I read with interest the perspective on the PASS meeting.1 Obviously, a great deal of work and thought went into the deliberations. Understandably, only general directions can be described at this stage of planning, but, for the naive reader, a few examples with some details would be useful. For example, there was frequent reference to the “paradigm shift” in health care delivery, yet a clear explanation of what the shift is going to be or even the potential possibilities was not evident. Possibly, the proposed “patient-centered” care is the paradigm shift, but the meaning and implications of this concept need additional explanation. In some ways, I always thought the patient was the focus. Maybe this is a way of saying that all of the individuals involved in a patient's care need to interact more than is currently the situation. This has been the “rehabilitation model,” but maybe not applied to other conditions. I believe that is because only relatively recently have we recognized the “lifestyle” relationship of most health-compromising conditions.
I did note a specific recommendation that physical therapy will be more involved in fitness, wellness, and health and that technology would be important. I do believe that exercise is key to what defines physical therapy and key to our economic future. What worries me is the implementation of this direction. Such recommendations have been made before, as in Marilyn Moffat's 2004 Mary McMillan Lecture.2 In her lecture, the critical issue that Moffat posed was that “we have lost sight of what is necessary to make us exercise experts.”2(p1078) Moffat specifically cited the educational programs as losing sight; …
