Author: Ashley Carroll
Recently, I had the pleasure of interviewing Nancy Garland, JD, CAE for the NCPTA SSIG blog. She is currently the executive director of the North Carolina Physical Therapy Association. She is an attorney but spent time in law school working on Capitol Hill and immediately went to work for the American Optometry Association following graduation. She began working for the American Physical Therapy Association a few years later as the Vice President of Government Affairs from 1995-2002, and then served as the Executive Director of the Ohio Physical Therapy Association. She also served for the Ohio House of Representatives before moving to North Carolina where she became the executive director of the North Carolina Physical Therapy Association.
Continue on to find out more about Ms. Garland, her impressive career, and her passion for physical therapy.
What does your job entail?
I am the executive director of the NCPTA. Before, [being hired] they had one staff person and it was an administrative position. I had worked for the APTA for 8 years then was director of Ohio PTA. The ED is different from what it used to be. I manage the association–that’s the biggest thing. I manage everything in terms of legislation, regulation, the conference, organize board meetings, and work with leadership—Kyle [Dr. Covington, president of NCPTA] particularly. I’m the liaison between our lobbyists and the legislative committee. For example, Advocacy Day—I put together all the materials for that and get the space for it, make sure the emails are sent out, [and] put the program together. I manage the conference, which is the major part of what I do. I work with others to help them understand what their role and responsibilities are.
I am an attorney, so I am the liaison with the law firm on lawsuits we’ve been involved with. Being an attorney is fun to do—the NC supreme court will hear our case and I’ll get to go to the hearing. Any type of writing that needs to be done, I write them. As of January 1st, we have started sending out an NCPTA newsletter. We’ve never had that before, and right now we’re doing it every other week. We’ve been working to convince Blue Cross Blue Shield to do something about really high copays, and recently there’s been a break in the action. I put all that in the newsletter!. When it comes to legislation, regulation, those kind of things—that’s what I spend a lot of time doing. I oversee the office, the budget, and all the “normal” office things and the website.
How does that differ from working at the national level?
At the national level, I was dealing with all 50 chapters and helping with their legislation. When I was with the APTA, direct access was not something that they were working on. I had just come from working with optometry [the American Optometry Association] which was getting direct access, and I felt like PT really needed something like direct access to not need a referral to see patients. I helped come up with the vision that all states would have direct access by 2020 and that was really exciting. At the state level, I work with just NC senate and house versus the US congress. I worked in congress as a lobbyist for many many years before moving back to Ohio, and the level of legislators is like working with the cream of the crop. Whereas at the state level, legislators only get paid a little over $13000 a year even though they put in tremendous hours. This is not their full-time job. So, the level of legislator that you’re working with is a little different.
At the APTA, I was working with the state President or vice president of their chapters, so you’re working with people that are very involved and really into development. Whereas here at the state level, we have officers—but the people at the national level probably spend over half their year doing things that are APTA related.
I worked a lot with Medicare and negotiating at the national level—but now, I’m working more with Medicaid and the opioid crisis. For example, a paper just came out on that from Medicaid and therapists were not involved anywhere on managing care for adults. Medicare affects everyone in the country. Whereas Medicaid affects people differently because it’s mandated by the state. I was dealing with things that were national in scope—now I’m doing things that are relevant only to North Carolina.
How did you get involved with the APTA?
It had more to do with what jobs were available [at the time]—but I worked on Capitol Hill while I was in law school. The day I graduated [law school], I started to work for the American Optometric Association. It’s pretty common for people working on Captiol Hill to go work for an association. And in Washington, coalitions tend to work together—so optometry, nursing, OT, PT—all worked together and I got to know PT lobbyists pretty well. The head of government affairs for PT passed away, and I applied to the position. I did not want to lobby for a position group, even though I could’ve made more money—but I believed in non-physicians and their benefit to health care. It was just a natural fit and I got the job. I have now been working for physical therapy for 25 years and I just love it. I think there is not a better profession and they just do so much good for their patients.
What do you think is the biggest misconception about physical therapists?
As a lobbyist, what we do is educate people. I cannot tell you how many times I walk into a legislators office and they say “Oh, my neck is hurting. Can you give me a massage?” I just want to scream when that happens! They think the PT is a masseuse. I say “oh, I’m not PT but I represent them and I’ve been working for them forever! They have a doctorate [degree]! They know more about the musculoskeletal system than most physicians, excluding orthopedic surgeons!” So I think unless they’ve had contact with a PT, they have a hard time understanding what a PT is and what they can do. I spend probably 50% of my time explaining that.
The other misconception is—people think that you still need a referral to go see a PT. And that’s just not true. In any of the 50 states.
What do you think PTs can do to help this misconception?
If I owned a private practice and I wanted to do some advertising—I’d do it on the radio and say “did you know you can come see a PT without a referral?” In Ohio, we actually used public service announcements and that really helped. Any time, any way you can do something to advertise that you don’t need a referral that can be really beneficial. Especially now that you all are graduating with a doctorate—why would you need a referral to go see a doctor?
What has been the biggest challenge of your job?
In terms of NCPTA, the person before me had been gone for 2 months before they hired me. So basically, they had no staff person before m. So the other volunteers, who had other jobs, were trying to keep this going! The transition was a little difficult. One of the directors had to step in and do all of this work for the conference and that was just really overwhelming. She did a great job, and I came in kind of the middle of that. But that year—we had literally the biggest conference we ever had! It was overwhelming but we made it through and had a successful conference. That was rewarding.
What is your best piece of advice to current PT students?
They have made the decision to be part of one of the best professions there is. They should realize what a difference they can make in people’s lives and they have chosen well.
What is your favorite way to spend time when you’re not working?
Playing tennis! I actually just got back from Australia and we went to the Australian open. Some friends and I many years ago made a commitment to go to every tennis open. And Australia was the last! Any free time I have, everyone knows I’m probably playing tennis. I’m part of 3 tennis leagues—used to be in 6 but that was a little too much!
Thank you so much to Ms. Nancy Garland for taking the time to let us know a little bit about our job! We are so grateful to have people like you to promote the profession.