lawguil said:
The DO, MD, DDS become worthy of the mighty D because of the extensive clinical training, intensity, and invasive autonomy of a physician. Viewing medical schools globally, they are probably more selective than any other educational program. The pre-requisites for medical school make sense and provide a foundation to construct a medical student. Further, referring to a physician as Dr is reflected in hundred and hundreds of years of history and by definition describes what it is they do.
Issues to consider: The MD, DO, DDS is not accepted by most academic institution for tenure tract position, but may be qualified to teach in a specific content area (such as a medical school). As a general rule physicians arent known for generating quality research outside of specific clinical subjects.
I agree, with the exception that Doctor was originally meant Teacher... so only according to our society and individuals perceptions, it describes what they do
lawguil said:
Now for the DPT, Im not quite sure what to say. Im sure that the DPT is an intense program, but physical therapy should be an intense entry level undergraduate program much like engineering.
Is that your opinion or something you've heard as feedback from patients and clients of physical therapists, or actual physical therapists themselves.
lawguil said:
This would give students an opportunity to then do real graduate work and really allow the profession to diversity.
By "Graduate work" I'm assuming you mean original research. For many years, before I was born, most undergraduate physical therapy programs required research theses as a part of the curriculum. Were they as extensive as PhD programs? No. As master's programs... yes.
lawguil said:
Imagine an undergraduate degree in physical therapy and a masters in kinesiology, exercise physiology, education or a DSc in Physical Therapy or Athletic Training.
This system you mention for us to "imagine" has been in place for about 30+ years. Many physical therapists move on to graduate degrees in public health, exercise physiology, applied anatomy, subspecialties of PT ie. pediatrics, orthopedic manual therapy, neurological PT, etc. DSc's, DHSc's PhD's etc have existed as academic programs in physical therapy as well.
lawguil said:
I cant seem to recognize any material in a PT curriculum that requires undergraduate work for the program to build on. As you already know, PT was a bachelors degree for many years and there is nothing I can find that showed that the programs were not producing competent providers.
Ok, so I have to admit that I wasn't angered about statements up until this point. Your arguments so far have been somewhat realistic, though skewed. However, this last comment regarding prerequisites not necessary makes me believe that the author has truly not delved into the requirements of a physical therapy curriculum nor the tasks involved in the physical therapy evaluation, examination, treatments or patient management.
Prereqs for PT include the following (parentheses is the requisite of clinical skill and patient management):
General Biology (understanding cell biology, bacteria, pro/eukaryotes, general laboratory research principles)
Human Anatomy (usually covers material similar to an abbreviated microanatomy/gross anatomy course - lab includes Cat Dissection, brain, eye ball, etc for orientation of the human body)
Human (systems) Physiology (cardiovascular/respiratory physiology is essential to know for Cardiopulmonary PT, neurophys for Neurological Physical therapy, renal/endocrine to understand basis of metabolic dysfunction - is patient medically stable to get out of bed?)
Exercise Physiology (Therapeutic exercises for strengthening, aerobic capacities, adaptations to exercises, training principles, etc)
General Chemistry - depending on the school, this can be General, Orgo and Biochem - much like Boston University (understanding acid/base in physiology, principles in ionic flow for nerve conduction, understanding enzyme principles for drug effects/interactions - yes PT's need to have basic understanding of drug effects to understand presenting signs and symptoms - why that sounds very similar to what a physician does.)
General Psychology (therapeutic relationship, personality types, principles of reinforcement and behavioral treatments)
Developmental Psychology (understanding the human across the lifespan used in pediatric, geriatric specialties as well as understanding what stage of life a person is in... this reflects their goals in therapy)
Abnormal Psychology (sick people have comorbidities that present psychologically as well. It is important to recognize and refer for individuals with eating disorders, OCD, etc. These issues have implications for therapy and how you instruct or interact with patients. This is used in education theory classes in DPT curriculum)
Physics (this should be self explanatory - physical forces govern the human body - physiology = physics and biology, functional anatomy and kinesiology is the application of biomechanical forces ie. lever arms etc in the human body)
Math (algebra or calculus) - health care management courses explore accounting and business principles. One needs to have a working understanding of exploring and creating graphs to track progress.
English Composition - technical writing is required for writing up case studies and research throughout the graduate program.
lawguil said:
If you follow the politics that are going on in all the states and nationally, PT is fighting for direct access and more autonomy. However, if you review the curriculum, the content of the courses hasnt really changed. You cant add a pharmacology course and more clinical training to qualify calling PT a doctoring profession. The clinical doctorate is being used as leverage for the APTAs political agenda. It simply doesnt work that way in academia (yes, I know that PT is a clinical degree). Currently, I do not know of any institution that has anything on the books that recognizes the DPT outside of the fact that it is a degree that they may or may not award simply because the APTA has mandated it as the future of entry level physical therapy
While I agree the politics are a major driving force (and this is my opinion that differs from others in the profession), the truth is another major driving force is the change in health care climate. The content of curriculum has changed in response to an increased need for primary care. Primary care physicians are lacking in this country and are overburdened, underpayed. PT's are now trained to medically screen more efficiently (though I think this can be improved even more), health care management classes have been created to stimulate interest in greater autonomy, political activism, and awareness of the health care system in the US. Education theory and practice courses have been added to improve upon the teaching skills of the therapist in various settings including media, classroom, and adult learning courses. Pharmacology courses have been added to improve upon the PT's understanding of drug interactions and appropriate timing with therapy to maximize patient ability.
You see what defines PT as a doctoring profession (and I'm not saying that it is or isn't) to those who feel PTs are doctors is the extensive education, clinical expertise in biomechanics, rehabilitation and functional improvement. In most cases, the patient has a greater relationship with the therapist than with the physician. Doctors care for patients, they examine, diagnose, evaluate, design a plan of care, treat, establish prognosis. Oddly enough, a physical therapist does all of those things, as well. Why there is such a disturbance among the health care professions to call a DPT doctor is absurd. It is in most part because of radical change (no one ever likes that) and lack of familiarity with PT education and the actual clinical tasks of a PT. Why are psychologists traditionally called Dr.? Studies have shown that master's educated therapists are just as effective. Physicians in other countries receive BSSM... bachelor's in medicine and surgery.
Patients don't need a referral just to let them know they have a sprain... patients don't need a referral just to let them know they can't walk...
They just need someone who can help them. A doctorally educated physical therapist is able to evaluate and treat, and appriopriately refer as necessary. Were BSPT's able to do the same? Probably. But professions change and health care has changed a lot in the last ten years. PT has adapted, and I think anything that ups the standards of education cannot ever be a bad thing for a patient.