Our next interview was one we have been very excited to share. We had the privilege to sit down with Dr. Marilyn Moffat. She was the president of the New York Physical Therapy Association, and the American Physical Therapy Association. Most recently, she was the immediate past president of the World Confederation of Physical Therapy (now World Physiotherapy). Dr. Moffat has been an instrumental part of what Physical Therapy is today. She helped advocate to establish DPT programs in the US. She is currently a faculty member as well as the director of the DPT Program at New York University.
Dr. Moffat is a ABPTS Geriatric Clinical Specialist, a Certified Strength and Conditioning Specialist, a Certified Exercise Expert for Aging Adults, a BoneFit® Professional, and a Certified Rock Steady Boxing Clinician. She has numerous clinical qualifications and certifications. In addition, she is also an incredible teacher and role model for PTs and students. This is especially true for those who are lucky enough to be part of the NYU DPT. Our team is so lucky to be able to study under such an influential part of the physical therapy profession.
Tell us about yourself
I’ve been a physical therapist for a long period of time as you all know. I have loved this profession and what I have been able to do for it. I’ve had the good fortune of every morning when I put my feet on the floor, I never even thought that “I don’t want to do what I am doing”. This, I think, is one of the joys of any kind of career, and certainly any health career. I’m a geriatric clinical specialist. My primary areas of interest are cardiovascular/pulmonary and geriatrics. I’ve taught in those areas in multiple environments all over the world.
Why Physical Therapy?
My career choice was not initially physical therapy. To give you a bit of background, I come from a business family. My dad was on Wall Street, and I worked for him for 5 summers. I was probably one of his best employees. But, in those days there were no role models for women on Wall Street. Hence, dad never thought of asking either of his daughters into his business. Whereas his partner’s three sons all went into the business.
Why did you start?
So I started in education, as many did in my era. I taught at the high school level, and I just knew this wasn’t for me. Luckily, I had a physiology professor who was also a physical therapist. He suggested I spend a little time at the NY State Hospital in Haverstraw to take a look at PT. So I spent some time there, and I absolutely loved it. I saw things that you would never be exposed to now. This includes youngsters with scoliosis who were in full body casts to derotate the curves. I thought this is for me.
This was during the early summer. I looked at programs in the New York area and saw New York University. At the beginning of June, I applied and was accepted for September as a certificate/post baccalaureate student. I eventually did my transitional DPT many many years later. Actually, as I look back now, if the profession had followed the post-baccalaureate certificate model and moved it to a post-baccalaureate degree very early on, we would have been far better off a lot sooner.. It just took us so long to get to DPT education.
How has your leadership developed as you continue practicing?
Very definitely yes. I have had the good fortune of having leadership roles almost all throughout my life and started very early on with the Greater New York District of the New York Chapter and served as Chair of the District. Then, I edited the Chapter Newsletter, served on their Board of Directors and eventually was elected President of the New York Physical Therapy Association. That led to major involvement in many areas in the American Physical Therapy Association and then to my election as President. My most recent Presidency position was with the World Confederation of Physical Therapy.
I had developed a real concern for where physical therapy’s standing was early on. That was what led me to be a very early early vocal proponent of DPT education. My colleagues in education thought I was crazy in those days. But, still, my instincts proved to be where the profession should be. We [NYU] were not the first program to get accredited, since we got mired down in NY State politics, but we were one of the first four, and we actually were the very first program to submit a proposal to the NYS Department of Education in 1984.
Tell us about your journey to become president of the APTA?
My journey to leadership probably started in the second grade, when I was elected class president. I wasn’t even in school that day and I still got elected. So, I think leadership was innately in my being. I also had parents who set a great example for me which was extremely important as well.
As I indicated, I started working with the APTA at the district level here in New York. I eventually started taking on just one more thing after one more thing. I was always one who thought if you want change to occur, you have to be there. Otherwise, don’t complain about it. So, that’s how it started.
