The Role of PTs in Addressing Social Determinants of Health: Advocacy Beyond our Profession

Brooke Pantano, SPT ’23

This past month, a University of Pittsburgh study was published in the American Journal of Preventive Medicine that highlights the outcomes of Medicaid expansion implemented as part of the Affordable Care Act (ACA). The study found that over a 3 year period, expansions have led to increased detection of early stage cancer diagnoses and decreased late-stage cancer incidence, highlighting the importance of health care expansion for cancer detection and preventative services. In some states (PA being one of them), these expansions allow individuals to qualify for Medicaid services based on their income alone, allowing single adults like myself to now qualify for free or low cost health insurance. Previously, Medicaid eligibility was also determined by household size, disability, and other factors that left many people out of the picture. 

Studies such as this repeatedly display the value that access to universal health care would bring to the entire population. But while advocating for the expansion of health care services is critical, it is only the tip of the iceberg when it comes to addressing public health. Factors in addition to health care, known collectively as the Social Determinants of Health (SDoH), address how the conditions that people live in impact health, functioning, and quality of life. Healthy People 2030, an initiative within the Department of Health and Human Services, groups the SDoH into the following categories – economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Categories like neighborhood and built environment focus on elements like air and water quality, rate of violent crimes, and building accessibility. Factors such as discrimination (in the context of race, gender identity, sexual orientation, disability, etc.), incarceration, and access to nutritious foods are addressed within social and community context.  

            When other aspects of patients’ lives are not met, whether that be food insecurity, lack of stable transportation, or literacy skills, our care is often not their first priority nor is it fully accessible. Failing to recognize the SDoH that may be impacting our patients can often lead to what we interpret as noncompliance, when in reality, it may be other external factors preventing adequate care. In physical therapy, we often emphasize the importance of movement and exercise when it comes to general morbidity and all-cause mortality. However, SDoH often prevent individuals from participating and reaping the benefits of movement and exercise, which in turn can actually contribute more to morbidity and mortality.

As PTs, our roles aren’t limited to just addressing musculoskeletal, neuromuscular, and cardiopulmonary deficits in patients. As healthcare providers, we have the voices, power, and responsibility to advocate for the overall health of our patients and communities. So how do we do it? We educate ourselves. We vote for legislation at the local, state, and federal level that supports our patients interests. We get familiar with and/or participate in pro-bono services and community health initiatives. We grow our lobbying power by increasing membership and participation in the American Physical Therapy Association (APTA). Through these efforts, we have the ability to change the trajectory of our profession and provide high-quality, accessible care to all of our patients.

Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from

Lauren Lin, Aparna Soni, Lindsay M. Sabik, Coleman Drake, Early- and Late-Stage Cancer Diagnosis Under 3 Years of Medicaid Expansion, American Journal of Preventive Medicine,

Volume 60, Issue 1, 2021, Pages 104-109, ISSN 0749-3797,

“Nothing Worth Having Comes Easy” -T Roosevelt

Dave Wu, SPT ’23

As a DPT student trudging through the first semester of the program, I sometimes catch myself thinking, “What did you get yourself into this time, Dave?” But this isn’t the first time I found myself doing something so daunting: after all, at one point, I was foolish enough to join the United States Marine Corps. If I could distill just one life lesson from Marine life and transfer it to the civilian SDPT life it would be that life’s difficulty is tied up with its worth: that life is fulfilled when we have an obstacle to overcome, people to face it with, and people to do it for.

In the middle of a week chock full of practical exams, I was commiserating with a classmate, who commented that PT school must be so much easier for me having experienced military life. There was some truth to that statement in that I’m fortunate enough to have learned to handle stress pretty well, but PT school is still PT school: we learn the same material, take the same tests, and face the same pressures. We are all held to the same standard that doesn’t drop for anyone, not even for Marines (no military discounts here). But it is the intrinsic difficulty of a high standard that makes meeting it so meaningful and such a worthwhile pursuit.

As I rewind back to first day of Marine training, I’m reminded of the people who chose to train us and hold us accountable to the standard. As the drill instructors made their grand entrance with their famed belligerence, they made one message clear: they would push us to the limit, but they wouldn’t let us fail; and even after we’d given up on ourselves, they never would. Our “drill instructors” here at Pitt DPT put forth that same message, and they wouldn’t be here if they didn’t have the competence and the confidence to see us through. Sure, there may be a few who might like to watch us squirm and flounder for a bit, but at the end of the day, but none of our instructors would ever let us drown in this program. So, it’s easy to trust in a system of people who have not only proven their knowledge but who are also committed to our success.  

