Everywhere I look, there’s a constant stream of dialogue. You can hardly check your email or log in to your social media accounts without being confronted by a passionate narrative or heated debate. It’s a byproduct of the “age of information,” and for some, this environment is invigorating—eliciting action and fervor. For others, it’s completely overwhelming. They tune out, power off, and wield the power of the “unfriend” button with impunity. For me, one topic of discussion that has risen above the noise—one that I believe is worth the dialogue it has spurred—is the need for uniformity among physical therapists, specifically with regard to professional designation.
Picking a Name
Within the uniformity discussion, there’s been a lot of talk around what we should call ourselves (e.g., physical therapist, physiotherapist, PT, or DPT). It’s safe to say that our profession has a disjointed brand, and that has certainly impacted the way the public views physical therapy. This is partially evidenced by our inability to capture more than 15% of patients who seek medical attention for their musculoskeletal injuries. So, the branding argument is definitely worth exploring.
Some professionals feel that uniformity in designation is the first step toward solving the brand issue. Of course, not everyone agrees, but that’s to be expected—we here in the US don’t really like to conform. After all, we have stuck to calling ourselves “physical therapists” even though the rest of the world uses the term “physiotherapists” to describe providers who do what we do. And our professional designation (i.e., the letters after your name) has also always reflected that PT moniker, though it has changed over the years based on the educational evolution of our profession.
Moving from PT to DPT
Speaking of education: We’re all familiar with the APTA’s 2020 decree. (If not, I urge you to familiarize yourself with it.) The vision calls for, among a list of other great things, the standardization of PT credentials—by way of standardized educational curricula. That vision was established in earnest, and I support the profession-wide transition to the DPT as an entry-level degree for physical therapists. In fact, PT industry leaders have been pushing for this transition for decades—since back when therapists could practice with only a bachelor’s degree. Recently, however, there’s been a lot of talk about taking that standardization a step further in the interest of expediting industry-wide uniformity in PT credentials. I’m talking about the proposal to simply change the PT designation for all licensed physical therapists to “DPT”—no doctorate-level education required.
When I first heard about this, I cringed, as I interpreted it to mean that all of the effort so many therapists put into obtaining their DPT and tDPT degrees would be in vain. I linked educational accomplishment to professional designation—after all, historically, that designation has seemingly evolved with education. I tried to keep an open mind as I researched the proposal further, and I began to understand that—if you widen the lens to look beyond the physical therapy space—a professional designation actually has nothing to do with educational level. It is simply an indication of a person’s qualification to perform a job. And in truth, every licensed therapist—regardless of degree level—is qualified to provide therapy treatment.
Today, our general professional designation is simply “PT”—and any licensed therapist can use that designation. Those of us who have completed a doctorate-level educational program can use the designation “PT, DPT.” If we changed the general professional designation to “DPT,” it would give every licensed therapist the right to use that designation—in the same way that all licensed therapists started using “PT” after the profession stopped using the “RPT” designation years ago. And perhaps, by not adopting the DPT professional designation from the beginning (i.e., back when we went from “RPT” to “PT”) as many other professions have done (e.g., DPM, OD, and DC), we have done our profession a disservice.
Now, before I offer my take on the matter, let’s run through the numbers: according to the APTA, 50% of licensed physical therapists have a doctorate-level degree. Bear in mind, however, that those figures were pulled from the APTA’s member base. And because only 30% of PTs are APTA members, those numbers may not accurately represent the profession as a whole.
So, despite the APTA’s best efforts to achieve universality in educational level—and thus, designation—via the 2020 decree, the numbers show we are not on track to meet that goal. In fact, the timeline has already been extended out to 2025—a move I don’t necessarily agree with, as it gives the impression that we’re simply kicking the can down the road and de-emphasizing what should be a major priority for our profession: claiming a seat at the doctor table. Still, I have to ask, of those who have the DPT degree currently, how many actually refer to themselves as “doctor?” How many think of themselves as equals to any other practitioner with doctorate-level credentials? And how many exercise their DPT credentials to the fullest?
Changing a Mindset—Not Just a Letter
This situation is eerily reminiscent of the fight for direct access. It’s hard-won autonomy that so few take advantage of—often because, even with a doctorate-level degree, they fear the liability that may come with misdiagnosing or missing something. And in my opinion, that mindset is the real reason our patients—and our peers in other disciplines—don’t look to us as the neuromusculoskeletal provider of choice. So, in no way do I think that a blanket designation change is the cure-all for our brand issues, our patients’ confusion, or the overall lack of trust in our profession.
