APTA Nebraska Podcast
The APTA Nebraska Podcast dives into the stories, challenges, and innovations shaping physical therapy in our state. We’re here to advance, promote, and protect the practice of physical therapy, build our community, and optimize the health and quality of life for all Nebraskans.
APTA Nebraska Podcast
E10 - APTA House of Delegates Update: Conversation with Bobby Griese and Ian Thompson
APTA Nebraska delegates share insights from the House of Delegates, revealing how key votes on professional policies and bylaws shape the future of physical therapy practice across the state and nation. The podcast explores the inner workings of APTA governance and highlights critical changes that impact all physical therapists and assistants.
If you're interested in getting involved with APTA governance, reach out to our current delegates. APTA House of Delegates
Links:
Primary Care:
APTA Federal PC SIG Canva Presentation
Competency Based Education:
New APTA Report Details Performance Outcomes for PT Entrance Into Practice
Welcome to the APTA Nebraska podcast, where we dive into the stories, challenges and innovations shaping physical therapy in our state. We're here to advance, promote and protect the practice of physical therapy, optimizing the health and quality of life for all Nebraskans. Join us as we connect with experts, share insights and build communities throughout our profession. Connect with experts, share insights and build communities throughout our profession. Welcome back to the APTA Nebraska podcast. I'm Brad Dexter, your host, and I'm joined by Bobby Greasy and Ian Thompson today, who are going to share a little bit about their time at the House of Delegates in July. Guys, welcome to the podcast.
Speaker 2:Thank you very much. Thanks for having us.
Speaker 1:So just a little bit of background. If you're not as familiar with how the House of Delegates works and guys, feel free to jump in and correct me on anything that I miss. Here there's a House of Delegates that is responsible within the APTA for continuing to kind of move our profession forward. Is that a fair way of explaining that? Yep, continuing to kind of move our profession forward Is that a fair way of explaining that? You guys, on behalf of our state, you were there as a delegation. You're voting on motions that are on the floor. Part of that process is just recognizing that physical therapy as a profession continues to evolve and change and we need to make sure that you know what we. You might have to help me with the language behind this, but what we're writing about our profession is kind of catching up to that as well. Is that fair to say?
Speaker 2:In a nutshell In a nutshell.
Speaker 1:I'm sure you could describe that much better than me, but you were telling me before, bobby, that, okay, there are 438 voting delegates at the House of Delegates. That does not represent everyone that's there, necessarily. I think there's a natural question then of well, how do you know how many delegates you get for each state? That's representative of the amount of members that you have in your state chapter, right?
Speaker 2:So state membership and we have five voting delegates and we're super close, so if we got anybody on here that wants to become a member, then we could ultimately get up to six voting delegates okay, so our voice, then, as a state within the APTA, as a national organization is, is just a little bit louder than with, you know, another vote right, like, like, north Dakota only has two voting delegates OK, because their membership of course is not very large.
Speaker 2:Up there, alaska too, I mean, there's these small states and they all have two. So we are actually pretty lucky in Nebraska to have five, because we're still a small state, but we have five voting delegates because our membership is so strong.
Speaker 1:It's so high. That's great, yeah, okay, so, as membership chair, there's everything you need to know. We need more members and it's valuable because it gives us a voice at that national level too. Thanks for saying that. I appreciate that. So you guys I was looking through, kind of, the agenda for House of Delegates. There were 48 different motions that you guys had to look through. Can you maybe just share with the audience? When do you get those motions? How many pages are there? What's your responsibility to read through those motions before you actually end up on the floor and voting on these things?
Speaker 2:Yeah, so we are changing with the times and developing our motions differently now than we have in the past, and so our first phase from February through April, was motion concepts, and so we have this hub online through the APTA and all of us chief delegates and delegates have the motion concepts in front of us and there's discussions through emails that go around for the first three months of developing a motion, and we didn't bring a motion to the House that wasn't in concept form to start with. So I don't know if that's confusing. So we're going from concept to motion. If the concept is not accepted, then it doesn't become a motion and then, once it becomes a motion, then we start to work on dialogue about that motion and then we don't debate, and that's confusing, I know, but we don't debate a motion until the House comes about in July.
Speaker 1:Okay, so I mean in other words like, yeah, you can't, you don't want to have 100 motions that everyone's responsible for, and so there's a process that you go through to even get that concept or idea to become a motion, something that's valuable enough that House of Delegates needs to actually vote on that enough that House of Delegates needs to actually vote on that.
