The Jaded Veteran’s Conference Post-Mortem: What Actually Happened in Orlando (Besides the Obvious Great Weather and Theme Park Adjacent Despair)

Or: How I Learned to Stop Worrying and Love the Exhibition Hall’s Identity Crisis

So you survived. Congratulations. If you followed my pre-conference survival guide, you made it through your 33rd PPS conference (or your first, in which case, I’m sorry and you’re welcome). Now comes the part where we debrief, process our feelings, and try to explain to our significant others why we spent 72 hours in a convention center that smelled like hope, desperation, and whatever essential oils the wellness booth was diffusing into the HVAC system.

Let me start with the exhibition hall, because nothing quite prepared me for the experience of walking into what I can only describe as if CES and a Microsoft Developer Conference had a torrid affair and a physical therapy private practice meeting broke out in the aftermath. I’ve been doing this for nearly 40 years, and I’ve never seen so much technology marketed to people who still can’t figure out how to get their billing software to talk to their documentation software to talk to their scheduling software to talk to their accounting system.

The aisles were packed with vendors promising to solve problems you didn’t know you had (but definitely do now that they’ve explained them to you with a 47-slide PowerPoint presentation). There were more touchscreens than a Tesla showroom, more QR codes than a Chinese restaurant menu, and enough AI-powered solutions to make you wonder if we’re training physical therapists or just teaching robots how to fake empathy while billing a 97110.

The Curious Case of the Missing Disruptors

But here’s what stopped me in my tracks: Hinge Health and Sword Health—the two companies who’ve spent the last several years explaining to anyone who would listen (and many who wouldn’t) that they’ve “revolutionized” physical therapy—were nowhere to be found. Not a booth. Not a banner. Not even a sponsored coffee break or one of those branded tote bags that everyone takes and immediately regrets because it’s slightly too small to be useful.

To our complete surprise, the companies that have raised a combined billions-plus dollars to disrupt our profession apparently decided that actually showing up to a conference full of physical therapists was… optional?

I have some theories about their absence:

Maybe they were busy preparing their next round of “we’re not replacing PTs, we’re augmenting them” talking points for their investor presentations while simultaneously running ads and selling to self-insureds about how you don’t need to see an actual physical therapist anymore but if you do we have a new “select” network that will take 50% below PPO rates while we get far more from what we charge.

Perhaps they realized that a room full of actual physical therapists might ask uncomfortable questions like “So when you say your outcomes are better, better than what exactly?” or “Could you explain how stick figures on an iPad constitute clinical reasoning?” or my personal favorite, “If physical therapy doesn’t require physical therapists, why is your company valued at more than a billion dollars with all commentary from 3rd parties about you providing physical therapy?”

Or maybe—and I’m just spitballing here—when you’ve spent years telling everyone that in-person physical therapy is outdated, inefficient, and unnecessary, showing up in person to a physical therapy conference creates some cognitive dissonance that even their marketing departments couldn’t resolve.

It’s also possible they were there virtually, watching us through our phones, collecting data on our booth-visiting patterns, preparing to disrupt the conference industry next. “Conference-as-a-Service: Why Leaving Your House is Keeping You from Your Full Networking Potential.”

Whatever the reason, their absence was noted. And I’m sure it was just a scheduling conflict and had nothing to do with the fact that the last time some of their executives attended industry events, they had to explain why their “revolutionary” approach looked suspiciously like regular physical therapy but with worse outcomes and better PR.

The Unbearable Optimism of Being a Physical Therapist in 2025

Here’s what got me though: Despite Medicare’s relentless march toward reimbursing us at rates that would make a 1987 payment schedule look generous, the physical therapists at this conference were genuinely upbeat. Not the forced, corporate-mandated positivity you see at mandatory “Culture Committee” meetings, but actual enthusiasm about the future of our profession.

These people—these beautiful, naive, possibly delusional people—were engaged, asking questions, taking notes, and acting like Medicare wasn’t actively trying to drive us into the sea. It was almost enough to make this jaded veteran remember why I got into this field in the first place (before the insurance companies, the consolidators, unprofessional managers, and the people who think stick figures doing exercises on an iPad constitutes “physical therapy” convinced me otherwise).

