03/04/2026
Every time I hear physical therapy referred to as an “ancillary service,” I have to pause… Ancillary.
By definition, ancillary means providing support to the primary activities of an organization. Secondary. Supplementary. Auxiliary. Helpful, but not central. That framing is the problem. Because if exercise, movement, function, and pain management are “secondary,” then what is primary?
We treat the consequences of immobility, metabolic disease, deconditioning, chronic pain, post-surgical recovery, and orthopedic injury daily. These are not fringe issues. They are major drivers of disability, healthcare utilization, and long-term cost.
Physical inactivity is a leading modifiable risk factor for chronic disease, associated with cardiovascular disease, type 2 diabetes, certain cancers, and all-cause mortality. Chronic musculoskeletal pain is among the top causes of disability globally. Post-operative outcomes are strongly influenced by rehabilitation and progressive loading… yet we are labeled “ancillary.” Let’s be honest about what that word implies. It implies optional. Revenue-adjacent. Something that enhances the primary service rather than something foundational. But movement is not optional biology.
You cannot separate medicine from movement. You cannot manage cardiometabolic disease without addressing activity. You cannot meaningfully treat chronic low back pain with imaging and injections alone. You cannot restore independence after a stroke without rehabilitation. You cannot return an athlete to performance without graded loading.
Exercise is not an add-on. It is a biologic input. Physical therapy is the discipline that applies that input safely and progressively. The irony is that healthcare spends billions managing the downstream effects of inactivity, frailty, deconditioning, and chronic pain… and then categorizes the profession addressing those variables as “support.”
Function is the outcome patients actually care about. Can I walk? Lift my child? Return to work? Play golf again? Live independently? Physical therapy is not ancillary to medicine. It is core infrastructure. Movement is not subordinate to health. It is foundational.