Speaker 2:In the past couple years we've had a couple of motions that haven't been seen as something that's beneficial to the association, and so the board and the directors and everybody is trying to develop a process that's more transparent so that everybody has a say all 438 voting delegates have a say before it becomes a motion, to make sure that it's something of value to the association.
Speaker 1:Okay, so that kind of happens between February and April and then it moves into motion. You guys get those motions, review them, and then you have a chance to vote on them at House of Delegates, right?
Speaker 2:So, just to give you an example, we had over 3,000 emails in our motion concept development. That's very busy. That's a lot of people giving input and getting input, because it's not just somebody telling you what they think, it's also there's questions and then answers from the APTA staff and answers from the board of directors to kind of help guide our thought processes.
Speaker 1:Okay.
Speaker 2:It's busy. I looked at my emails every day.
Speaker 1:Wow, that's maybe a good place for me to pause and remind people that you guys also have full-time day jobs, right?
Speaker 2:Yep, bobby, you're in Shadron, yeah, I can tell you a little bit about that. I'm out in Shadron, nebraska, of course, a small rural community hospital. I've been practicing 23 years. I've been a delegate since 2004, and I've been a chief delegate since 2017. I have a lot of experience in the governance process and I just have a lot of experience on how we of experience in the governance process and I just have a lot of experience on how we've evolved in the governance process, because before there was no computers, you didn't bring your laptop. There's no cell phones. We just had three ring binders of hundreds of papers.
Speaker 1:Wow, yeah, that means a heavy backpack.
Speaker 2:It was, everybody had a heavy backpack. That means a heavy backpack.
Speaker 1:It was. Everybody had a heavy backpack. And, Ian, can you tell our audience where you're located and what you do too?
Speaker 3:Absolutely. I am an instructor in the DCE at Southeast Community College in the PTA program. I've been the well. Originally I was a caucus rep and I can talk a little bit later about how that's evolved. Rep and I can talk a little bit later about how that's evolved. But I was the caucus rep I was elected in. I believe 2020 was my first house. I want to say I was elected in 19,. Actually, 2020 was the first house which was a COVID house and I've been going to them since. We've since changed to the engagement group and so it's our role in governance is just a little bit different than it was prior, because now we have two voting delegates that are part of the PTA council and so we help to steer their decisions when they go to the house floor and vote.
Speaker 1:Okay, thanks, yeah, thanks. Thanks for giving us just a little bit better idea of the fact that, oh yeah, you guys are working all long and then you're maybe having to sift through 3000 emails over the course of a motions. That was on the floor and I'll bet our podcast listens would be at maybe like one. It would be my mom who would probably last through that entire thing. But I do want to hear from you guys you know what kind of stood out during your time at House of Delegates what do you think would be of value for our membership in our state chapter in Nebraska to be aware of?
Speaker 2:Yeah, thank you for that question.
Speaker 2:So just a little background. The governance process for the American Physical Therapy Association is our House of Delegates and we are elected by the state. But then there's also sections that will elect two members and, like Ian said, the physical therapy council now physical therapy assistant council has two members that are voting, so 438 votes on the floor. We try to encompass every aspect of physical therapy, so it's education, it's clinical based, and then this year was a bylaw year. So then it's also something as important as code of ethics, mission vision. All those sort of things are brought forth and voted on by the House of Delegates. Again, this year was bylaw year. On the zero years and five years we bring forth bylaws.
Speaker 2:Code of Ethics was our most important bylaw this year. It's been a four-year process by a task force Gail, I was saying earlier, gail Jensen sat on this task force from Creighton University. She's just a wealth of knowledge in the ethics area and what was brought forward is we brought together PTA code of ethics and PT code of ethics and made one solid document. Some of the verbiage was debated a little bit on the floor and felt that it wasn't powerful enough, but when it all came down to it. We adopted the code of ethics with almost a unanimous vote and got a very good document going forward. For any litigation, for any problems that you see in your day-to-day actions with coworkers, please use that code of ethics as a resource for moving forward, cause I think it'll stand up for at least the next 10 years as far as how we're going to practice physical therapy.
Speaker 1:Can you guys maybe either one of you would you be able to talk about like why? Why is it important that the PT code of ethics and the PTA code of ethics kind of merged together?
