Three DMU graduates are leading an innovative program in the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) to embed physical therapists into the primary care setting and enhance the holistic care veterans receive.
Mark Havran, D.P.T.’05, M.S.P.T.’95, Chris Rowedder, D.P.T.’11, and Brandon Peterson, D.P.T.’11, Cert. MDT, ATC, have worked together on the project on the national level since 2015. Havran is a physical therapist and chief of extended care and rehabilitation at the VA Central Iowa Health Care System in Des Moines, where Rowedder is a primary care physical therapist. Peterson is a primary care physical therapist at the VA Health Care System in Sioux Falls, SD.
“Physical therapists are now serving on the front line of the medical model within the VA to provide veterans care for their musculoskeletal complaints right away,” Havran said during meetings with national stakeholders in Washington, DC, in May. “This helps to off-load walk-ins for primary care staff and decreases downstream referrals and costs per episode of care. It’s a win-win for everyone involved.”
This model was first adopted by the Department of Defense and later by the Tampa Bay, FL, VA in 2008 with high success rates. It gained traction after 2015 when Havran, who is the national physical therapy executive for the VA, started a primary care PT program at the VA Central Iowa Health Care System in Des Moines, in which Rowedder, Chaz Williamson, D.P.T.’09, and Ryan Spreitzer, D.P.T.’14, were embedded into the primary care department.
Rowedder shared the approach with Peterson, his DMU classmate. With the support of his leaders, Peterson created a similar program at the Sioux Falls VA Health Care System in 2016. For his efforts he was named the system’s Employee of the Year in 2019 and, in 2022, given a VA challenge coin by Denis McDonough, U.S. secretary of Veterans Affairs.
“Veterans were often referred to physical therapy as sort of a last resort. When they finally made it to physical therapy and were getting better, they were frustrated to have had to wait so long,” Peterson says.
Rowedder adds that having physical therapists as members of multidisciplinary primary care teams can help avoid unnecessary medications, imaging and other tests. Veterans also get quicker access to walkers, canes and other mobility equipment they need. “We’re following the research that shows early access to care produces better outcomes for the patient,” he says. “This model allows us to do that.”
In 2017, the team collaborated with the Minneapolis VA to lead an initiative across VISN 23, the VA Midwest Health Care Network, in which physical therapists were embedded into all Patient Aligned Care Teams (PACT) within the region. In 2020, they pitched the VISN 23 PACT PT program in the VHA Shark Tank Competition. It was selected as a Promising Practice by the Diffusion of Excellence and later chosen as a National Diffusion Project to be “diffused” across the VHA system.
“Our goal is to have every VA embed a PT into primary care within their main facility or community-based outreach clinic in the next three years,” Rowedder says.