ModelLEAD ModelACCESS ModelACCESS Model: landing page for referring and co-managing clinicians (including PTs and OTs)Advanced Primary Care Management services and codes under the Physical Fee ScheduleDuke research finding removing financial barriers to physical therapy led to more evidence-based care and cut unnecessary healthcare utilization."Healthcare Dive's" coverage of the Hinge Health IPOWaymo's March 2026 landing page covering their safety dataAbout the show: Future Proof PT is a podcast for physical therapists, physical therapists assistants, and others who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant 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.Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.
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    36 Min.
  • Episode 31: Physical Therapy is the Swiss Army Knife Profession

    Episode 31: Physical Therapy is the Swiss Army Knife Profession
    May 25 2026
    Duke's Dr. Chad Cook on the 5 things MSK therapists obsess over, and what we should be doing insteadA VA physician once told a colleague of Dr. Chad Cook's that physical therapy isn't really the movement profession, it's the Swiss Army knife profession, because PTs do a little bit of everything. Whenever no one else knows what to do, the patient gets sent to PT to "get it sorted out."Chad isn't sure he disagrees. In this episode, Chad joins Alex and Dana to walk through five sacred cows in MSK physical therapy. These are the things clinicians treat as essential that, in his view, matter far less than the profession believes, and the skills we should be leaning into instead. Chad is a tenured professor at Duke University with appointments in Orthopaedics, Population Health Sciences, and the Duke Clinical Research Institute. He's been a PT for 36 years, a health services researcher for 27, and is one of the most cited voices in our field.What we cover:Why the "movement expert" identity has limited what PT can become, and the cost of letting ourselves be bucketed as specialists when so much of what we do is primary careWhere tissue-specific diagnosis still matters (red-flag screening) and where it really doesn't (the 56 SIJ tests, the rotator cuff special-test rabbit hole)Why treatment specificity often doesn't drive outcomes, and what therapeutic ritual, contextual packaging, and alliance actually doHow the top 10% of clinicians handle session-by-session symptom fluctuation without losing the long-term trajectoryWhy social media arguments about exercise intensity and volume miss the point, and what behavior change should look like insteadPlus three threads that emerged outside the five-things framework:The case for training prognosis communication with the same rigor as diagnosis, and why patients are really looking for someone who can tell them what to expectWhat top US psychologists told Chad about the power of physical touch: "You're lucky. You can put your hands on your patients. We don't have that." — and why it's a privilege PTs underuseThe phrase from one of Chad's fibromyalgia patients that frames what he thinks PT actually is: "negotiated behavior change"Dr. Cook shares some uncomfortable numbers that we need to face to address.-75% of PT referrals never initiate,-30% drop off after the first visit,-and MSK patient outcomes have actually gotten worse over the last two decadesPlus, where Chad sees AI, digital-first care, and lifestyle medicine fitting in.Chapters00:00 Introduction to Dr. Chad Cook02:56 The Identity Crisis in Physical Therapy05:47 The Role of Physical Therapists in Primary Care08:33 The Precision Paradox in Treatment10:51 The Emotional Aspect of Diagnosis13:29 The Transition to Self-Management15:41 The Impact of Digital Health Solutions18:20 The Future of Physical Therapy28:45 Navigating Uncertainty in Healthcare30:45 The Digital Transformation of Health Systems32:08 The Role of AI in Patient Care36:51 Understanding Patient Recovery Trajectories39:36 The Importance of Prognosis in Therapy46:04 Redefining Exercise and Patient Engagement50:48 The Power of Touch in Therapy55:22 Negotiating Behavioral Change in Healthcare59:09 The Future of Physical TherapyFind the full transcript here.Related: Episode 30 with Dr. Trevor LentzAbout our Guest:Dr. Chad Cook is a tenured professor at Duke University with appointments in the Department of Orthopaedics, the Duke Clinical Research Institute, and the Department of Population Health Sciences. He is a physical therapist with more than 36 years of clinical experience, an active health services researcher, and a clinical board member for multiple healthcare organizations. Dr. Cook has been involved in securing over $16 million in external funding and has authored more than 450 peer reviewed manuscripts, 46 book chapters, and four textbooks. He has delivered over 100 keynote lectures across 40 countries.Chad’s recent article in Journal of Orthopaedic and Sports Physical Therapy: Many Paths to Recovery: The Case for Treatment Pluralism.About the show: Future Proof PT is a podcast for physical therapists who want to think beyond the clinic, about policy, payment, identity, and the future of the profession.Hosts: Alex Bendersky and Dana StraussWant 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."Follow Dana Strauss on Linked In.Follow Alex Bendersky on Linked In.Subscribe to the Future Proof PT Linked In page.Subscribe to the Future Proof PT YouTube Channel.Subscribe to our newsletter and email list.Subscribe to our sister newsletter, Timeless Autonomy, Dana covers health policy insights and career growth tips for healthcare professionals and sends a weekly newsletter (nearly) every Sunday evening.
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    1 Std. und 1 Min.
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