Now, I want to make it absolutely clear that I believe any physical therapist—regardless of degree or credentials—who keeps up with industry trends and self-educates can be an outstanding provider. Much of our “on the job” learning and experience can’t be taught as part of any curriculum, nor should it have to be. However, as with any major industry-wide movement, I think the designation debate needs to be examined from all sides. And while we’re talking about clarity, let’s get very clear on the proposal at hand: it is not about grandfathering in all PTs as DPTs in the educational sense. It simply means that the designation by which we are recognized would be DPT instead of PT. Furthermore, I want to make it very clear that I believe we need to have an honest conversation about the state of physical therapy education. At the 2015 Graham Sessions, we discussed the enormous disparity in curriculum requirements among PT schools. The lack of uniformity in education for entry-level PTs is astounding, and it’s no wonder that it carries over into clinical practice.
Bringing it Back to the Patient
The real goal should be delivering exemplary care on a consistent, universal basis. And to do that, we need better data. After all, by changing to a doctorate-level designation across the board, we are setting the stage for expectations of doctorate-level expertise and practice from our patients. If our mindset doesn’t change to match our designation, we run the risk of diminishing the meaning of a doctor title.
There’s been a lot of research aimed at identifying what patients really want, and from what those studies have found, it has nothing to do with their therapist’s title. It’s empathy, clinical knowledge, a comfortable treatment environment, and care efficiency that matter most. If this tells us anything, it’s that these are the areas we should focus on if we want to cultivate a better reputation for our profession and live up to the DPT designation.
Prioritizing Data Over Designations
When you go out for a meal, do you spend time researching which culinary school the chef attended? When your car breaks down, are you really scrutinizing the mechanic’s certifications? The answer is an emphatic “no.” Instead, you’re looking at the online reviews. You’re asking your friends and family for recommendations. And, when your experience is a positive one, you return to that same place the next time you need the same type of service. Medical services, from the client’s perspective, aren’t much different. In fact, the Pew Research Center found that eight in 10 health inquiries start on a search engine like Google, Bing, or Yahoo.
While credentials certainly hold some weight, true credit comes from word of mouth and validation through outcomes—and that’s a far better advertisement for your services than an extra letter after your name. Furthermore, with the majority of patients still coming to us via physician referral, the importance of data is undeniable. And by prioritizing data—specifically, our patient outcomes—over designations, we’re showing the world the true efficacy of physical therapy. That is how we can elevate our industry and protect the consumer.
Allowing all PTs to use the DPT designation is merely a gateway to creating a strong, consistent PT brand. By supporting the effort to change our professional designation to DPT, we can improve name recognition and minimize confusion to patients, referring physicians, and insurance companies. But that alone will not solve the problem at hand—which is why, as I mentioned above, we must start a stronger dialogue around creating consistency in physical therapy education. That means not only overhauling the current curriculum, but also examining the quality of clinical internship and residency programs and implementing universal standards that focus on outcomes (South College, started by John Childs and EIM, is a great example of a program that has disrupted the current model). Outside of the classroom, we must turn our attention to raising our standards for the quality of care we provide—not just in our individual clinics and states, but across the entire country.
Advocating for Meaningful Change
At the end of the day, our patients should always be at the heart of our advocacy efforts. Each and every therapist—official designation aside—should strive to deliver uniformity in professionalism, service, empathy, and compassion, regardless of setting, specialty, or degree level. The goal here is to reach a level of practice consistency that our patients can easily recognize—and safely expect. If we each do our part to achieve that goal, we can all empower each other to deliver the best results to every single patient who walks through our doors. Changing the universal designation of physical therapists to DPT can be the catalyst to implement the changes we need—starting with altering our mindset to think of ourselves as doctors of physical therapy.
Are we painting ourselves as effective—and necessary—care providers? Don’t get it twisted—changing our professional designation to DPT does not change the curriculum or education required to become a licensed PT; it simply changes the letters that mean, “I am a licensed physical therapist.” To drive real change, we must rely on data and facts—rather than feelings and anecdotes—or we essentially become the “fake news” of the healthcare world. And that’s not the reputation any of us want.
About the Author
Heidi Jannenga PT, DPT, ATC/L is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has since guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.
An active member of the sports and private practice sections of the APTA, Heidi advocates for independent rehab therapy businesses, speaks as a subject-matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. In 2014, Heidi was appointed to the PT-PAC Board of Trustees. She also serves as a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice rehab therapy professionals.
Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a bachelor’s degree in biological sciences and exercise physiology, went on to earn her master’s degree in physical therapy at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her doctorate of physical therapy through Evidence in Motion. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.