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Re: Should PTs be called "Dr."
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Re: Should PTs be called "Dr." - January 29, 2005 2:59:00 PM
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ptdan23
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tc...I was not referring to MD's, just other professions that also have a clinical doctorate (chiro, podiatrist, etc). They use the Dr. title so why shouldn't a PT who has achieved that level?
I also don't think that we have to be called Dr. to get respect but since the general public knows very little about PT that would sure be a step. It is also about respecting ourselves as a profession. If we achieve a certain status such as having a doctorate why shouldn't we use the title.
Dan, PT.
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Re: Should PTs be called "Dr." - February 1, 2005 7:50:00 AM
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JLS_PT_OCS
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Interesting.... it seems the title "Doctor" comes from the latin root for 'teacher' and really has nothing whatever to do with the medical profession, from that standpoint.
That is a common term in a university for anyone with their PhD in a particular field, be it english literature, medicine, or particle physics.
Our colloquial usage in the US historically makes it apply more specifically to Physicians, as in Medical Doctor.
In the 1960s, the AMA recognized Doctors of Osteopathy as essentially the same type of practitioner, and gave them equivalent status. Some differences persist, but since I only know from my discussions with DOs/MDs and am not an expert, I'm not exactly sure what those differences are.
(somebody correct me if my facts are off, this is off the top of my head)
It is important, I think, for us to realize that Physicians hold the keys to the kingdom in the medical world, and they have guarded this power rather carefully from others. Perhaps out of a sense of public protection, perhaps out of greed, I can't say. It seems that non-physician healthcare providers are the only groups that have to argue over the table scraps of state legislatures deciding what their scope of practice will be.
In most states, after graduation from medical school (which does not require a baccalaureate degree), you are awarded the degree and the title and are allowed to call yourself that. Residency programs (so my physician friends tell me) are not required to take a state licensure exam. So in fact, an "MD" doesn't necessarily have any more training than a "DPT" would. Just different fields.
In the US, this has led to PT-MD, and PT-Chiro wars that still rage today. In the courtroom, and in the legislature, it is hard to pull off your case when you argue as "Mister/Miss so and so" and the other person argues as "Doctor so and so".
In my opinion, the DPT seems to be as much about political parity for the purpose of maintaining our professional scope of practice than about what's really needed to practice safely and effectively.
In other countries such as Australia, where PTs enjoy direct access to patients, no such doctoral push is in existence (to my knowledge). That's because it's simply not necessary. The coffers of the medical societies in that country are not partially filled by PTs providing POPTS indentured servitude to help line another provider's pockets. Nor is it full of Doctors of Chiropractic who seek to restrict the scope of practice of PTs (to my knowledge). So it seems as always, it's as much about money as anything else. That doesn't make it wrong or bad, just something to think about.
The future of PT as an independent provider depends as much on MD/DO cooperation than on anything we do or do not do. It's hard to get that with too many noses pushed out of shape. Read the position statements of the AAOS (orthopedic surgeons) to find out where the money goes and why they REALLY want to keep PTs in servitude.
I will agree with Drew that just because you CAN call yourself Doctor doesn't mean you SHOULD. Picking and choosing when it is appropriate is the hard part. Vision 2020 is just that, a vision, not a fait accompli. We should not act or speak as if it is.
And I don't even have my DPT yet, imagine how opinionated I might become with some more experience under my belt!
Jason.
_____________________________
Jason Silvernail DPT, OCS, CSCS
Homo Vegetus
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko, Writer and Physical Therapist
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Re: Should PTs be called "Dr." - February 1, 2005 1:55:00 PM
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ptdan23
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I totally agree w/ Jason. The push toward the DPT is hugely political. While most of us even w/ our BS have an excellent education and background as good or better than a DPT, we just can't switch to being doctors, that is where the DPT comes in. In order to advance our profession the APTA made this move to do so.
Jason makes a good point of someone being called a doctor vs mister or misses. Having the title kind of elevates you to a different level. Kind of sad in a way but that is our culture.
Dan, PT.
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Re: Should PTs be called "Dr." - February 4, 2005 1:28:00 PM
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dosrinc
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Jason, I think you hit the nail on the head, good post.
