The Jaded Veteran’s Guide to Surviving PPS 2025: Do’s and Don’ts for the Eternally Optimistic

Friends, it’s that magical time of year again when thousands of physical therapists descend upon a convention center to pretend we’re not all slowly drowning in prior authorizations and productivity standards. Yes, PPS 2025 is upon us, and as someone attending their 33th PPS conference (yes, you read that right—I’ve been doing this since before some of you were zygotes), I’ve compiled this handy guide to help you navigate the conference like the battle-scarred veteran you either are or soon will be. For a reminder, here is a recap of 2024 PPS.

OBSERVATIONS FROM A 32-TIME ATTENDEE:

Having attended PPS since the Reagan administration (slight exaggeration, but barely), let me first paint you a picture of what you’ll observe this year:

The AI Apocalypse: Every single vendor—and I mean EVERY vendor—will have “AI” somewhere on their placard. The people selling therabands? AI-optimized resistance. The old school traction table that never works? AI-enhanced for more personal comfort. If a Martian landed at PPS 2025, they’d think we were a technology profession, not a hands-on healthcare profession. Gone are the days of wall-to-wall modalities and exercise equipment. Now it’s all tablets, apps, and “cloud-based solutions.” Look to more RMT options than ever-all of course “AI enabled”.

Follow the Money: Want to know which companies are well financed or are evaluated on technology valuations (recurring revenue or multiple of revenues vs. cash flow)? Look for the biggest booths and the ones throwing parties with open bars. The correlation between booth size and financing is 1:1. The company with the three-story booth and celebrity spokesperson? They’re the ones convincing insurers that PTs can be replaced with an algorithm and a resistance band (although I highly doubt non-PT Friendlies Hinge and Sword will actually be there) but keeping my fingers crossed. 30 years ago Chattanooga through the biggest and best party-shows you how far our profession has progressed!

The Great Infiltration: You’ll meet more non-PTs at this conference than ever before. MBAs, “healthcare executives,” (executive doesn’t mean they have had any business training) and “digital health entrepreneurs” who’ve never touched a patient but somehow know exactly how to “optimize” our profession. It’s like letting vegetarians run a steakhouse. The conference has been thoroughly inoculated by unprofessional, non-PT management types who think “manual therapy” is something you do to a PDF and we have to remind them that this is a conference that was always intended for physical therapists in private business! There are more stolen badges by non PT’s than Starbucks cups inside the booth areas where free coffee is given.

The Lost Art of Networking: Back in my day (yes, I said it), all the private practice PTs were together for the entire conference. There weren’t seventeen simultaneous sessions to choose from. We all sat in the same room, suffered through the same presentations, and bonded over our shared trauma. The networking was 10x better because you couldn’t escape to a “mindfulness for billing optimization” breakout session. You were stuck with each other, like a dysfunctional family reunion where everyone actually understood your dysfunction.

The Great Generational Divide: Watch for the beautiful dichotomy on display. The younger PPS private practice PTs will be there, eyes sparkling with optimism, talking about “disrupting healthcare” and “practice innovation.” They still believe they can change the system. Bless their hearts. Meanwhile, us old codgers will be huddled in corners, grumbling about staffing shortages, reimbursement cuts, and spinning tales about the “Camelot Days” when insurance paid $15 for a hot pack and we could actually afford to pay our staff a living wage. Both groups are right, and both are completely delusional.

The Ribbon Envy Phenomenon:

You’ll spot them from across the exhibit hall—the Ribbon Warriors, walking around with name badges that look like a North Korean general’s dress uniform (admittedly, this is more of a Combined Section Meeting phenomenon). Their badge dangles with so many achievement ribbons you’d think they were trying to achieve liftoff. “Committee Member 2003,” “Task Force Participant 2007,” “I Once Sat Through an Entire Board Meeting Without Falling Asleep 2015.”

Look, I get it. We all want recognition. But there’s something deeply unsettling about broadcasting your entire CV on your chest like a walking LinkedIn profile. These are the same people who list “proficient in Microsoft Word” on their résumé and put “thought leader” in their email signature unironically.

Here’s a radical idea: Show some humility. Let your name tag just show your actual name. Novel concept, I know. If you’re genuinely accomplished, people will know. If you need seventeen ribbons to prove your worth, including that one from the “Subcommittee for Considering the Formation of a Task Force to Discuss Strategic Planning” from 2012, maybe the problem isn’t your lack of ribbons.

The worst offenders are the ones who angle their badges toward you in conversation, like they’re flashing a badge at a crime scene. “Oh, you didn’t notice my ‘Past Chair of the Committee for Committees’ ribbon? Let me just adjust this so the light catches it better.” Meanwhile, some of the most successful practice owners I know walk around with a plain name tag and let their reputation do the talking.

HOW TO CHOOSE A PRESENTATION (OR: SEPARATING THE WHEAT FROM THE BULLSH*T)

Now that you know what you’re walking into, let me share my foolproof system for choosing which presentations to attend:

The Success Filter: First question—is this speaker actually successful in private practice, or are they just a talking head? There’s a special breed of “expert” who ran their practice into the ground faster than a Medicare audit, declared bankruptcy or that they were going to close down, and then miraculously emerged as a “consultant” or “thought leader” in some niche area. You know the type: couldn’t manage their way out of a paper bag when they had skin in the game, but now they’re teaching you about “practice optimization” or “office success” as if they ever really had it. It’s like taking swimming lessons from someone who drowned. Litmus test: If it is a presentation on a topic that everybody would view as “common sense,” don’t attend.

The Veteran vs. Theorist Test: Look for speakers who have years of PROVEN success as measured by actual growth, not just survival. If their bio says “former owner of...” dig deeper. Did they sell at the top or did they “pursue other opportunities” (aka got out before the ship completely sank)? The best speakers are the ones still in the trenches, not the ones who retreated to academia or consulting because they couldn’t hack it in the real world.