Speaker 2:Yeah, I mean Ian can can jump on this too. But as far as having two different documents, they didn't. They didn't coincide with today's practice standards, and so what they did, instead of having you go to two different documents, is they just molded it into one universal document for both PTs and PTAs. Just to you know, help the public, help lawyers understand how physical therapists should practice so that when they're looking at these different ethical dilemmas, then you don't have so many documents.
Speaker 3:And I think the one thing too is when we're looking under physical therapist practice in general, that's where the physical therapist assistant falls is under physical therapist practice, and so having as looking at us as a team versus separate, then we're we're all, all should be, we all should be ethical right, we all should be doing what's best for our patients, what's best for the profession, those types of things. And so having one document that serves physical therapist practice the best, with the physical therapist assistant falling under that just was it just made sense?
Speaker 1:Excellent. Thank you, and Bobby, I think I cut you off a little bit. Did you have anything else that you wanted to add on the bylaws?
Speaker 2:Well, as far as the bylaws go, I think it's important for members in the state of Nebraska to know that litigation can come about because of documents from the APTA, and so it's really important that we keep up to speed with what's happening in the country, because we have had trouble with physical therapists across the country. There's no specifics and we can't name anybody, but we've had litigation against physical therapists because of different core documents through the Physical Therapy Association. So the board and the APTA staff was really big this year in how we worded our documentation that we passed in order to protect every physical therapist, not just the members. Now, the members, of course, are, so to speak, the most important, but it also protects just everyday practicing therapists too, because the association only represents 30% of practicing physical therapists across the nation. So it's important to also give those non-members some assistance as well, and so the APTA Code of Ethics is one of those documents that can move across the association and to the non-members. But as far as passing the documents, we're most concerned with our membership.
Speaker 2:Okay, so I did. You know, as far as bylaws go, it's different every five years on what our practice standards are and how they're changing. So, for instance the code of ethics was adopted. So that means that it was this fresh document that had never been seen before by the house because there was two code of ethics for PTs and PTAs. So then we molded together. So the adoption of that RC was different than the other seven, because then the other seven were just amendments to already standing bylaws and they didn't all pass either. So that's kind of interesting that the House of Delegates didn't feel like the changes that needed to be made. From the mainly the board brings forward the bylaw amendments, mainly the board brings forward the bylaw amendments. They didn't feel like those amendments were of enough substance and so some of the bylaws failed, which is kind of ironic because then we'll have to wait another five years.
Speaker 2:We can see bylaws every year but you have to vote them in to a non-bylaw year by a two-thirds vote and sometimes that can be pretty tough to get in. But I want to highlight one more bylaw. As far as an amendment goes and I want Ian to talk a little bit about this we voted in an amendment that gives the physical therapy assistant a chance to run for a director position, and a director is one of nine people on the board, the executive board that governs the House of Delegates. So you have APTA staff, you have the board of directors and then you have the House of Delegates, is the governance for the American Physical Therapy Association, and so that might be a little confusing to people. And again, I'm always up for answering any questions if I get emails or phone calls or whatever questions you have about the governance of the American Physical Therapy Association, because I don't ever get too many people that are interested in it. So I would entertain any and all questions if it's confusing, because I'm sure it is to some people.
Speaker 1:Now, Ian, why don't you maybe fill us in a little bit more?
Speaker 3:All right, I will talk about RC525, which was a bylaw change that would grant the PTA an opportunity to serve on the board of directors, and originally we had hoped that we would have a physical therapist assistant that would have a designated spot on the board of directors. This was an RC that was brought forth by the state of Oregon and the PTA council. Just a little bit of background In 2015, there were three bylaws that were brought forth and, just like Bobby said, bylaw years are the fives and the zeros, and so there were three bylaws in 2015 that were brought forward. One was to give the full vote to the PTA at the component level. The other one was to allow a PTA to serve as a chapter delegate and the third one was the opportunity to serve on the board. Well, that's taken a little bit of time, but in 2015, we got the first one with the vote at the component level, and Nebraska was one of those first eight states that voted that through right away, so we were pretty happy about that. Two years ago, we now voted in an RC that bylaw change that would allow the PTA to serve as a chapter delegate. So we were at two out of three of those original bylaws from 2015.