Fast-forward as the training days pass, recruits reach a point when they get out of their own heads to see a platoon full of others who have all cast their lots together in the pursuit of a standard. Stripped of the more superficial aspects of individuality, each recruit is left revealing their true character (and the fact they’re barely keeping it together). In this DPT “platoon,” I look to the individuals left, right, front and back to see not the race, gender, creed, or upbringing that would divide us. Instead, the stress and strain has revealed “brothers and sisters in DPT” who embody the common struggles, passions, and ambitions to meet the standards of this program. It’s near impossible not to respect and grow closer to people who are in the trenches you, whom you lean on, and who lean on you.

If being a Marine weren’t so difficult, would it still instill the same kind of pride? If DPT school weren’t so difficult, would it still be worth pursuing? For me, if my endeavors didn’t challenge me and if I didn’t have people to share in the struggle and achievement, it simply wouldn’t mean as much. It’s personal adversity that provides me with motivation, and it’s the people I do it for and do it with that strikes me with inspiration. So, if the Marine Corps has taught me anything, it’d be to find something difficult that’s truly worth doing and then find some people to share it with. For all of us in the DPT program, I think we’ve got those boxes checked, but regardless of career choices, I hope that some part of this encourages and resonates with anyone who has read this to the end.

 “The purpose of life is to discover your gift. The work of life is to develop it. The meaning of life is to give your gift away.” — David Viscott

Athletic Training Certification to DPT School

Krista Berzonsky, SPT ’23

My athletic training background has helped me remarkably in the DPT program thus far. Specifically, it has aided in my understanding of detailed concepts more quickly and has allowed me to feel more comfortable taking practical exams. My past clinical experiences in athletic training have aided me greatly with the challenges of being a first-year PT student.

The first semester of PT school is notably one of the hardest, and that’s without the looming presence of a global pandemic. There is a great deal of information coming at you very fast every day. The concepts and hands-on skills we are being introduced to this semester are advanced, but I’ve been fortunate that there hasn’t been much that I’m hearing about for the first time. This prior knowledge has allowed me to focus on the details, instead of learning the entire concept for the first time. For example, I’ve previously assisted in rehabilitation programs for athletes returning to play from an ACL surgery, meaning I know the detailed anatomy of the knee joint and its functions, along with how to track progress in terms of range of motion and strength. This experience helped to make learning palpation, goniometry and manual muscle testing much easier.

Another huge benefit of being an athletic trainer is feeling comfortable taking practical exams. It’s already challenging and nerve-wracking enough to be told to do something on the spot in front of a proctor, let alone doing it for the first time in a graduate program. Most people are used to being tested on the material by taking written exams, so this unfamiliar format can be intimidating. During these practicals, we are expected to communicate with our partner in the same manner as we would with a patient in the clinic; meaning we can’t speak “PT language” to them. Because of my extensive clinical experience during undergrad, translating “PT language” to laymen’s terms is something I’ve had a lot of practice with, since many athletes and patients don’t acquire the same level of medical knowledge as we do.

Even though there is a strong correlation between athletic training and physical therapy, there is also a lot of variation. However, I know there will be many opportunities to apply my current knowledge as I move forward in the program and learn new PT-specific skills. I’m excited to combine my education and experiences from both of these careers to help me become the best healthcare professional I can be. Regardless of your undergraduate experience, I believe that Pitt has built a program that ensures each and every one of its students are on the best path to becoming great physical therapists.

Telehealth in Physical Therapy

Sara Beck, SPT ’23

Throughout the Coronavirus pandemic telehealth has proven to be a great means for treating patients. It allows healthcare professionals to provide care to their patients from the comfort and safety of their home, which has been a necessity the last few months. Prior to the pandemic, telehealth was on the rise due to the many benefits of virtual treatment sessions, including increased accessibility and high success rates. We are all learning how to organize virtual meetings for nearly everything, and physical therapy does not have to be any different.

Telehealth increases access for patients to physical therapists in varying specializations, even some that may not be near where they live. For example, a patient who is struggling with vertigo but does not live near a vestibular physical therapist would be able to set up a video call visit with a specialist. This is beneficial for both therapists and patients. Therapists will have an increased patient population, spanning much farther than their immediate surrounding areas. Patients have access to a wider range of physical therapists and are more easily able to find a specialist to treat their specific need. There is also an enormous increase in accessibility for people living in areas with limited physical therapy clinics, meaning a greater number of people would be able to choose physical therapy before other means of treatment.

