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PHYS THER
Vol. 79, No. 11, November 1999, pp. 1082-1084
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Letters and Responses

More on the Clinical Doctorate


To the Editor:

First, I want to express my gratitude to the Editor of our Journal for having the intestinal fortitude to invite all fellow physical therapists (especially clinicians) to participate in an open forum regarding the subject of a clinical doctorate. I hope both Dr Rothstein and the American Physical Therapy Association (APTA) Board of Directors will demonstrate their commitment to this initiative by publishing and responding to the appropriate concerns of the body of clinicians who make professional contributions in patient care on a daily basis.

Next, I would like to qualify my comments by describing myself so that my perspective will be totally clear to those who choose to read my comments.

I have been a full-time physical therapist for 22 years. I had the opportunity and honor to attend a university that was a bastion of physical therapy mentors. Some of my academic and clinical instructors included individuals that have achieved our profession's highest honors, including clinical, academic, and political distinctions. I have been a clinical instructor/mentor for more than 100 students, have presented research at our national meetings, have been a guest speaker at other national organization meetings, and have published in the Journal. I am very grateful for and humbled by all these opportunities; no one could ask for a more enriching and motivating professional experience.

Yet, I have serious concerns about the opportunities for future physical therapists. Although I agree that we must continuously examine and change our standards for education and clinical practice, I feel these changes must be made in the context of reality. They must be fiscally responsible, and the profession of physical therapy must be an accessible goal for all who qualify. Schools must not proliferate as mere investment potentials. The patients, physicians, and administrators we serve and work with must not be misled into thinking that a professional (entry-level) clinical doctorate is more desirable than a master's degree with clinical experience. The APTA has to exert its influence on the development and revision of more stringent accreditation criteria. Our elected leaders should lead for the common good; they should not have their own agendas. It is unreasonable to suggest a moratorium on accreditation and proliferation of schools and at the same time propose larger class sizes with longer and more expensive academic programs, especially in the face of the current supply-and-demand imbalance. We have already received enough bad press in The Wall Street Journal regarding supply and demand. I would suggest that the officials in APTA enlist the assistance of all practicing clinicians before an "enlightened few" make a serious mistake regarding professional qualifications. Physical therapy will survive the pendulum swing of cost-driven-only health care. Let's hope the next aspiring Mary McMillan will not change her or his occupational desires merely on the grounds of temporary fiscal incompatibility.

Michael W ThomasPT

Cary, NC

 

Editor's Response:


I hope that Mr Thomas' example of engaging in dialogue on this issue will serve as an example to others, and I appreciate his kind words about our desire to see the entire physical therapy community address this issue. I am, however, not sure where the idea has come from that class sizes will be larger with the DPT. They shouldn't be and don't need to be larger. As for the expense, I believe this, too, is not an appropriate assumption. Currently, most physical therapy postbaccalaureate degree programs require time in class that is comparable to 3 academic years (and these are usually at the master's degree level). These programs do not necessarily always take much more than 2 years to complete (the difference is due to course loads, scheduling creativity, and use of summers). Therefore, if—and this is a critical issue—students are currently paying for the cost of their true course loads (and faculty are given full credit for the loads they teach), the cost should not change dramatically. What should change is the product. That product, the new therapist, should indeed be better able to deal with the realities that exist in practice, because, with the DPT, curricular design can be creative and straightforward and can include clinical education designed not to fit a time limit but to fit the educational needs of someone who must be able to practice at a skilled and knowledgeable level upon graduation.

Jules M RothsteinPhD, PT, FAPTA, Editor in Chief

 

To the Editor:


Thank you for your candid editorial in the June 1999 issue of Physical Therapy. I agree with your insight on the issues our profession is currently facing. I, like many of my colleagues, have been displaced due to our "selling out" to the highest bidder. I have learned a lot about downsizing, priorities based on the bottom line, and what we, as physical therapists, have to offer the public. This education process has given me greater respect for my profession and has inflamed my passion to provide high-quality physical therapy services regardless of the monetary reimbursement.

In response to the article by Threlkeld et al in the same issue, I believe this will be another step to improve our credibility to the public. A title does not make us who we are, but should reflect our accomplishments. All those who have earned a degree of some sort should be proud of the accomplishments they have made and be able to show them off if they choose to do so. However, this does not demonstrate whether they can do the job. They may have all the paper qualifications in the world, but if they are unable to perform the task at hand, then what good are they? I apologize for being blunt, but the reality in our society is, if you cannot perform, then you're gone. Now, you can probably fool people for a period of time, but eventually it will catch up to you. I personally have seen this happen. This last point is probably what drives me to keep up with what is going on. I want to be able to provide the services people expect of us and continue to improve, modify, or implement programs and techniques to deliver these services.

So does a title ensure that? In my opinion, no. My hope is that we will focus on other issues that will continue to allow our profession to grow versus how our names look. As a true clinician, I am more interested in function versus appearance. Thank you for your hard work and dedication to our profession. I appreciate your contributions and have actually benefited from them.

Johnny Galver

Salem, Ore


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Related Articles

The Future We Want; the Future We Get
Jules M Rothstein
Physical Therapy 1999 79: 544-545. [Full Text]

The Clinical Doctorate: A Framework for Analysis in Physical Therapist Education
A Joseph Threlkeld, Gail M Jensen, and Charlotte Brasic Royeen
Physical Therapy 1999 79: 567-581. [Abstract] [Full Text] [PDF]




This Article
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Copyright © 1999 by the American Physical Therapy Association.