No Shame DPT
Today I’m going to talk about a topic that is somewhat of a hot topic in the PT field…I am frustrated that it even IS a hot topic, but we need to talk about this. I made this video to break down the reasons why introducing ourselves as a “doctor” of physical therapy has become such taboo in our profession and what our role is in breaking out of this box.
History:
Physical Therapists haven’t always been Doctors. There is a History of our profession with big changes being made in relatively recent decades.
We went from a certificate (1900-1930) to a B.S. in another field with a certificate in physical therapy (1930-1950) → B.S. in PT (1950-1980) → Masters (1980-1997) → to a Doctorate by 1997…and now, as of 2015, all PT programs are at the Doctoral level!
Why did this evolution occur?
Because it needed to. Because physical therapy is an incredible field that can have a profound impact on people’s function for the better and healthcare began to see the way that PT could be utilized in treating patients. They saw decreases in the need of surgeries, decreases in the need of pain and other medications, improvements in function and increases in the independence of patients…and therefore an overall reduction in healthcare costs. Many PTs before us fought for our profession to be looked at more seriously as an alternative form of Tx for many patient populations.
This was exciting!
But as we came into the spotlight, we realized we had to prove that what we did worked. There wasn’t very much research happening before the 70 and 80s in this field and there were a lot of doubters out there challenging the efficacy of our treatment. And for good reason! Through research we have indeed found that former treatments that used to be commonplace in PT were indeed not effective, and through research we have found value in what is effective. PT used to mainly be modality based and very passive. In fact, did you know that for a long time physical therapy was not even a profession…it was a treatment or commodity or thing that one would perform. But now we are a PROFESSION. We are still fighting those old perceptions. The push in our profession is that A PCP should no longer be prescribing physical therapy, they should be referring to a physical therapist. See the difference?
PTs began taking initiative to grow. They knew our field couldn’t stay the same and that if we were to be taken seriously as health care professionals we needed to up our game.
That’s why the profession eventually progressed to a Masters level program. This was a push to increase our knowledge of the body, anatomy, the study of movement and biomechanics and to teach PTs how to read and value research.
And we didn’t stop there, we went further. The doctorate programs began to arise as we realized more and more the need of an understanding of not only what we treat as clinicians but also the need to see what else the patient may have that requires treatment outside of our scope of practice. We have been pushing to have direct access to patients…in other words, we want to be able to have patients come straight to us by being referred to a physical therapist rather than getting a physician’s prescription for physical therapy. We want to be considered capable of being autonomous. But we can’t be trusted to this direct care without the ability to see reasons for them to be treated elsewhere. We had to be educated more on how to catch red flags and get our patients the help they needed.
And beyond that point, having a doctorate pushes for a level of respect our profession has always had difficulty attaining. It is pushing insurance companies to recognize that we have a level of education worth respecting, reimbursing, and worth providing patients direct access to. It has also shown other healthcare professionals the same thing. There is still growth needed in this area, but growth is indeed happening!
There is actually a long history of some PTs being uncomfortable with the push our profession took to become doctors of PT, but for all the reasons stated above, I’m hopeful that you can see why it was an important evolution that occurred. There are PTs who have fought hard to get our profession to this point. The bar has been raised! And we are expected to rise to the challenge.
This all leads into the hot topic.
Physical therapists who have graduated from a Doctorate of Physical Therapy Program ARE doctors of physical therapy. According to APTA we have the right to put the prefix Dr in front of our name due to our academic degree. When it comes to how we introduce ourselves to patients, different jurisdictions do mandate this a bit differently. But in many states, we have the legal right to introduce ourselves as doctors (of physical therapy) to our patients. And yet…a lot of us never do. And worse, a lot of us are ashamed to do so. And even worse than that, I’ve heard PTs tell patients they are NOT “real” doctors!
What is going on?!
I’m going to touch on the reasons I’ve heard some PTs give for doing this (some of whom are my friends). I also want to hash out some counter arguments for each one.