Speaker 3:And so the board of directors one was pretty important to us the AOTA, or our friends, our occupational therapy friends. They do have a bylaw that designates one particular position or one position on their board of directors to a CODA, but it doesn't limit the number that that can run. And so currently there's two CODAs on the board of directors for the AOTA, and so that's something that we were really hoping for, and there was some debate. There was an amendment that was introduced pretty much right away that asked that, instead of a designated position, that a PTA could run as an at-large person for those positions. And you know, initially I think we were really hoping for that one position, because it may be difficult for a PTA to to win one of those positions against a PT, but there are some really, really good candidates out there right now. So that was something then that we really thought a win is a win, so whatever could get us across the finish line, at least allow us to potentially have that voice.
Speaker 3:We have a lot of PTAs out there that are in leadership already. There's's some, as myself, that serve on the exec board at the state level. There's PTAs that are clinic owners and so allowing them to have some of the same voices that our PT friends have as well. We thought was pretty important. So we were pretty happy about the bylaw and we were okay with that amendment because now, instead of the one designated position I mean technically, there was some talk about whether a PTA could, essentially you could have eight on the board, which will never happen because there's a nominating committee that's going to be in charge of helping to build that slate to begin with, but it did allow the opportunity for us to maybe have more people. So, like I said, the AOTA has one designated position but right now has two COTAs that sit on their board, and so we do have the opportunity to run as a board of directors for board of directors position, and so, whether it's one or whether it's two I know it will never be eight, but just the fact that we can have one I think was a really big win for the PTAs and there were I want to say at the end there were 17 co-sponsors to that and it passed pretty easily. So we were happy about that and just the wins that we've seen for the PTAs.
Speaker 3:I think there was a disassociation for a while with the association itself with the PTAs, because we used to have a vote and they took the vote was taken away. But now we've gotten back to that full vote. Now we have two voting members, now we can run as a delegate position and so all of those things and even the delegate spots. That was a bylaw change that happened in a non-bylaw year. So, as Bobby said, we needed two-thirds vote just to hear it and then we needed the two-thirds to pass it and we were able to achieve that. So just some wins for the PTA and I really believe that the association is really stepping up to make it known that they are inclusive of PTAs and they do want the voice and that we are one profession, and that's really all that really matters.
Speaker 1:Thanks for the overview of that and, again, I think that's just part of our profession continuing to move forward as well.
Speaker 1:You spoke really well about why that's important, so thank you, ian, for that.
Speaker 1:Hey, one other one that you guys brought up and I guess some thoughts that came into my mind here is hey, every single one of us, when we went through our education process as a PT or a PTA, you know, really focused on maybe some of the manual skills that we're doing and we would have those psychosocial aspects of healthcare classes that we would take but maybe not quite see the value of those until we actually got out into the clinic and realized that we're working with real people, right, and real people have more things mixed up in what's going on physically than just the physical component, right, we call that that biopsychosocial model, and so one of the motions here was just the role of the physical therapist in behavioral and mental health, right, recognizing that, hey, we have a lot of access to individuals that maybe their mental health or trauma or other things that have happened in their lives are also impacting some of their physical condition as well. Can you guys talk about that motion and maybe why it's valuable and what it does for our profession, moving forward.
Speaker 2:Yeah, I thought it was an important one for us.
Speaker 2:The problem is, as far as the debate went on the floor, it wasn't like very encompassing because there's so much dialogue that happened in the motion concept leading into the rc and then, even as we were developing the rc, all the different information from, like, the specialists, so to speak, in this field gave very moving reasons why we should have this as a document for the APTA.
Speaker 2:So I can't divulge like what those people say in the background of the hub, but it was very moving and, just like you said, there's just a whole other aspect of what we're treating nowadays compared to just the movement dysfunction that these people bring to the table. There is a lot of mental health that goes into your movement dysfunction. So it was really good and the motion passed with little to no trouble. So, yeah, I just think everybody kind of understands. Well, you just see in the world all the trouble that we have like. Look at michigan with the, the this guy stabbed the mental health there, the, the shooting just last night in in manhattan. There's just a lot of mental health things that we need to keep in the forefront and so having a document like this helps again, progress, the profession and I think that it was important.
