consideration of a change in the physical therapist regulatory designator

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Consideration of a Change in the Physical Therapist Regulatory

Designator



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Meeting Agenda

• Issue background and history

• Questions to be answered

• Pros, cons, barriers, and opportunities

• Process to change designator

• Discussion



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Definitions• Academic degree/designation/credential

• The credential earned as a result of completion of an academic degree program

• E.g., DPT, BSPT, MSPT, PhD, EdD, etc.• Specified by institution and profession

• Regulatory designator• The credential earned as a result of licensure• E.g., “PT” is the regulatory designator for all licensed

physical therapists; consistent with current HOD policy

• Specified in state law• Other designators for PT have included LPT and RPT



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History of Issue

• RC 26-05 Consideration of the professional (regulatory) designation change to “DPT”– That the APTA investigate the appropriateness

of changing the regulatory designation of the physical therapist from “PT” to “DPT” in all jurisdictions, with a report to the 2006 HOD, which shall include but not be limited to: Strengths, weaknesses, opportunities and barriers

for implementing the regulatory change Criteria for implementation Mechanisms for implementation



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Regulatory Designator

• BOD appointed Task Force that met 12/05• Task Force report was provided to the BOD and

2006 HOD for consideration• Task Force Members

– Karen Donahue, PT, DPT (AZ, originator of motion)– Averell R. “Tootie” Overby, PT, DrPH (OH, PT with licensure

board experience)– Barbara Sanders, PT, PhD (TX, PT educator in non-DPT

program)– Joe Smith, PT, BSED (MT, PT with BS professional degree)– Ann Tyminski (MD, non-PT licensing board administrator)– Connie Hauser, PT, DPT (KY, BOD liaison)



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Task Force Recommendations

• The regulatory designator should be changed to be consistent with Vision 2020

• The regulatory designator should not be “DPT” because “DPT” is a recognized academic degree

• Guidelines should be developed for the use of the term “doctor” in clinical practice*

• The Association should make a statement that the minimal entry-level academic degree should be the DPT

• All state practice acts will have to be changed to reflect the change in designator and to provide title protection



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Task Force Conclusions

• Change the regulatory designator to “PTD” or something other than “DPT” that indicates physical therapy is a doctoring profession

• At the point in time in which the majority of licensed physical therapists have earned a DPT degree and/or CAPTE changes the evaluative criteria to reflect the minimum degree is a doctoral degree, the APTA should promote changing the regulatory designator in all jurisdictions



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• Physicians(MD)/Podiatrists(DPM)/Dentists (DDS or DMD) – changed the degree and designator together at the same time in the early 1900’s

• Optometrists (OD) – award first doctoral degrees in 1920’s; not offered by all Schools of Optometry until 1960’s; grandfathered the degree and designator at the same time

• Pharmacists – endorse Doctor of Pharmacy (PharmD) as sole entry-level degree in 1992• Only PharmD programs accredited since 2003• Pharmacists decide not to change regulatory

designator from RPh

OTHER PROFESSIONS



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Entry-Level Current Status• 164 DPT professional programs (9/1/06) (78%)• 1 developing DPT professional program• 2 programs approved to convert to DPT• 21 programs have expressed intent to convert

to the DPT in 2009 or earlier• 209 of 210 programs (99%) either are or will be

offering the DPT professional degree by 2009



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Transition DPT Current Status

• 64 Transition DPT programs (10/06)

• 4 developing Transition DPT programs (10/06)

• 2,724 graduates (10/05)

• 9,147 students who have or were currently enrolled (10/05)

• There may be currently approximately 10,000 who have the DPT degree



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Questions to be Answered1. Should the regulatory designator remain the

same? (Yes or No)

2. If no, to what should it change? (DPT, PTD, etc.)

3. What are the conditions that should be met in order for the change to be pursued? (A critical mass of DPT graduates (e.g., 50,000), etc.)



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Questions to be Answered4. If the designator changes to reflect a doctoring

profession, which option do you favor for managing individuals who have not earned a DPT degree?A. Include all licensed physical therapists regardless of

degree

B. Apply the change only to those who have earned the DPT degree

C. Include those with the DPT degree and those who can demonstrate competence equivalent to the DPT

D. Other method (please describe)



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PROS in Favor of Changing the Regulatory Designator to Indicate PT is a Doctoring

Profession

• Establishes the clinical doctoral degree as the minimal level of practice

• Regulatory designator would remain the same for all PTs, maintaining consistency and uniformity for the public (assuming the new designator would apply to all licensees as is the current case)

• Success of other professions who have moved to the doctoring level (e.g., optometry, podiatry, pharmacy)

