“Doctor of Physical Therapy”
A recent story on the front page of the Seattle Times (10/2/11) from the New York Times talked about the title “Dr.”, and who it belongs to. At issue are other people in fields of Medicine who now earn doctorates. This list includes physical therapists, nurses, and pharmacists. Currently there are 203 programs that offer the professional doctorate in Physical Therapy. These programs are typically 3+ years long (post graduate), often associated with other medical education programs, and are a combination of didactic classroom study, labs and clinical rotations ( averaging about 27 weeks) following classroom training.
This article discusses about the battle over the title “doctor” and the money, power, and prestige that come with it. In practice, the title of Doctor of Physical Therapy does not increase the reimbursement for our treatments. Power is really not an issue in terms of access the patient has to Physical Therapy. In Washington State, people have had direct access to visit Physical Therapists since 1988 (meaning that a prescription from an MD is not required. Currently this is true in 46 states). Even with this autonomy, we continue to work as a part of the traditional healthcare team.
Prestige is involved here. The title “doctor” is deserved as an indication of the level of education and training Physical Therapists receive. It does not define nor expand the “scope of practice” of Physical Therapists. Without a doubt, we are the experts in musculoskeletal injuries and rehabilitation, providing the direct hands-on treatments that benefit patients.
The article goes on to say that direct access leads to getting a larger share of money spent on patient care. This in fact is not the case. Direct access has not led to overutilization, and in fact reduces the overall cost, often eliminating the costs of a brief MD visit prior to seeing the Physical therapist, and expensive diagnostic procedures that might not be necessary in many cases.
We are the experts in movement, and musculoskeletal injuries, and well as rehabilitation of neurological conditions. Our training is very focused, and many therapists specialize following graduation, obtaining Specialist Certifications in 8 distinct areas after completing the training and passing the certification exams. As an important part of our training, we quickly recognize conditions that are outside the scope of our practice or that require additional diagnostic tests. Because we practice within the medical profession, we refer these patients to the appropriate healthcare provider.
Interestingly, chiropractic is not mentioned in this article is. With generally less training, and operating outside of traditional Medical establishment, chiropractors nevertheless call themselves “Doctor” with great pride and autonomy.
I believe the take-home lesson from this article is not the confusion it might cause patients. No one should represent themselves falsely, but the title of “Doctor of Physical Therapy” should re-assure patients of the academic and clinical training their therapist has, and the professional and effective treatment they receive.