When I was elected president of the New York PT Association, we embarked on a legislative program that the state had never done before. We had a very antiquated practice act. Physical therapists were licensed to do high colonics and other things that are just unheard of now. But we recodified that and got together a practice act that reflected physical therapy practice.
We tried to go for direct access even then, but the medical society, as we well know, was very influential in opposing our change. So we slipped in that we could prevent and examine without practitioner referral. But we couldn’t treat without referral. So the medical society said that was ok, as long as we needed a referral to treat.
Throughout the ensuing years, I continued to work with the NYPTA Chapter to change the referral requirement for treatment. At least for now, we have 30 days or 10 visits, whichever comes first in the way of direct access practice in NYS. This is still not total unrestricted direct access, but hopefully the physical therapists working on legislative issues will eventually get this necessary change.
When and why did you start teaching?
Well I came from an education background. So I, unlike most PTs, had a very strong background having a minor in education at the baccalaureate level. I did student teaching, and I knew about educational theory, unlike those physical therapists who often go from PT practice into education. Teaching was also an inherent part of my life. I started part time teaching, and then I went to full time teaching here at NYU along the way completing a master’s degree and a PhD degree.
What is your vision of the physical therapy profession?
There are so many changes occurring right now. I’m concerned with the corporate takeover of physical therapy practice. I hate to see all these small independent practitioners being bought up by the bigger corporations. I say this because I think it eliminates a lot of the wonderful opportunities that I have had as a private practitioner, and that many of my colleagues have had as private practitioners. So that is certainly a concern, and I think it is going to be more and more difficult as time goes on with increasing corporate takeovers. I would really love to see the mom and pop practices and the solo or small practices entrepreneurs have the chance to really thrive.
What barriers do you see that must be overcome to reach this vision?
I have a concern about the whole arena of telehealth, and the virtual provision of services. You may not know this, but there are essentially 13 companies, with major backing from the insurance companies, that are providing physical therapy like services via telehealth without a single PT on staff and services being given by health coaches. APTA has been trying to indicate that one cannot call it physical therapy unless it is provided by a physical therapist. For me, this an area that we as PTs really need to look at very carefully.
There’s also the whole reimbursement arena, and the problem that you all are facing [new and upcoming PTs], is the student debt. But really, it is not student debt that is the problem. It is that you don’t make enough when you enter the profession. This is due in large part because there are too many programs (over 600) in this country. They graduate so many PTs and PTAs that employers have many to choose from. In addition, they have no need to pay wages that are appropriate for the education. CAPTE continues to approve more and more programs in this country every year. I would hope that in the future there is more of a balance of supply and demand. When I was president of the APTA, we did a study looking at supply and demand which is a critical need today.
Advice for pre PT students or current students?
For me, physical therapy is truly a wonderful profession, and I think in spite of all the constraints and pressures placed on practice by insurers, policy makers, and corporate environments, it is still one of the few professions that we get to spend time with individuals and really make a difference in their lives. Physical therapy offers a multiplicity of opportunities. From an agenda perspective, women and men have a lot of opportunities in PT – it can be a flexible profession that allows you to practice full time, part time, time and a half, allows you to completely scale back when family responsibilities may supersede all else, allows you to practice, to teach, to do research, to consult, to be an administrator, and to do many other activities related to the profession.
Any advice for practicing physical therapists?
The more open minded you are, the more opportunities there are for you in practice. I do provide services for many patients with orthopedic problems or sports injuries. But, for me, I love to see those aging patients who have multiple comorbidities and who are faced with many life challenges begin to live lifestyles that they thought were no longer possible under my guidance and our work together. The same thing with my patients with cardiovascular and pulmonary problems. I think that there are incredibly exciting and challenging opportunities in ICUs, in step down units, and in other practice environments to learn and to grow as a professional. But regardless of the route one chooses to follow, be sure that you are providing the absolute best, highest quality services that you are able to provide.
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