McDonald’s remains one of our country’s top franchises with over 14,000 locations across the United States. Ray Kroc’s quote about not being in the hamburger business but instead real estate comes to mind as you review the numbers. Franchises are based on successful operational systems where new owners hope to achieve similar results despite new employees and locations. Early in McDonald’s history they encountered a problem in their dining rooms. Customers were not used to the fast food etiquette of throwing away your own trash and stacking your trays, instead they commonly left their trash on the tables. Reports detailed various attempts to break these habits including coupons and financial incentives for customers who handled their own trash, but none creating lasting change. Finally, McDonald’s instructed their employees to dress in street clothes, eat in the dining room, and handle their own trash. Other customers followed suit and the rest is history.

It is easy to look into any profession and identify inefficiencies, ineffective methods, and laggards. In the Physical Therapy profession we face significant barriers including limited patient access to Physical Therapy services, inadequate reimbursement, overlapping patient scheduling, and Physician Owned Physical Therapy services. While our national organization works to address some of these challenges facing our profession we must continue to model our practices to resemble a more ideal delivery of Physical Therapy services. As with the McDonald’s example above this may create a lasting change in a patient’s expectations for our services and in turn help our profession reach its’ full potential. The quote often attributed to Gandhi, “be the change you wish to see in the world”, may help others follow suit.