Unprofessional Management Showed Up (Between Mandatory Productivity Meetings)

And yes, for those keeping score at home, representatives from what I lovingly refer to as “Unprofessional Management” did indeed make appearances—presumably during the brief windows when they weren’t scheduling their PTs for 7am “opportunity optimization sessions” or conducting BI data meetings that are essentially just elaborate PowerPoint presentations on “Why You’re Not Productive Enough and Here Are 47 Data Points Proving It.”

I couldn’t help but wonder: if these folks were in charge of planning the conference, what would the educational sessions look like? “Maximizing Burnout: A Data-Driven Approach to Ensuring Your Therapists Quit.” “The ROI of Misery: How to Extract Maximum Productivity from Minimum Staffing.””How to Fire Founders and Entrepreneurial PT’s and Sell it as a Re-Org”. “Advanced Techniques in Gaslighting: Making Your PTs Think They’re the Problem.” or “Elevate Your Career through Strategic Use of Search Firm Misrepresentation.” They’d probably offer CEU credits as well.

(And before anyone emails me: yes, I know not all management companies are created equal. Some of you are genuinely trying to do right by your therapists. You know who you are, and more importantly, your therapists know who you are. This isn’t about you. But if you’re reading this and getting defensive, well, maybe sit with that for a minute.)

Remote Therapeutic Monitoring: The Umpteenth Opportunity to Become Invisible

Speaking of things that made me want to check if I’d accidentally wandered into a dystopian future: the sheer number of Remote Therapeutic Monitoring solutions on display. I counted at least seventeen different platforms (I stopped counting after my third lap because existential dread was setting in) promising to revolutionize patient care through the magic of having patients… not actually see their physical therapist.

If even a fraction of these succeed, we’ll have achieved the remarkable accomplishment of making physical therapists so virtual, so remote, so digitally abstracted that we’ll eventually just be disembodied voices monitoring compliance data while patients follow stick figure instructions on their phones. It’s like we looked at the absolute worst predictions about the future of healthcare and said, “Yeah, but what if we could bill for it?”

The pitch is always the same: “Increase your capacity! See more patients! Improve outcomes!” What they mean is: “Reduce yourself to a data point! Become a notification! Watch your profession slowly transform into something a chatbot could do but we’re legally required to have a human in the loop so congratulations you’re the human!”

(And before anybody emails me, I believe in RTM and omnichannel solutions as an adjunct, not as a replacement, which is too often how they are sold.)

The Mirror Booth: A Moment of Clarity in the Chaos

But here’s where I need to give credit where credit is due: The best giveaway at the entire conference was the booth that handed out mirrors. Just small, simple mirrors. So participants could look into them and be reminded what an actual physical therapist looks like.

I’m choosing to believe this was intentional commentary and not just a vendor who got a great deal on mirrors, because in a conference where we’re being sold virtual this and remote that and AI-powered the other thing, someone decided the most valuable thing they could give us was a chance to remember: this is who we are. Flesh and blood humans who went to school for this, who passed our boards for this, who show up every day for this.

Not a stick figure. Not an algorithm. Not a “care navigator” or “movement specialist” or “exercise therapy leader” or whatever sanitized, venture-capital-friendly term they’re using this week to describe people doing physical therapy without the inconvenience of being physical therapists.

That mirror was worth more than all the styluses, stress balls, and branded USB drives combined.

Ribbon Shaming: A Multi-Billion Dollar Industry’s Newest Anxiety Disorder

Then there was the ribbon situation. Oh, the ribbons. Registration had bins—BINS!—full of ribbon opportunities. First-timer ribbons, speaker ribbons, volunteer ribbons, committee member ribbons, ribbons for people who’ve attended for 5 years, 10 years, 20 years, ribbons for people who know people who knew people who once thought about becoming a physical therapist.