Speaker 3:a lot of the talk was we spend so much time with our patients and much more time than a physician or maybe even nursing or any of some of those other professions. I mean, there's not very many professions that spend in the healthcare field that spend 45 minutes or an hour with somebody that's not already on the psychological side to begin with, or a therapist, and so sometimes we're thrown into those situations where you get told some things and it's really learning and understanding how to deal with it.
Speaker 1:Yeah, absolutely. I remember a few years back being a CSM, and I went to a panel discussion that had Adrian Lowe on the panel and there was a psychologist and and they're really you know, they're they're kind of talking about this very issue of hey, you guys are on the front line, you're seeing these individuals. We know that it's difficult to get into counseling or into psychologists at times, and so if we, if there's anything we can do to help equip you or even get that referral to psychology, we need to make sure that PTs are equipped and knowledgeable in those areas as well.
Speaker 2:So yeah, he kind of started this whole behavioral health movement, is his group and so I would use him and his educators for state meetings, because I was the Western district chair for the longest time while I was just a delegate, and so I would get meetings going in the state before we had zoom and before we had all these cool things. We would have to just meet face to face and he would teach and do a lot of the different hour lectures. Uh, for the state of Nebraska.
Speaker 1:Oh, that's excellent.
Speaker 2:Yeah, because they were just down in Missouri. Yeah, and so even when I worked in Lincoln at St Elizabeth's before I got out to Western Nebraska, they would come up and do talks in Lincoln and Omaha as well. They're just a wealth of knowledge. They really help our progression or our profession progress.
Speaker 1:Yep, and we all know kind of the chronic pain realm. You know it's not just a physiological issue that's always going on. There's a lot that's wrapped up in that Right. Um, I was just having a conversation recently about functional neurologic disorder too, and there's a lot of just kind of the mental health aspect that's wrapped up in what's manifesting in a physical way and at least in the neuromuscular realm. Fnd it's up there diagnosis-wise, with actually greater than MS and greater than Parkinson's disease and the number of movement disorders that are diagnosed in that way. And so, yeah, this is a great one. I'm really glad that you guys brought that up and it's recognizing the role of the physical therapist in that realm too. What else Offline? We had a conversation about primary care, physical therapy and telehealth. Do you guys want to go there? Is there anything else that's kind of come up in your minds?
Speaker 2:Well, I think that kind of leads into why we adopted a, uh, rc 17, um, 25. It's because primary care is here and it's going to stay in physical therapy. So the APTA is kind of helping lead forward with how to make that possible in education programs. So yeah, rc 1725, super important Primary care is the 11th. I think I said 12th earlier. It's the 11th specialty within the APTA. 12th or later it's the 11th specialty within the APTA. So you will be able to apply for specialization through the American Physical Therapy Association.
Speaker 2:To become a specialist in primary care doesn't mean that in our state practice acts we have everything in a line to practice that way yet.
Speaker 2:So again, that might be confusing to some people we still have to abide by the laws of our state in order to get referrals to diagnostics, to medication. We do not have those powers yet, but there are some states that have radiology, that have a little bit of laboratory referrals that they can do. So we as a state of Nebraska just need to open up our practice act which is not easy to do and start to go through the legal process of gaining certain rights, certain laws that will allow us to refer for an MRI and refer for some medication that makes sense in our movement spectrum, refer for lab tests to look to see how our diabetic patients are doing with exercising and blood glucose control. Those sorts of things are kind of cool to think about and that's why the APTA adopted this primary care specialization so we can start to get the education of primary care into physical therapists and then, once that happens, we'll show that we have value in the system to function, just as the physical therapists in the armed forces have been since the 70s.
Speaker 1:If you're not familiar, sorry, go ahead, Ian.
Speaker 3:I was going to say, and hopefully someday. I mean I think Utah just passed their primary care there here, or just they passed their legislation to allow the PTs or recognize as primary care providers. So hopefully someday.
Speaker 1:Yeah, I'm not going to make you guys talk about it right now but, for the listeners, if you're not familiar with primary care physical therapy, I'll put a couple resources into the show notes. There's a really good podcast with Utah's state chapter president just talking about the process that they went through to get recognized as primary care providers within their state, and then there's some good resources that have come out from the Federal Academy of the APTA, just kind of talking through. What does primary care integration look like in more of the I don't know what the word is for civilian healthcare environment as opposed to the military healthcare environment? Right, Like you talked about, you know there's been socialized medicine within the military for a very long time, and so the way that PTs can operate within that setting is different than what we're dealing with in more of a civilian environment. So, yeah, great, that's another really good one, I think, for us to be aware of and the impact on our profession moving forward. We have time for probably one more guys. Where would you like to go?
