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Leading Without The Label: Physical Therapist Advocacy Against Prior Authorization and Utilization Management
Dissertation   Open access

Leading Without The Label: Physical Therapist Advocacy Against Prior Authorization and Utilization Management

Theresa Anne Marko
Doctor of Education (EDD), Creighton University
2026

Abstract

advocacy advocacy leadership prior authorization qualitative phenomenological research utilization management Educational leadership Physical Therapy
This Dissertation in Practice examines how licensed physical therapists describe theirleadership experiences when advocating against restrictive prior authorization and utilization management policies. Prior authorization and utilization management are insurance processes that have created widespread delays, denials, and administrative burdens within healthcare, and physical therapists remain largely absent from the broader literature on health policy advocacy. The purpose of this study is to explore how physical therapists experience and describe leadership within their advocacy efforts, including what motivates their involvement and how they navigate systemic barriers created by insurance policy. This study used a qualitative phenomenological design, which is suited to understanding participants' lived experiences and the meaning they assign to them. Data were collected through semi-structured virtual interviews with licensed physical therapists practicing in the United States. Participants were recruited through snowball sampling and targeted outreach within professional advocacy networks. Interview data were analyzed using an inductive thematic analysis approach. This document is organized into three sections: a literature review and research proposal establishing the need for this study, a submission-ready manuscript prepared for publication, and a practitioner recommendation plan that translates the study's findings into guidance for physical therapy education and professional advocacy organizations, alongside the researcher's reflections as a practitioner-scholar.
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