And yet, when you walked the exhibition hall, you’d see attendees who’d clearly engaged in what I can only call “ribbon shame reduction” to the point where their lanyards only reached their knees instead of dragging on the floor. Everyone started off with good intentions, taking all the ribbons they’d earned, but by Day 2, the collective anxiety about looking either too accomplished (pretentious) or not accomplished enough (imposter syndrome) had reduced most people to just their name badge and maybe one ribbon if they were feeling brave.

I saw one woman who appeared to have attended for 35 consecutive years, served on every committee, volunteered for everything, and was probably personally responsible for founding at least three state chapters, wearing zero ribbons. When I asked her about it, she said, “I didn’t want to make anyone feel bad.”

We are the only profession that would feel guilty about acknowledging our own achievements at a conference designed to celebrate those achievements. This is very on-brand for us.

The EMR Invasion: Where the Money Actually Is

The biggest surprise—and I mean this genuinely surprised me, which at conference number 33 is saying something—was the number of new EMR companies entering the physical therapy RCM space. I’m talking companies I’d never heard of, backed by investors who clearly looked at the market and thought, “You know what physical therapy needs? Another documentation platform that promises to solve all your problems while creating entirely new ones.”

But here’s the thing: this tells you everything you need to understand about the current state of physical therapy as a business. Growth isn’t happening in the margins of delivering services—Medicare and the insurance companies have made sure of that. Growth is happening in the infrastructure, the technology, and the systems that support the delivery of services.

Venture capital isn’t investing in opening new PT clinics (well, except for the occasional cash-incinerating digital health company that thinks physical therapy is just stick figures and an app). They’re investing in becoming the pick-and-shovel suppliers to the people actually doing the work. The real gold rush money isn’t in treating patients; it’s in building the systems that help people treat patients more efficiently, document faster, bill cleaner, and analyze more data about their productivity so they can be reminded they’re not productive enough. This observation is even broader and truer when we extrapolate it to the larger healthcare ecosystem’s tech and infrastructure bets vs. services.

It’s honestly brilliant in a deeply depressing way.

PromPT: Or How Physical Therapists Party When Given Permission and a Wristband

I’d be remiss if I didn’t mention the parties, which were exactly as advertised—by which I mean PromPT absolutely delivered. Live band, surprises I won’t spoil for those who missed it (you know who you are and you should feel bad), sensory overload that would make a Vegas nightclub jealous, and a wristband that actually lit up because apparently we’re all 12 years old at heart and that’s exactly what we needed at 9 PM after eight hours of learning about the latest developments in innovative payment models and how to smile at the front desk education sessions.

But the real genius was the PT-friendly food: meaning you could eat it with your hands while still holding your drink and networking and pretending you remembered the name of the person you met at this exact same event last year who definitely remembered your name and you’re now committed to an entire conversation based on an enthusiastic “Hey! Great to see you!” while frantically trying to remember literally any context.

The food situation alone—finger food that people eat while standing up between patients while charting from the morning. We’ve mastered the art of drinking coffee while demonstrating a lumbar stabilization exercise. Hand-held food isn’t just convenient; it respects who we are as people.

Random Observations From the Trenches

A few more gems from the week:

• The hotel room water bottle situation deserves its own paragraph. You arrive after a long day of walking the exhibition hall, ready to hydrate, and there on your nightstand sits not a complimentary bottle of water, but two bottles wearing little paper crowns like they’re auditioning for a miniature Renaissance fair. These crowns serve one purpose: to inform you that you’re about to pay $8 for something you can get for free from the sink two feet away. Like every other conference attendee with basic math skills and a functioning sense of proportion, I found myself filling the in-room coffee maker with sink water at 11 PM, wondering if this was what they meant by “luxury accommodations” in the conference brochure. Nothing says “you’ve made it as a healthcare professional” quite like making coffee with Florida bathroom tap water because you refuse to pay hotel minibar prices for basic hydration. At least the coffee maker was free. For now. Side note: What the hell is an empty, off refrigerator doing hiding behind a door?

• The number of people who asked speakers if there was “an app for that” in response to literally any clinical or general concept taught me that we’ve fully embraced becoming the profession of “surely there’s a technological solution to this clinical judgment problem.”

• Overheard in the bathroom: “The speaker just told us to ‘work smarter, not harder’ and then handed out a 47-page implementation manual in the downloadable PowerPoint.”