- “Some patients have bad experiences and distrust of the “doctors” in their life. I don’t want them to think that way about me. I want to be fun and approachable.”
Then be the first doctor to give them a great experience! Why is it that patients get irritated at their PCP or other kinds of doctors? Because they don’t feel heard. So make them feel heard, which is something unique our profession offers our patients. I’ve had many patients comment on how thankful they are to have been heard by myself and other PTs. You don’t have to ditch your title and dumb yourself down to make a patient respect you. They respect you for the way you treat and listen to them. I personally have never had a patient run out of the clinic because I called myself a doctor of physical therapy. In fact, I have seen the respect increase by patients knowing that I am not just any doctor, I am a doctor who will listen to them. And this doctor who listened to them is a doctor of physical therapy. Score for our profession!
How many of you have gotten frustrating questions from patients like, “so how many months did it take for you to get your certificate in PT?”. Well, you can’t get all that annoyed if you don’t allow space for your patients to know your title in the first place. Give space for even your patients to be educated on your level of education! It won’t run them off, it increases respect. I hardly gotten any of those frustrating comments since I started calling myself a doctor of physical therapy.
- “No one else in my clinic calls themself a doctor of physical therapy, so I feel uncomfortable doing so. I’m not sure where everyone stands.”
I hear you there. It was the same way at my first job and it was really hard and confusing to me why my DPT colleagues didn’t call themselves doctors or would even deny such a title. And I think respect towards your coworkers is very important regardless of differing opinions and that it’s not a bad idea to bring this up to your superior to see where the clinic stands. I did ask my supervisor about it and (in short) she didn’t have an issue with me using the title. It’s also very important to check what the law allows you to do in your jurisdiction. In my state, I can call myself a doctor of physical therapy. So once I did this research and asked some questions, I decided that at the very least, I was going to introduce myself on Day 1 as Dr. Walkup (your physical therapist) followed by the permission to call me Mel. This way I was able to accurately use my title with my patients while also not feeling uncomfortable by being the only PT who was having her patients call her “Dr.” all the time. This has worked great for me. Oftentimes a patient will even ask about my education on that first day or later which has helped me educate my patients on how far our profession has come and I find this very important and helpful for patients to know these facts. I want every patient of mine to leave with a positive experience and with a new understanding that our profession is not what it was 20 years ago. I want them to know they were treated by a DPT who really took good care of them.
- “My mentor has her/his Master’s and it feels demeaning to call myself a Doctor when she/he has so much more experience, yet doesn’t have the title.”
I will never encourage any kind of belittling of our colleagues who do not have a Doctorate. Because they absolutely do have experience that is highly valuable and something we DPTs have a lot to learn from. So absolutely respect all levels of education in our profession. However, you are worthy of being respected as well. You worked hard to get to where you are and no one above you has the right to make you feel as though you cannot use your title of doctor. It’s your right! No one’s technically allowed to keep you from using Dr. in your name. I’ve heard of people who have been discouraged in the workplace by superiors to not use the title doctor and I believe they are doing the profession an incredible disservice by doing this. It is also demeaning to a DPT to tell them their level of education is not meaningful or that all colleagues should be looked at from the lowest level of education rather than as they are. That is lowering the bar. Not raising it.
We need to build each other up. We need to be on the same page about this. Our profession needs to stand together and push each other towards dignity and respect for each other and the route that got us to where we are in our profession. I think that for a long time our profession was so at odds with other kinds of doctors that many are still bitter towards the title. But we are in a new age now. If you are a DPT, you are a Doctor of Physical Therapy. And you are called to rise to everything that this title means. Be an approachable, listening, friendly, and professional doctor of physical therapy who has every intention to optimize your patient care and rapport. Whether you have all of your patients call you Dr. or you introduce yourself as a Dr. on day one with the permission to call you by your first name from then on…please know that you are indeed a doctor of physical therapy.
References:
http://www.apta.org/PTinMotion/2006/7/Feature/TheFutureofPhysicalTherapyEducation/
http://www.apta.org/PTinMotion/2014/11/EthicsinPractice/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076909/