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My 1st Time as a Delegate to APTA's House of Delegates

As a physical therapist now for over 18 years, I vaguely knew about the American Physical Therapy Association’s (APTA) House of Delegates. I knew it was a place where the “rules” were made, but I never fully understood how exciting and important a place it was. As they say in the Broadway phenomenon Hamilton, this is “The Room Where It Happens”. If you care about your profession, your patients, your specialty, or your niche, it’s important that you come to the table at this meeting to represent those interests and be heard. For it is, you, that will help to shape the future of all that we become together.

The House of Delegates is held each spring in various locations around the United States. This year’s HOD was held in Chicago and next year’s will be in Phoenix, AZ (Grand Canyon anyone?!) It lasts for 3 days cumulatively: Sunday evening, Monday, Tuesday, and Wednesday Morning, with each day being a meaningful event all on its own. Each state chapter sends a “delegation” to represent the chapter at HOD and the proceedings are carried out in a parliamentary manner, where you discuss “motions” brought forth by the members, the board of directors, or the special committee.

Getting To The House

As I became more involved in my state chapter, I heard more about the House of Delegates and it sounded intriguing. You must put your name in the running to say you would like to attend. In the spring of that year, an election is held in the chapter to pick the delegates for the following year. When I initially ran for this position I was on the alternate list and didn’t think I would end up going. As fate would have it, I got bumped up and was able to attend my first House of Delegates. There were 461 delegates present this year.

Sunday Evening: The Opening

I was mentally unprepared for how invigorating Sunday evening at the house would be! It is in a huge room with rows of long tables with designated areas for each state delegation to sit together, over 430 people. At the back of the seated tables there is a section called the gallery where guests, the student assembly, and the PTA caucus sit. There is a large stage in front of you with a podium and a deus that the Speaker of the House sits at, along with other members such as the Secretary of the APTA. There are several microphones throughout the room for delegates to speak at and three jumbo screens behind the deus that show the person who’s speaking or the various slides or motions that are being discussed. Upon entering, there is music, lights, and an announcer counting down the beginning of the house session. It reminds me of how the NFL draft looks on TV! Pretty cool if you ask me! That evening the APTA president, Dr. Sharon Dunn, gave the opening remarks where she took on topics that need to be challenged, such as why the cost of the physical therapy education is so high and why do colleges and universities require so many credits to graduate when CAPTE has set the actual standard lower. I watched this speech in awe as I knew not everyone would appreciate this challenge and felt proud she is president and to be in a profession where we fight to change status quo. Then Dr. Dunn said goodbye to the outgoing members of the APTA board who had served out their terms. This goodbye to the board members was intimate and touching and exalted people I am happy to call my friends who have given so much to this profession and to the service of the association. We were also able to watch a video by board member Dr. Sheila Nicholson, which ended up being her last words to us as fellow physical therapists, house delegates, and change makers, as she sadly passed away the next day. The video was inspiring and most of us were crying. She implored us all to continue to do the good work. After the opening ceremony I went to “caucus” with my state delegation and discussed the upcoming motions we were going to vote on while we ate Chicago deep dish pizza and drank some wine. It was a fun time, getting to know your chapter colleagues on a more personal level.

Monday: The Elections

On Monday, those individuals that have thrown their name in the ring to run for APTA elected positions undergo rigorous interviewing by all the delegates that attend HOD. As a delegation, you are broken up into one of four rooms, where each candidate will come to answer two prepared questions and then multiple questions from the delegates. Candidates must do this in each of the four rooms! You realize all the hard work and dedication that these candidates have put into our profession to volunteer for this challenging process. We spent all day listening to interviews and then in the late afternoon caucused again as a delegation to discuss the nominees. This year, the slate of candidates was abundant, and every single candidate was more than qualified. It was a hard choice! During our delegation discussion on the candidates we weighed qualifications and balancing the existing members of the board. Later that afternoon, the house reconvenes, and the delegates place their votes. That evening the election winners are announced and sworn into their new positions in front of the House and they accept their duties to serve our professional association. This whole process made me gain a further appreciation of APTA as I witnessed the dedication of our newly elected servant leaders.

Seersucker Tuesday: The Motions, Professional & Social

After an exciting first two days, Tuesday is when we get down to the business, the motions, while dressed in your finest seersucker outfit! This year there were 70 motions brought forth due to a special committee being instituted in a previous year, whose responsibility it was to go through existing motions to amend or rescind them. Thankfully, there is a “consent calendar” that a good number of motions were assigned to that the entire house agreed on ahead of time in unanimous support. However, there were still many motions to vote on that day and the next morning. There were seemingly two kinds of motions: Professional & Social. The professional motions were on important topics such as the physical therapist & physical therapist assistant core values, the APTA’s stance on physician owned physical therapy practices, telehealth, and more. Social issues were whether PT's should have increased knowledge of cannabis/CBD oil use by patients, diversity and inclusion of minority groups, whether to take a stance on the public health crisis of firearms-related injuries and deaths in the U.S., the support for PT's administering Naloxone, and more. Each motion was brought forth and delegates from all over the country stood up in support or opposition of the motions. At times, the commentary got tense, but always remained respectful. I was proud the profession I have devoted my entire adult life came to make decisions on important topics that affect society as a whole.

So Worth It…

House of Delegates felt like a whirlwind of change that I was excited to be a part of. The days are filled with the commitment to transform our profession and society into something better, while the nights are filled with the camaraderie of other passionate individuals at receptions and dinners. It is part devotee work and party, but the whole time is a “togetherness” that you must experience for yourself.

You go to the House as a representative of your state chapter but are always allowed to speak as an individual to represent yourself and your ideals. It is a meeting of our collective body, coming together to create a unified message and stand together. If we do not have a collective voice, who will speak for us? In the words of the late Dr. Sheila Nicholson, “Stewardship of our association is both a precious opportunity and a great responsibility and we must never take either for granted. Each person in this body brings forth a unique perspective and expertise… I encourage you to make an impact that outlasts us all”.



Dr. Theresa Marko, PT, DPT, MS, OCS is a Board-Certified Clinical Specialist in Orthopaedic physical therapy & owner at Marko Physical Therapy, PLLC in NYC.

Dr. Marko specializes in general orthopaedics, as well as adolescent injuries and pediatric issues. If you would like to reach out to her you can by email or phone.

Phone: 347.766.5979


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