Rick
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Re: Should PTs be called "Dr." - February 19, 2005 5:39:00 PM
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ravisekhartvm
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i think we should be called Dr. as we are following almost the same sylabus of the M.B.B.S for the first year & from the third year we are specialising in PT subjects & we are getting good clinical exposture during the clinical postings.
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Re: Should PTs be called "Dr." - February 20, 2005 9:50:00 AM
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jma
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It would be nice if all could be called Dr. However, the terminology should be clear enough to know the difference between a Doctor of Physical Therapy and a Physiatrist.
JMA
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Re: Should PTs be called "Dr." - February 21, 2005 11:13:00 AM
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TLB
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http://azapta.org/Publications/Docs/APTAN/APTANFeb04.pdf
My solution would be to grandfather everyone to the DPT. AZ has one of the strongest state associations around and they are very proactive in regards to protecting turf and equaling the playing field for everyone. I've been in TX for the last year and the 2 associations don't compare, I need to check and see if they have passed this legislation yet.
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Todd
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Re: Should PTs be called "Dr." - February 21, 2005 2:32:00 PM
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JLS_PT_OCS
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I think grandfathering is not the best plan... we have so many different levels of education currently.
We have BSPTs, MPTS/MSPTS, and DPTs. We even have some still practicing who earned a certificate! What a way to see how our profession has grown.
I think that the best way to make this transition hard on everyone is to push for being called "Doctor" as soon as possible.
Let's keep in mind we are all in the early stages of this thing, and we need the cooperation and support of other healthcare professionals who respect our work and believe that we have earned the title...I don't think we can get that by being pushy with, of all things, what we are called. It would seem to be the least important piece of the puzzle...
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
Homo Vegetus
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko, Writer and Physical Therapist
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Re: Should PTs be called "Dr." - February 21, 2005 2:58:00 PM
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Andrew M. Ball PT PhD
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Earning a transitional DPT isn't difficult. There's no way that anyone should expect to be handed a DPT if they haven't EARNED it. The transitional DPT IS the grandfathering plan for the profession.
Instead of complaining, I suggest that the subeducated (not to be insulting, but the reality is that "entry-level" is a MOVING TARGET and as such, PT school today IS better than it was 5 or 10 years ago and covers diagnostic and treament topics in MUCH greater depth) experienced ranks of our profession should get off their collective rears and earn a transitional DPT . . . unless of course ya'll think that we should "grandfather" the massage therapists and athletic trainers into being PT's because they claim to be doing rehab now . . .
Drew
I'm working hard for my DPT and am only a course away from finishing, and I'm sure I speak for quite a few transitional DPT's, educational programs, and the most likely the APTA in saying that we'd be ****ED before allowing anything remotely like an unearned DPT to come to pass. The Arizona plan, I thought, was killed long before it grew legs. I suspect that those raising it as a viable solution are simply thinking wishfully.
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Dr. Andrew M. Ball, PT, DPT, Ph.D.
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Re: Should PTs be called "Dr." - February 21, 2005 5:32:00 PM
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TLB
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Drew,
No need to get pissy. I don't mind taking a few extra courses or passing some sort of competency exam, what I do mind is being gouged by a university to earn that DPT. Can you give us some kind of idea on the cost of a DPT. Not sure about the AZ plan, I need to check it out. If it was killed, who killed it?
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Todd
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Re: Should PTs be called "Dr." - February 21, 2005 6:10:00 PM
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ptdan23
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I read over the link provided by TLB to the AZAPTA newsletter. I have very mixed feelings on the whole grandfathering issue. I was just wondering if anyone knows if there are different levels of education for lawyers and podiatrists which are two examples given in that newsletter. I think that is something unique to our profession - those other professions while not stated - may have had the same education level (same number of years). This is not true for ours. I think that is one reason why it would be hard to push to grandfathering everyone to a DPT. Any thoughts?
Dan, PT.
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Re: Should PTs be called "Dr." - February 22, 2005 1:33:00 AM
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SJBird55
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All those levels of education that can occur in our field is the problem. All of them are considered entry-level. Any one of them met the requirements for the licensure exam. We moved from BS to MS to now DPT. And, honestly, that's fine. What isn't fine is telling everyone that they have to have the wonderful DPT. And grandfathering? What a bunch of hogwash - I'd be the rebel and refuse to use the DPT designation.