• The coffee situation on Day 2, after they underestimated demand, was like watching a David Attenborough documentary on resource scarcity among pack animals. Survival of the most caffeinated.

• At least four separate vendor booths tried to explain how their product used AI, and in every case, what they meant was “we have a search function and some if-then statements.” I’m not saying they were lying exactly, but I am saying we need a better collective understanding of what AI actually is.

• The number of conversations that started with “So what are you doing about…” followed by some acronym I as a former Military dude never heard of (MIPS, QPP, PDGM, PDPM, and at least three others I wrote down but can’t remember now) reminded me that we’re a profession that has Stockholm Syndrome with regulatory compliance.

• Someone—I won’t say who—gave a presentation about practice efficiency that included a slide about “optimizing patient flow” that accidentally revealed their patients wait an average of 13 minutes past their appointment time. The irony was not lost on the audience. I’m pretty sure it was lost on the presenter.

The Future Belongs to Us (If We Stop Letting Others Define It)

Here’s what I took away from all of this, after the sensory overload subsided and I could think clearly again: Physical therapy, left in the hands of physical therapist owners and entrepreneurs, will drive the future of physical therapy. This has always been true. This will always be true.

Every innovation that mattered came from PTs who owned their practices, took risks, tried new things, and figured it out. Not from consolidators who bought up practices and optimized them into productivity vortexes by unprofessional managers trying to monetize stock they never stroked a check for. Not from digital health companies that think physical therapy is just an algorithm waiting to be automated. Not from insurance companies that would prefer we didn’t exist at all.

From us. From physical therapists who actually treat patients, who understand the work, who know the difference between efficiency and effectiveness, who recognize that everything that makes physical therapy valuable is everything that can’t be captured in a productivity metric or a satisfaction score or a remote monitoring dashboard.

If we can hold insurers accountable by utilizing litigation strategies, imitators will stop acting like stick figures—and I mean this both literally and figuratively—the future is ours. Not just the future of physical therapy, but potentially the future of healthcare, because we’re one of the few professions left that still remembers healthcare is about humans helping humans, not platforms optimizing outcomes.

The PTs at this conference, despite everything working against them—the reimbursement cuts, the corporate consolidation, the technological disruption, the administrative burden, the documentation requirements that make War and Peace look like a tweet—were still optimistic. Still engaged. Still showing up.

That’s not naivety. That’s not delusion. That’s knowing something the MBAs, the venture capitalists, the insurance executives, and the health tech bros don’t: We’re not going anywhere. We’re too stubborn, too committed, and too aware of what’s at stake to let someone else decide what physical therapy becomes.

So if you went to PPS, if you walked that exhibition hall, if you collected your modest number of ribbons, if you ate your hand-held food and wore your light-up wristband and listened to people pitch you solutions to problems you’ll have in three years that don’t exist yet: thank you for showing up.

The profession needs you. The patients need you. And despite what the latest productivity report says, you’re doing better than you think.

Now get back to work. Those 7am appointments aren’t going to schedule themselves.

(Though I’m sure someone in the exhibition hall has an AI-powered solution for that.)

larry

@physicaltherapy

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I am a lifelong fanatic of physical therapy, and write“All Things #PhysicalTherapy” where I try to make sense of an industry that increasingly makes no sense. This was my 33rd PPS conference, which explains both everything and nothing about why I keep going-and I don’t intend to stop “showing up”, “presenting”, and “calling BS”. Please subscribe here-it is free like the exhibition mirrors give away.

For various writings on my good friends at Hinge and Sword:

When Your “Physical Therapist” Is Literally a Stick Figure: Sword Health’s Latest Marketing Masterpiece

Hinge Select: Same Script, Different Cast

Physical Therapy is a Hands-On Profession that Uses Exercise — Not a Digital Exercise Platform that Uses AI Chatbots,

Virtual Health in Physical Therapy: Navigating the 2025 Landscape and Beyond, or

The AI Therapist Will See You Now… Or Will It?, or

New Smart Skills: From AI Panic to Human-Machine Powerlifting