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Attitudes on the DPT

This survey reveals a shift in professionals' opinions.

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For the past three years, I have been conducting a study consisting of field interviews of physical therapists concerning their attitudes toward the doctor of physical therapy (DPT) degree. I have been assisted in this project by physical therapy students from the University of Texas Health Science Center San Antonio, Husson University in Bangor, ME, and Rocky Mountain University of Health Sciences in Provo, UT.

This article summarizes the results of the surveys of Texas-based physical therapists from March to May, 2011.

Background of the Project

In 2000, the APTA House of Delegates established Vision 2020, under which, by the year 2020, "physical therapy will be provided by PTs who are doctors of physical therapy, recognized by consumers and other health care professionals as the providers of choice to whom consumers have direct access for the diagnosis, intervention and prevention of, impairments, activity limitations, participation restrictions, and environmental barriers related to movement, function and health."

In 2009, the APTA declared 6 operational goals to be achieved as part of Vision 2020, including: (1) autonomous practice, (2) direct access, (3) entry-level and post-professional preparation of doctors of physical therapy, (4) evidence-based practice expertise, (5) PTs as practitioners of choice for movement dysfunction, and (6) high levels of professionalism by physical therapy practitioners.

Currently, 48 states are recognized by the APTA as direct access states, with or without practice restrictions.

The Study

For this part of the study, 10 interview questions were asked of respondents: 

    1. How long have you been a PT? 

    2. Are you aware of the APTA Vision 2020, and the new standards of a doctoral degree? What does it mean to you? 

    3. What is your impression of new DPT graduates? 

    4. What do you see as differences, if any, between BS, MPT and DPT-educated PTs? 

    5. Would you be more likely to seek or hire a DPT vs. a non-DPT professional? Why or why not? 

    6. How would you bridge the gap between work experience and formal education? 

    7. What is your experience with, and application of, evidence-based practice? 

    8. What is your stance on direct access? 
   
    9. Where do you envision the physical therapy profession in 10 years? 

    10. Is there anything I forgot to ask, or anything else you would like to add?

Five Texas-based PTs from widely variegated practice settings with an average of 15 years of clinical experience were interviewed for this segment of the study. The apparent softening of opposition to the DPT degree evident in prior interviews of PTs from across the United States is noteworthy.

The Results

Four of five interviewees (80%) are aware of Vision 2020. However, their interpretations of the policy differ. Two respondents view Vision 2020 as a means to incorporate more research into physical therapy practice, while the other two respondents envision Vision 2020 as a means to equalize the status of PTs with other primary health care professions, including medical doctors and doctors of chiropractic.

All five respondents (100%) view the DPT positively. The four with the most practice experience consider DPT graduates to be on par or slightly ahead of MPT graduates in their knowledge base, but perceive no differences in the two groups' hands-on clinical skill sets. One respondent believes that DPT graduates are better prepared academically and warrant expanded clinical privileges.

All five (100%) of respondents report that DPT graduates are better prepared to interpret and apply research to practice than MPT graduates, and respondents unanimously opine that MPT and DPT-educated PTs possess superior skill sets and clinical currency compared to baccalaureate-level PTs.

Four respondents (80%) would preferentially hire a DPT graduate over an MPT or baccalaureate-degreed PT. An additional justification for this response is the opinion that DPT graduates more readily embrace and utilize evidence-based practice strategies. The fifth respondent believes that the factors espoused by Farmer -- character, interpersonal skills and team-orientation -- are more important than a PT's degree level.

All five (100%) respondents are highly critical of the current physical therapy education model in terms of amount of time spent by MPT and DPT students in the clinic. One stated, "Being 'book-smart' is not enough!" All believe that 8- to 10-week clinical rotations provide inadequate clinical experience, and that physical therapy education should expeditiously transition to the 50-50 classroom-clinical experience-model utilized by medical schools across the United States.

Two of five respondents (40%) advocate greater emphasis on residencies and fellowships for DPT graduates.

Regarding evidence-based practice, four of five consider it critical for their practice success. All five respondents view direct access PT practice positively, although three of five believe that new graduates may be unprepared to assume an independent primary care role, and that seasoned clinicians may require additional education in differential diagnosis and related topics in order to practice autonomously.

All five respondents express strong optimism regarding the future of autonomous physical therapy practice over the next 10 years. One believes that, in 10 years, patients hopefully will say "I need to see my physical therapist" instead of "I need to see my medical doctor" for non-emergent musculoskeletal conditions.

An invitation to express additional thoughts yielded three observations from respondents. One believes that the DPT degree adds "significant respect for the profession as a whole." Another wants a more expedited transition to the DPT degree for seasoned clinicians. A third respondent is thankful for the opportunity to serve physical therapy education as an adjunct instructor.

Paradigm Shift

The results of this set of interviews evidences a shift in opinion about the DPT degree from mostly negative to strongly positive. More data is being collected and will be disseminated over the next two years regarding additional input concerning this fundamental paradigm shift in our profession. The complete study results are expected to be published in May 2014.

Michael Auer, Cindy Boyer, Brooke Cody, Steve Elliot, Germaine Herman, Rumali Kulkarni, Teddy Ortiz and Joshua Trock were UTHSCSA-based student PT-research assistants for this segment of the ongoing study, expected to conclude in December 2013. I thank them, along with many other student colleagues from UTHSCSA, Husson University, and Rocky Mountain University of Health Sciences for their dedicated work in support of this study.

References

1. APTA Vision 2020, www.apta.org. Accessed March 1, 2012.

2. Farmer, J. Hiring staff in private practice. PT Magazine, 2004; Sept., 42-49.

Ron Scott is associate professor at Rocky Mountain University of Health Sciences, Provo, UT, assistant professor at UT Health Science Center San Antonio, and lecturer at Husson University, Bangor, ME. He is also associate professor at the University of Indianapolis and faculty affiliate at the University of South Florida and the University of Montana.


 

I actually stopped reading following "Five Texas-based PTs from widely variegated practice settings with an average of 15 years of clinical experience were interviewed for this segment of the study." This isn't even a research paper for undergraduate school. The term "study" is actually denigrated from this research. It's akin to asking my neighbors if they want a power plant close to their homes.

Ryan WilliamsNovember 21, 2013
PGH, PA



"comprehensive survey" is not only a misnomer, it's the craziest title I've read today. This is barely a pilot study. Maybe it could be titled "what a handful of PTs near me think about the DPT".

Joshua August 26, 2012



I think it's important to understand the basis for our profession's shift towards doctoral education. An enormous reason for Vision 2020 is the need to improve the perception of our training to the public...both to fend off infringing healthcare professionals and to justify our reimbursement from insurance entities.

That being said, the focus on public perception has, in my own opinion, created a sense of urgency that has undermined the transition process. I often see advertisements for t-DPT programs offered by companies--not research universities. Even the programs that are University-based often only require a few extra courses in "professional practice" combined with a handful of hours that focus on topics previously covered in BS and/or MPT programs. The shift is, I believe, good for the profession as a whole, but we have to be VERY careful with putting too much stock in the type of degree, especially when they are being granted in an environment/context that places so much emphasis on expedition in the name of perceptual change.

Jeff ,  PTAugust 21, 2012
LA



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