I'm not saying that I don't believe in education. But, I have said and do believe that it is up to the individual therapist what the therapist wants to do. The APTA may have the vision to be doctors of physical therapy in 2020... come on, reality is that even if I don't have a DPT, I'm not going to be out a job. Like my state practice act is going to change? Uh, huh... right - heck, we don't even have direct access yet. I see how the political wheels work. I see what reimbursement is at - is there any "gain" for me financially? Heck no.... Why am I going to spend about $20,000 for my transitional DPT? For job security for the professors at some university... hmmm, to take the course online??? I guess I just don't do something because of "peer pressure." There is no substantial "gain" for me to get a DPT - none whatsoever. That $20,000 will serve me better in a retirement plan or for my kids' education. I have a passion for what I do, but I'm sorry, I'm not going to just follow the advice of others or the APTA when the advice just doesn't have a strong rationale. A course on diagnostic testing might be nice - but hey, I don't order the tests, don't receive the tests and generally never see the tests - so, ummm, what good does it do me? I did a continuing ed with Boissonault - bought the boook and took the differential diagnostic course - awesome information and I use it with every patient. Definitely made me a better therapist. (A ton cheaper than a DPT). Let's be realistic - a pharmacology course - sure - lots of drug names... that aspect is always changing. Earning a DPT will not keep me current in pharmacology. That world is always changing... and, frankly, I don't order meds. What I do feel is important though, is the affect meds can have on patients and the impact that may occur with physical therapy.
And for the argument that the DPT has a better education than 5-10 years ago... well, geesh, it SHOULD be better. Why is something like that news to anyone? ALL fields (engineering, athletics, info tech) are BETTER now than they were 5-10 years ago. Our field is no different than any field out there. Every field is a moving target.
The question that I would pose... if entry-level is such a "moving target" and it is so important to keep the profession within the range of that target, well, why is there nothing in place to keep everyone's sight on that target? Is it realistic for everyone in the profession to keep on going back to school to keep achieving whatever degree is offered? I do believe that there are other alternatives if the importance really and truly lies in maintaining a current and competent profession as a whole.
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Re: Should PTs be called "Dr." - February 22, 2005 3:12:00 AM
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TLB
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SJ,
The whole grandfathering concept in AZ was brought on by new DPT grads insisting on being called doctor in the clinic, even though it was against the state practice act. Some felt that the general public who didn't know any better would rather be treated by a DPT than a PT or MSPT. Think about as if you have no concept of the medical field. Would you as a lay person rather go see someone who has a measley old bachelors degree or someone who has an advanced Doctor of Physical Therapy? The general public has no idea they are one in the same. It was just basically leveling the playing field for everyone without as you state spending 20 grand.
Todd
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Todd
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Re: Should PTs be called "Dr." - February 22, 2005 3:14:00 AM
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dosrinc
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In my opinion the only reason to go through the process of obtaining a DPT is to learn how to better treat your patients. This is the only way that the profession will benefit from this move. I know too many PT's who have signed up for the cheapest t-DPT they could find, do all of the work on line and when you ask them what they are learning or what line of study they are specializing in they can't even answer. "I just read the stuff and take the test after". This kind of DPT will do the profession a disservice and I don't believe it is what the APTA had in mind with vision 2020. Please take some personal responsibility to advance yourself and the profession otherwise you are wasting your time and money.
Rick
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Re: Should PTs be called "Dr." - February 22, 2005 2:22:00 PM
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ptdan23
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I think as PT's that we should all use PT in our title whether or not we have a BS, MS/MPT, or DPT/tDPT. That in most states is the official title as far as I know. It should then be followed by the degree. I have seen this written may other places. That would help some of the confusion to the public.
I think one of the main reasons for the push to the DPT is to get both total direct access as well as more autonomy in decision making for our patients. I believe both of those things are very important for our profession. Whether or not the DPT is the right way to go about it, who knows. May be, may not, will see soon enough. I think what needs to be a huge push is with each state practice act. That is the way that things change, it has to be said somewhere that we can do it. Also, we have to be recongnized by payors. In my opinion, these two things need to happen in order for us to achieve direct access and great autononmy.
Dan, PT.
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Re: Should PTs be called "Dr." - February 23, 2005 8:42:00 AM
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Andrew M. Ball PT PhD
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In answer to some of your questions. The t-DPT's come in may flavors. The Boston U t-DPT has focus upon management, the program at UNC is very wide in scope as to allow for advanced electives, and the program at MGH/Harvard has a mixed evidence-based practice/advanced understanding of clinical research/patching holes in imaging, pharmacology, and imaging skills kind of focus.