The LinkedIn Investigation: Before attending any business or practice management session, check the speaker’s LinkedIn. If it’s full of buzzword soup (”synergistic healthcare solutions evangelist”), or multiple jobs over a short number of years, run. If they’ve had seven different titles at seven different companies in five years, they’re not a “serial entrepreneur”—they’re serially unemployable.

The Publication Check: Has this person published anything other than self-congratulatory blog posts? And I don’t mean peer-reviewed research on the biomechanics of the ankle (though that’s nice). I mean real-world, practical content about running a successful practice. If their only claim to fame is a single case study from 2003, perhaps skip it.

The Conflict of Interest Scanner: This one has largely been resolved due to careful checking and disclosure requirements by PPS. Is the speaker being sponsored by a vendor? Check if their “evidence-based approach to improving outcomes” aligns with the product being hawked three booths over. It's amazing how many “independent” speakers have financial relationships with the companies whose products they happen to recommend or post on their social media.

The Reality vs. Theory Ratio: If the presentation description uses the word “innovative” more than three times, it’s probably theoretical garbage. If it mentions specific numbers, percentages, or actual case examples, you might learn something useful. If it is the same garbage presentation from years past repakaged, its’s still going to be garbage.

DO’s:

DO attend my session with Paul Gaspar on “When Physical Therapists Go to War (And Actually Win).” When was the last time you heard about PTs actually beating insurance companies in court? How and why do we win? That’s right, about as often as you see a unicorn doing your documentation. We’ll share real victories that prove David can occasionally dropkick Goliath in the nuts—legally speaking, of course. Here is a good primer on the talk! Do also attend this 7:30am panel on burnout on Friday-have written more about this topic than any other, even more than Hinge and Sword masquerading as physical therapy friendly.

Do visit the Hinge Health booth if they are there – but only for the entertainment value of watching them explain how their “digital MSK solution” is not just reconfigured physical therapy without the physical aspect or the therapist. Bonus points if you ask them why they need to rebrand our profession to make it palatable to VCs. Double bonus if you time how long it takes them to use the word “disruption.”

DO stop by Sword Health’s display if they are there – because nothing says “innovation” quite like a company that literally tells patients “when your physical therapist is actually a tablet.” Pro tip: Ask them about their therapist-to-patient ratios. Then watch them squirm harder than a patient trying to explain why they haven’t done their HEP in three weeks.

DO attend the Dicus Award ceremony and reception, along with the other awards PPS hands out. These are the people actually advancing our profession, not the AI-peddling charlatans three booths over. Plus, free alcohol helps wash down the bitter taste of reality.

DO network at the hotel bar after 9 PM. This is where the real conference happens. The truth serum flows freely, and suddenly everyone admits their clinic is also hemorrhaging staff faster than a hemophiliac in a knife factory. The content sessions are just for CEU’s, the conversations amongst practice owners are the education.

DO attend at least one session on “innovative payment models.” Not because they’re actually innovative—they’re usually just creative ways for us to think somebody else is actually doing this—but because you need fresh material for your dark humor repertoire. We have had “cash pay” presentations at PPS for 20+ years but the needle to actually convert the profession has not moved materially-but maybe, just maybe it is really happening this year!

DO bring comfortable shoes. The exhibit hall is roughly the size of Rhode Island, and your plantar fascia doesn’t care that you’re a movement expert.

DON’Ts:

DON’T believe any vendor who promises their product will “revolutionize” your practice. The only thing revolutionizing our practice would be insurance companies actually paying us what we’re worth. Spoiler alert: That’s not happening.

DON’T get sucked into the “PT mill success story” sessions unless you enjoy hearing how to cram 30 patients into an 8-hour day while maintaining “quality care.” These are the same people who think group therapy for individual billing is “efficiency.”

DON’T skip breakfast to attend the 7 AM sessions. Despite what the eager beavers tell you, no career-defining revelations happen before caffeine. The early bird may get the worm, but the second mouse gets the cheese—and a full stomach.

DON’T engage with the MLM “wellness coaches” who somehow infiltrated the vendor floor. No, essential oils or CBD won’t fix Medicare reimbursement rates, Karen.

DON’T forget to grab every free pen, stress ball, and tote bag available. Your clinic’s supply budget is a joke, and these vendors’ marketing budgets are not. It’s called resource redistribution, comrade.

DON’T be fooled by the “AI-powered” anything. It’s usually just a fancy algorithm that does what your clinical reasoning does, except worse and for a monthly subscription that costs more than your annual raise.

DON’T expect the conference app to work to be robust. It will crash more often than a new grad’s confidence after their first workers’ comp eval. Screenshot everything or go old school with paper.

The Bottom Line:

Look, we all know why we’re really here. It’s not for the groundbreaking research (though some of it is genuinely good). It’s not for the CEUs (though we desperately need them). It’s for the fleeting moment when we’re surrounded by thousands of people who understand why we laugh-cry when someone says “prior authorization” or “KPI’s or Metrics.”

So come to PPS 2025. Attend my session where we’ll discuss actual legal victories against the insurance industrial complex. Mock the digital health charlatans with me at their booths. Commiserate at the bar. Honor the real heroes at the awards ceremonies. And remember: we’re not pessimists, we’re just optimists with 39 years of experience and used to have really good documentation skills.

See you in the trenches, I mean conference halls.

larry

@physicaltherapy

P.S. - If you see me wandering the exhibit hall with a thousand-yard stare, just hand me coffee and point me toward the nearest session on “burnout prevention.” The irony alone will revive me. And by the way, I will be on a burnout panel on Friday morning right after eveybody will be burned out with the late night parties.

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