Speaker 3:Ian, did you have one that was a particular on the education side of things? I mean it's more geared towards PT practice or DPT programs. But just you know, the arguments is to we're always looking to that ways to save money. I mean you can look at company-based education and see ways that you might be able to save money If there are some things that can be checked off or there's some things that we can do to help eliminate some of those costs, especially as things are changing when we're looking at grad school and those types of things.
Speaker 3:But the talk at the house kind of the pushback on the RC and I don't remember the RC number off the top of my head, but the pushback on that there was a report by the APTA that came out the day after the House that does discuss some of the components of company-based education. So I'd encourage members to go check that out to learn a little bit more about it. But I think that that'll be something that will. Obviously we have a school here in the state that is really big on competency-based education and the development of it at Creighton, and so I think it'll be an argument that will come. I don't want to say an argument, but it'll be something that will be discussed in the future and it'll continue to maybe look at ways to incorporate that down the road.
Speaker 1:Yeah, competency-based education isn't necessarily new, but it's maybe a little newer to physical therapy education. Again, I think Gail Jensen has been a big part of that and a few of the other instructors at Creighton University have been helpful in spearheading some of that. I think, even from what I'm gathering from you guys, a lot of people are still trying to kind of wrap their head around what does that look like as an educational model? What does that change? I don't have all the answers for some of that, but maybe an observation.
Speaker 1:You know, as someone who's newer in academia but spent a long time as a clinical instructor, I think my perspective as a clinical instructor Ian, hopefully you appreciate this as a DCE too my perspective as a clinical instructor was hey, you have a good, solid foundation coming into the clinic and I've really got to kind of sharpen that up and tighten that up in a lot of ways within your time with me and coming into academia.
Speaker 1:There's a temptation for me to want to teach everything I know as a clinician to my students. Right, and there's always a balance of what's need to know and what's nice to know, especially early on, and helping to create entry-level clinicians, and I've really just learned to respect how much we need our clinical instructors to be a solid part of that education process and we have to lean on them in a lot of ways to add in more information and to layer on top of what we've been able to do within the classroom and lab settings already. And so there's really this seamless process that has to happen from classroom into clinic before becoming a full-fledged PT, licensed PT or PTA, so to say right.
Speaker 3:Yep.
Speaker 1:And competency-based education. As we continue to learn more about that and engage with it, I think that we will need the help of our CIs and there will be a lot of engagement of that clinical community to try to understand what that looks like.
Speaker 2:Hopefully I'm not speaking out of turn on that, but Absolutely not. Yeah, I'll also put in a plug for any member that's listening to this. We're going to need sites for primary care to have different residencies. So something to think about going forward have your clinic be a residency for either Creighton or UNMC.
Speaker 1:Yeah, and again, if you're not quite sure what that means, I'm going to try to give you some resources in the show notes to kind of bring that bar down just a little bit and help us understand, wrap our minds around what that is. Well, hey guys, thanks for the conversation, thanks for representing the state and just for everything that you do as delegates for us at House of Delegates. Any parting words, final wisdom that you want to belie upon us, appreciate the time.
Speaker 3:Yeah, absolutely, I think, if anybody's interested. I mean, there's positions that are typically open every year. That evidence may seem boring, but it really is not. There's a lot that goes on there and a lot to learn, and I do come back energized every time I go to the house and I'm hoping that I'll have other PTAs in the future that would like the role that I have, or we'll run for a delegate position, since now in the state of Nebraska you can do that.
Speaker 1:Excellent. Well, guys, thanks again for oh go ahead.
Speaker 2:The intimidation down of of having to run for governance. I'll make it really easy on you.
Speaker 1:Good, you have Bobby's support already. Anyone that wants to fly?
Speaker 2:Just run.
Speaker 1:I love it. I love it, guys. Thanks again for your time. Appreciate the conversation and audience. I hope that this was helpful for you too. Thanks for tuning in to the APTA Nebraska podcast. Stay connected with us for more conversations that elevate our profession and improve the lives of Nebraskans. Don't forget to subscribe, share and join the discussion because together we're driving the future of physical therapy forward.
