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Consideration of a Change in the Physical Therapist Regulatory Designator. Meeting Agenda. Issue background and history Questions to be answered Pros, cons, barriers, and opportunities Process to change designator Discussion. Definitions. Academic degree/designation/credential
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Consideration of a Change in the Physical Therapist Regulatory Designator
Meeting Agenda • Issue background and history • Questions to be answered • Pros, cons, barriers, and opportunities • Process to change designator • Discussion
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
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
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)
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
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
OTHER PROFESSIONS • 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
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
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
Questions to be Answered • Should the regulatory designator remain the same? (Yes or No) • If no, to what should it change? (DPT, PTD, etc.) • 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.)
Questions to be Answered • If the designator changes to reflect a doctoring profession, which option do you favor for managing individuals who have not earned a DPT degree? • Include all licensed physical therapists regardless of degree • Apply the change only to those who have earned the DPT degree • Include those with the DPT degree and those who can demonstrate competence equivalent to the DPT • Other method (please describe)
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
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
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)
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
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
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
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
Questions to be Answered • Should the regulatory designator remain the same? (Yes or No) • If no, to what should it change? (DPT, PTD, etc.) • 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.)
Questions to be Answered • If the designator changes to reflect a doctoring profession, which option do you favor for managing individuals who have not earned a DPT degree? • Include all licensed physical therapists regardless of degree • Apply the change only to those who have earned the DPT degree • Include those with the DPT degree and those who can demonstrate competence equivalent to the DPT • Other method (please describe)
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.”
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
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
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
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