evolution of the Doctorate of Physical Therapy: Moving beyond the controversy, The

Journal of Physical Therapy Education, Spring 2002 by Plack, Margaret M, Wong, Christopher K

A great deal of debate has surrounded the newest professional (entry-level) degree in physical therapy, the Doctorate of Physical Therapy (DPT). This article provides a historical view of the evolution of physical therapy education from its earliest technical roots to the current status it holds within academia. Political, social, and economic factors that have influenced the growth of the field and the development of physical therapy education are explored to give perspective to the transition to an entry-level DPT degree. A presentation of different viewpoints on controversial issues surrounding the DPT highlights the challenges currently facing the profession, which the adoption of new entry-level educational standards may address. Weighing the historical advances of the field with consideration of the challenges today's health care environment present, the authors recommend elevating the rigor of entry-level educational standards and validating academic outcomes to support the credibility of the DPT.

Key Words: Doctor of Physical Therapy, History. Physical therapy education.

INTRODUCTION

The current movement toward a professional (entry-level) doctoral degree in physical therapy has engendered excitement in some members of the profession and skepticism in others. Some physical therapists are excited by the prospect of holding a doctoral degree, while others are concerned that their present credentials will not equal those of a new graduate with a Doctor of Physical Therapy (DPT) degree. Some practitioners look forward to the prospect of greater respect from health care professionals and insurance representatives and to the potential for fully autonomous practice, while others are skeptical that a new degree will improve entry-level preparation or provide the increased skills necessary to meet today's clinical challenges. These differences in opinion are apparent in letters to the editor in professional publications as well as debates in clinics around the country, demonstrating that there is no clear consensus, hut rather continued controversy, surrounding the definition and potential benefits of the DPT degree.1,2

Nevertheless, movement toward accepting the DPT degree as the entry-level degree is occurring much more rapidly than past transitions in physical therapy education. In October 1999, 8 entry-level DPT programs had been accredited, 17 were developing or in the process of making the transition to DPT programs, and 18 to 20 were in the process of deciding to transition.1,2 Less than 2 1/2 years later, the American Physical Therapy Association (APTA) reported that 42 entry-level DPT programs were accredited, 12 were developing or in the process of making the transition to DPT programs, and another 46 were in various stages of discussion or planning to transition to entry-level DPT programs.3 The Vision Statement endorsed by the APTA House of Delegates (APTA-HOD) in June 2000 also states that by 2020 physical therapy services will be provided by doctors of physical therapy.4 In 1999, citing the number of programs currently contemplating the transition, Joseph Black, Director of the Education Division of APTA, stated that the question is no longer whether the DPT is appropriate, but rather how the profession can make the transition smooth and beneficial.2

During these times of change, examining the history of physical therapy and physical therapy education may help physical therapists decide how to proceed. The field of physical therapy emerged from the great demand for physical rehabilitation resulting from worldwide medical crises, and continuing demand for services stimulated further growth of the field. Sociopolitical influences, including public views of health, legislation expanding the breadth of health care, and public funding for health education and services, have broadened the reach and responsibilities of physical therapists. All the while, major technical advances in medical care have led to an increase in the depth of knowledge and level of skill required of physical therapists. Academic standards required for entry into the profession have evolved concurrently with physical therapy practice. Educational standards have progressed from oversight by individual physicians to accreditation by medical doctors and finally to standard regulation by physical therapists. The progression of educational standards parallels the expansion of physical therapist duties from technical skills such as exercise and massage to the examination and evaluation of individuals with multisystem problems and the provision and supervision of all interventions within the plan of care. When considered in a historical context, is the DPT the next logical progression in the evolution of physical therapy education?

PURPOSE

We will provide a historical perspective on the evolution of the DPT, detailing the progression of entry-level preparation as well as the historical events and educational advances that influenced the growth and development of physical therapy. This historical perspective serves as the framework through which controversial issues surrounding the DPT degree are explored. We suggest that all those involved in the physical therapy profession should critically consider what educational standards for a new entry-level physical therapy degree will be sufficient to meet current and future challenges of the profession and uphold the responsibility that comes with adopting the title "Doctor of Physical Therapy."