Andrew M. Ball PT PhD
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Joined: July 28, 2002
From: Charlotte, NC
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Having recently explained the origins of PT to a chiropractor friend of mine, it occured to me that many PT's may not know the complete story --- or at least less of it than what follows.
Contrary to popular belief, Mary McMillian may not have been the first PT --- she was the first formally trained PT in the United States, but the names Dr. Robert Lovett, Wilhelmine Write, Janet Merril, and Alice Lou Plastride have faded from the conciousness of physical therapists. We cannot allow that to happen!
The physical therapy profession in the United States owes its existence to acute anterior poliomyelitis, known at that time as infantile paralysis, and its widespread occurrence in the New England states from the 1890’s through the 1930’s. At the height of the epidemic, between 1914 and 1916, teams of workers were organized under the direction of Robert W. Lovett, MD, a Vermont physician, to treat those affected with polio. His team consisted of three individuals (Wilhelmine Write, Janet Merril, and Alic Lou Plastride) with backgrounds in massage and exercise, physical education, and gymnastics respectively. Under Dr. Lovett’s instruction and guidance, these women eventually came to be known as physical therapists. At roughly the same time, a woman by the name of Mary McMillian returned to the United States from England, where she had completed a formal course of study in physical therapeutics. She was eventually given the title of Reconstruction Aide, and is today regarded as the first PT in the US.
WWI had the unfortunate consequence of leaving many military personnel with lifelong disabilites in movement and function. As a result, in 1918, under the directive of the Office of the Surgeon General of the Army, Marguerite Sanderson unveiled what is today regarded as the first PT curriculum in the United States. The three month emergency course curriculum was offered to individuals in the field of physical education, and was intended to expand knowledge in human anatomy and exercise so as to fill the need for personnel within the Division of Special Hosptials and Physical Reconstruction. Graduates of the title carried the title of Reconstruction Aide.
The use of the title had two significant effects. First, it standardized the terminology used to describe the profession (until 1917, they were called everything from physiotherapy aids, to physiotherapists, to physician assistants). Second, agreement on the use of the title Reconstruction Aide solidified the subordinate and submissive role that PT was to play within healthcare for the next 50 years.
In 1928, the professional organization standardized educational curricula across the eight PT programs of the time, the intent being to ensure equity across the basic knowledge of one Reconstruction Aide to another. As a result, the time required for completion of a PT program exploded from 260 hours to 1200 hours. In 1936 the AMA assumed responsibility for development and oversight of PT education programs. Though the intent was to add credibilty and facilitate development of the profession of PT through AMA oversight, the effects were far more supressive in nature. Curriculum standards, for example, were so neglected that they were not updated until 1955, and not adopted until 1960, when it was decided that if a PT curriculum could be integrated into a BS or BA program, a BS or BA in PT could be awarded.
In 1977, CAPTE was recognized as the sole independent accrediting agency for physical therapy education, and by 1983, had eliminated all AMA oversight. In 1979, free to act without the constraints of AMA control, the APTA’s HOD resolved that PT programs must award post-baccalauriate degrees for entry-level education by January 1, 1991. Although most programs converted to MSPT or MPT programs, University of St. Augustine, Creigton University, Slippery Rock University, USC, and Duke, began preparation to move toward entry-level doctorates upon successful completion of their respective course curricula. This prompted just over half of the 200 PT programs in the United states to declare that they will produce 20 to 30 DPT’s each, by 2007, and most others to declare intentions to offer an entry-level DPT by 2015. The initial APTA vision stated that by 2015 it will be understood that, “the doctor of physical therapy is a primary care practitioner who is the recognized expert in the diagnosis and management of neuromusculoskeltal function for humans and animals across the continuum of care.” That’s since been revised and the vision 2020 can be found on the APTA’s website at [URL=http://www.apta.org.]www.apta.org.[/URL]
Entry-level DPT’s have prompted the creation of five advanced clinical doctorates (DScPT’s) --- but that’s another discussion entirely!
Drew
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Andrew M. Ball, PT, Ph.D., MBA
Adjunct Professor of Physical Therapy
University of Maryland DScPT Program
[This message has been edited by Andrew M. Ball PT PhD (edited January 15, 2003).]
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