There are some differences in cost due to the background experiences and education that the learner enters with, which modifies which courses need to be taken, but the average cost of a t-DPT is under $5000, and the tuition is tax deductable.
Rick's statements in his last post lack a certain insight into the experience of the t-DPT. First of all, most t-DPT's I know play down their educational experiences to those not engaged in the t-DPT process. There is so much venom out there (see thread to date), that it's usually just easier to describe it as "as easy as a few tests online." There's more to it than that, to be sure, and it's certainly not as rigorous as a PhD, but if my downplaying the academic rigor results in an experienced clinician going and getting the degree, so as to lead the profession with BOTH experience AND a DPT education --- I think we'd all agree that THAT's the kind of person that should be the DPT icon --- not the new grad.
Finally, t-DPT's are GENERALIST degrees, designed simply to patch the differences between the courses taught when we as expeprienced PT's were in school, and the additional expectations and coursework of what's now considered entry-level. Generally, this means updated pharmacology, imaging, diagnostics, and single-subject research. Beyond that, opinions differ on what today's NEW GRAD should have, and as such, the range in programs.
Let's get something straight, however. The DPT (or MPT) graduate of today has a much better education than the PT graduate of 10 or 15 years ago. The whole point of a DPT is to patch the holes in what the experiened PT of old never got in school. There is not, and should not be, an advanced clinical practice focus because if you're been practicing for 10 years, you should have quite a bit of that through experience and continuing education.
By the same token, walking out of an entry-level program with DPT in hand DOES NOT make a better therapist. What it does do, however, is to give the new graduate the tools by which to be a better therapist then their mentors once they achieve an equivocal level of experience.
DPT's are right in thinking that experience isn't all it's cracked up to be, often it's the same first year of practice repeated 20 times over . . . but experienced PT's have got to get it through their heads that their 20 year-old education simply isn't as good as what these kids are getting today.
Want to be an iconic agent of change in the profession? BE BOTH!!! DON'T LEAVE THE PROFESSION'S PUBLIC IMAGE IN THE HANDS OF NEW-GRAD DPT'S. BE BOTH!!! BE AN EXPERIENCED CLINICIAN WITH A DPT. That is the value of the t-DPT, and quite frankly, those experienced clinicians who publically bemoan the DPT because inexperienced clinicians shouldn't be the public face of the profession (and they shouldn't be), should lead by example (which demands EARNING a t-DPT), or quit complaining.
That's not an insult, it's a call to professional duty!
Drew
_____________________________
Dr. Andrew M. Ball, PT, DPT, Ph.D.
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Re: Should PTs be called "Dr." - February 23, 2005 4:03:00 PM
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jma
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Well said!!!
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Re: Should PTs be called "Dr." - February 23, 2005 5:41:00 PM
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ptdan23
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Couldn't agree more w/ Drew's comment re: public image of our profession. The "senior" PT's in my experience are the ones that are most against getting the degree while they are the ones that should be setting the examples for the younger PT's.
Dan, PT.
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Re: Should PTs be called "Dr." - February 23, 2005 6:08:00 PM
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tc
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This is specifically for Drew. I completely agree with your most recent post. But I do want your opinion on something.
I work primarily in peds. There are always more courses I want to take - Kinesiotaping, many different NDT courses, Infant Massage, etc.etc. When I look at the tDPT curriculum I see many thousands of dollars spent on courses like pharm., differential dx, and research methods which don't seem as beneficial to my daily practice as the pediatric continuing education courses. If I had all the money and time in the world, I would do all of the above. But, since you have a strong peds background and you are currently doing a DPT, what is your opinion on someone in my situation in terms of where is my money best spent? (I have researched the peds DScPT at RMU but that is really cost-prohibitive at this time *and* doesn't include some courses I would really like to spend that money on)
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Re: Should PTs be called "Dr." - February 24, 2005 3:47:00 AM
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jma
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You have a point. From what I am seeing initially, there are a few T-DPT programs that are orthopedic and manual therapy. There are no programs related to peds. If you were that interested in peds, my guess is that you continue down that road and then go for the pediatric specialization exam.
JMA
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