• Create enhanced public perception of qualifications and preparation of the PT

• For those who have earned the DPT, the regulatory title would be consistent with their educational achievement



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CONS against Changing the Regulatory Designator

• May discourage PTs who don’t have the skills to practice in a doctoring profession from pursuing the skills

• Potential alienation of members and stakeholders, including PTs, who have pursued a tDPT who might be disillusioned that others without the degree will be considered a “doctor” as well

• May antagonize the medical and health care professional communities

• May lose the consistency and uniformity both internally and for the public that “PT” currently provides



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BARRIERS to Regulatory Change

• Differences in state laws/legislatures• Money, time, and people• There are not yet a “critical mass” of DPTs

practicing• Lack of legislator knowledge about PT vs. DPT –

providing evidence that the change will provide clarification for the public

• Haven’t completely achieved the other characteristics of a doctoring profession (autonomy, direct access, professionalism)



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OPPORTUNITIES Created by the Process

• Chance to develop consensus among members and nonmembers

• Chance to incorporate/educate about “who we are” (branding)

• Chance to educate legislators about who PTs are• Chance to create tools to ensure continued

competency and thus raise the level of practice consistent with a doctoring profession

• Opportunity for APTA to work with educational institutions to enhance post-professional education and to upgrade the knowledge, skills and behaviors of practitioners consistent with a doctoring profession



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Process Internal to APTA to Change Designator

• Determine whether the regulatory designator should change

• Develop motion(s) for future House of Delegates• Develop strategies for adoption of motion(s)• A future House of Delegates considers motion(s)• Make relevant changes to APTA documents, as

indicated



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Process External to APTA to Change Designator

• Education and communication with Chapters, FSBPT, state boards of PT, and international professional/regulatory communities

• Request that FSBPT Delegate Assembly make appropriate changes/revisions to Model Practice Act

• APTA/FSBPT jointly develop legislative strategies, talking points, lobbying tools (including discussion at State Government Affairs Forum)

• States proceed with legislative changes in partnership with Chapters, educational institutions, and licensing boards



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Next Steps

• Go to www.apta.org, click on Advocacy, State Government Affairs

• Complete on-line survey on DPT as Regulatory Designator

• Generate discussion among groups of PTs

• Talk to delegates to HOD



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Questions to be Answered1. Should the regulatory designator remain the

same? (Yes or No)

2. If no, to what should it change? (DPT, PTD, etc.)

3. What are the conditions that should be met in order for the change to be pursued? (A critical mass of DPT graduates (e.g., 50,000), etc.)



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Questions to be Answered4. If the designator changes to reflect a doctoring

profession, which option do you favor for managing individuals who have not earned a DPT degree?A. Include all licensed physical therapists regardless of

degreeB. Apply the change only to those who have earned the

DPT degreeC. Include those with the DPT degree and those who can

demonstrate competence equivalent to the DPTD. Other method (please describe)



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Thanks for sharing your views!!



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History of PT Education• Prior to the 1950’s, most programs were hospital-

based certificate programs• 1960 – HOD passed a resolution to establish the

baccalaureate degree as the minimal standard for the PT

• 1979 – HOD raised the level of professional education to the post baccalaureate level– “Resolved, that the APTA adopt the policy that entry level

education for the physical therapist be that which results in the award of a post baccalaureate degree;”

– “Resolved…all educational programs….shall comply with the policy on entry level education in this resolution by December 31, 1990.”



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History of PT Education• Before 1979, 7 post baccalaureate programs

existed (all at masters degree level)

• Strong opposition to the move to post baccalaureate education was present throughout the next decade from many stakeholders, including APTA members and academic leaders

• 22 years (1979 to January 1, 2002) required for all programs to convert from baccalaureate to masters degree



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Professional and Societal Factors

• Since 1980, changes in the legislative area and in the health care industry expanded the role of PT into new areas

• 1983 - AMA ceased accrediting PT programs; CAPTE became solely responsible for accrediting all PT programs

• 1995 - APTA Guide to Physical Therapist Practice published, reflecting the depth and breadth in practice and in the educational preparation required to enter practice



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DPT• 1992 – First post-professional “transition”

DPT program at USC• 1993 – First entry-level DPT program (first

graduates in 7/96) at Creighton University

• 1998 – CAPTE published new accreditation standards requiring PT education to culminate in the awarding of a post- baccalaureate degree



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DPT

• 1/1/02 - CAPTE no longer accredits baccalaureate programs

• 2000 – HOD endorsed Vision 2020; specific reference to “doctors of physical therapy” reflecting support for the clinical doctorate as the preferred professional degree in 2020

consideration of a change in the physical therapist regulatory designator

Documents