Direct access and doctoral entry to profession

[Joe Wells]

Hi Redge & et al:   I totally agree with your viewpoint on issue 1 & 3. Also, thank you for introducing the motion on direct access. It was very much needed.   However, I must to differ on issue 2. I believe the chiros have indeed boosted their professional image and services by establishing entry at a doctoral level. It is unfortunate we must follow the path of the PTs in order to ensure our own viability. I agree that currently neither of our professions (PT or OT) are prepared to be primary care providers, but that is what is intended to be achieved through the DPT/ OTD programs. Primary care practice must be viewed seperate  from primary care medicine. The word that I came across while researching the Chiros quest for status and now the PT's, they used the term 'limited' medical professionals, i.e , limited to their scopes of practice alone. It would be interesting to note that Chiropractors(in the few countries that it is practiced), dentistry, medicine, PT, OT, Psychology, optometry, podiatry , osteopathy are all at the bachelor's entry level in countries other than the US and Canada. I do believe with the overwhelming responses from the schools transitioning to DPT, whether the 'prescriptive' authority is granted or not, the PTs of the new generation will enter the field with a DPT. In my opinion, this will negatively impact the admission to OT programs either way. Why will I choose a 5- 6 year degree to be an OT, when I could in almost the same time or a little more be a DPT with a wider scope of practice. The referrals (and, if direct access is granted) may be more condusive to be achieved by a doctoral trained professional. I understand the opposition that we or the PTs may face in their efforts to do so, especially from the physiatrists. But the analogy is similar to that of the optometrists and opthalmologists, and that of an audiologist and otolaryngologist (ENT). Optometry, chiropractic, osteopathy, and the most recently Audiology, was able to overcome these hurdles. I would not be too suprised if all the PT schools convert their entry level degrees to a DPT within the next 10 years (sooner than their expectation, i.e, 2020). If the master's program is intended to produce competent clinician, why can't a doctoral program with appropriate skills introduced such as a residency program in a specialty, etc., further intensify the same objective. Obviously, financial and political issues come to play. I believe the true independence and direct access to a profession comes with its ability to stand alone as a profession and seen as an equal by similar professions. Once PT moves up to a DPT entry, with the disparity of degrees, it would be difficult to do so. I am including a letter from the PT bulletin for further perusal. Also visit http://members.aol.com/PTdoctor/PAGE-Newsletter-Review.html, for APTA presidential address 1998 on this issue.   Would love to hear more takes on this.   Joe Wells President AmeriCare Health Services, LLC 502 Clinton Street Defiance, OH 43512 (419) 782 0101   _____________________________________________________________________________________   Limited Medical Professionals? EDITOR: With the continued growth in the competitive field of medicine, the future of the doctor of physical therapy (DPT) degree appears to be moving physical therapists toward becoming independent medical practitioners. I finish my DPT degree in 1999, and I, for one, am convinced that sometime in early 2000, there will be a significant move on the part of physical therapists to join the ranks of"limited medical professionals" such as dentists, podiatrists, optometrists and clinical psychologists. These individuals practice a "limited" scope of medicine, focusing their medical knowledge and skills to a particular part of the human body. DPTs, like these independent medical practitioners, will be specializing in the evaluation, diagnosis and treatment of neuromusculoskeletal dysfunctions of the human body. Obviously, their field of expertise in physical therapy, such as orthopedics, neurology and geriatrics, will designate them in their specialty area and will be a source of referrals when necessary. Only by fitting into the role of a "limited medical professional" can DPTs finally gain acceptance as independent medical practitioners in the medical arena. The trend is inevitable as well as logical. Only with the perseverance of all PTs joining hands and pushing toward reaching this goal will progress finally be made. Our duty at the present time is to call for all practicing PTs who have not attained the doctoral level to upgrade their educational degrees to DPT status and for all PT schools to change their programs from the current master's level to the doctoral level in order for us to achieve the "limited medical professional" status and become the independent medical practitioners that we should have been in the first place. With the current popularity of specialty certification in the field of physical therapy, it is clearly obvious that the move is on and will continue to escalate with the continued education of physicians, other medical professionals, insurance companies and the public regarding physical therapy. Edsen Donato, MPT Loma Linda, Calif. PT Bulletin, September 26, 1997