Building off of limit access to physical therapy, there are many patients who have to commute far distances or get a ride to their PT sessions. This is eliminated with telehealth because it is a patient centered model meaning safety and ease for the patient is the priority. It saves the patient time and allows them to get treatment without having to leave their homes. This is especially important for patients who are unable to drive themselves, not everyone has access to a car which makes getting to an appointment extremely difficult. Cutting out the need for transportation takes stress off the patient.

There are some challenges to telehealth, such as communication between the patient and therapist. But, despite the oddities there has been high success rates with virtual PT visits. According to the APTA’s Choose PT campaign, patients who take part in telehealth actually have a greater likelihood of sticking to their at home program (Crawford). This is because the physical therapist is able to see the patient’s home and make sure they have the materials needed to complete their exercises. Also, they can recruit family members during the at home sessions and teach them how to do partner exercises or watch for correct form. Although the family members may be around the house, the patient will be receiving completely individual care. There are not any other patients on the video call so the therapist is able to focus 100% of their attention on each patient for the entire duration of their visit.

Finally, a physical therapist will have the opportunity to work more closely with other healthcare providers during a telehealth visit. If a patient is going to both PT and OT the two therapists could meet on the call formulate the treatment plan that will best improve the patients functionality. Telehealth has become utilized much more in 2020 due to the state of our country; however, I believe it will remain a popular choice for many of our patients even after the COVID-19 pandemic due to the numerous benefits of virtual visits.


Crawford, Christina Sue. “6 Reasons to Consider Telehealth Physical Therapy.” American Physical Therapy Association, 8 June 2020, 

PT School in the Midst of a Pandemic

Beth Trinker, SPT ’23

COVID-19 has made its presence acutely aware across the world, affecting every corner of daily life from the way one grocery shops to how one goes to work. This is particularly true at universities and has personally impacted my graduate studies here at Pitt. As a first year student in the DPT program, my experience has been nothing like I’d expected — majority online class instruction, limited interaction with my fellow classmates and faculty, and balancing the stresses of being a grad student during a pandemic. But living in “these unprecedented times” comes with a level of understanding and adapting, two skills that are imperative to being a healthcare practitioner.

          The Doctor of Physical Therapy program has an innately physical course load, one that unfortunately does not translate well to an online platform. Whether it be through asynchronous lectures or real-time online learning with your cohort, there is just no parallel to getting the hands-on experience so necessary to being an effective physical therapist. Luckily, the first years have had the opportunity to attend certain labs and classes at Bridgeside Point II, requiring the proper PPE and designated classrooms/pods. Even though gloves, goggles, and masks can be burdensome to wear, being in the classroom can yield immense rewards for those students whose learning styles just don’t coincide with an at-home study environment. In an article focusing on the effects of online learning, “Researchers are increasingly attending to the fact that online learning may be more beneficial for some types of students compared to others” (Francis, Wormington & Hulleman 2019). It should also be noted that studying for exams while learning through a screen after learning all day through a screen can be draining, something to consider for classes to come if more hybrid learning were to be incorporated. In my experience, learning through Zoom and testing on Canvas has not greatly impacted my performance thus far, but it is truly not for everyone.

          While Pitt has done its best, there are still some aspects of attending school during a pandemic that just can’t be helped. I had always heard that getting close with your cohort is important and creates a much needed support system. I think we can all understand that “getting close” is not an option at this time. Interaction between pod members is permitted, but it is hard to feel part of a community when you have only met ⅓ of its members. Yet, the times that I’m with my classmates and instructors reconfirms that I’m not alone through this journey, a feeling that some students might have during the online portion (Driscoll et. al, 2012). While the present situation doesn’t lend towards much collaboration not only with my fellow students but also with faculty members, I’m hopeful that we will learn much from this experience and continue to adapt if such a time were to occur in the future.

          Overall, I think the biggest take-away from the past few months is that it is possible for the DPT program to function under a hybrid learning style with a combination of in-person and at-home instruction. I truly believe that I’m getting the proper preparation to be the best physical therapist despite the conditions we are under. I give a lot of credit to the faculty for the adjustments they’ve made for instruction, knowing how I’ve had to adjust. And as I go forward, I’ll use what I’ve learned from this presented challenge in my practices as I become a physical therapist. Hopefully, we all can.

Driscoll, A., Jicha, K., Hunt, A. N., Tichavsky, L., & Thompson, G. (2012). Can                               Online Courses Deliver In-class Results? Teaching Sociology, 40(4), 312–331.                      ×12446624

Francis, M. K., Wormington, S. V., & Hulleman, C. (2019, September 10). The Costs of Online Learning: Examining Differences in Motivation and Academic Outcomes in Online and Face-to-Face Community College Developmental Mathematics Courses. Frontiers in psychology.