Personally, I don’t prefer to be called one thing or another by the patients I treat. Maybe that’s because I’m still a student and not yet a doctor of physical therapy, but I do know (for certain) the reality of the doctorate level work that is being required of me at my current institution. It’s real, and intensive, and when I finish…I will have earned a doctoral degree.
Many arguments have been made about who should be called doctor. Should we (as PTs) be called doctor? Should we refer to ourselves as doctor? Often, physicians (or their attorney advocates) attack physical therapists for using the terminology to describe themselves, claiming various reasons, but typically with no real substance behind their reasoning.(1) I usually find that kind of behavior highly unwarranted and slightly ignorant. To go through four years of post-graduate schooling and not realize the distinction between a doctor and a physician…well…it’s alarming, but I honestly don’t think that is the problem here.
The problem lies with the language we use to refer to all types of healthcare professionals. As a society, we forget the technical definition for the title. A doctor, by technicality, is a person who holds a doctoral degree. That is, the highest degree status that is awarded by any university is…the doctoral degree, thus making doctors out of those recipients. Without going any further into the etymology of the word, I think it is clear that PT’s graduating today deserve to be called doctor…just as a medical doctor, doctor of dentistry, doctor of osteopathy, doctor of podiatric medicine, or even doctor of philosophy. And there’s plenty of good evidence to support our expertise in the musculoskeletal domain over PCPs(2,3), the number of nonspecific diagnoses from PCPs in relation to musculoskeletal pathology and subsequent screening for referral or diagnosis made by PTs(4), and our ability to appropriately use and request diagnostic imaging studies for patients.(5)
BUT…that’s not even what I am proposing. I think this language mix up is confusing to many different groups. Somewhere along the line, at least here in America, we grew lazy with our words (big surprise) and decided it was easier to refer to “physicians” as “doctors.” One might ask, “What’s the big deal? They are doctors.” Well, I would agree 100%, and inform that person that all those groups I listed above are doctors as well. Doctor is a degree status or level, and it tells an individual nothing about what you or another healthcare provider actually does. A surgeon performs surgery, a dentist maintains oral health, a physician practices medicine, and a physical therapist practices physical therapy. A doctor…could do any of those things given the right training.
What am I proposing?
I’m proposing that all doctors start using clear language. This starts with doctors of physical therapy. When you want to ask a patient what their physician instructed them to do, ask them in that way exactly. Lets all refer to each other by our actual area of practice, instead of a degree status. PTs: Don’t reinforce–via your language–an outdated hierarchy that is cumbersome to the healthcare system as a whole. Lets help change the societal understanding of who and what a doctor is, and maybe we will help start a recovery process for healthcare as a whole.
So…what kind of doctor are you?
This was topic was also recently discussed on EiM, here. Read through for more thought food.
This gem was just shared in response to some of the Twitter conversation about this post:
1. Edgar C. The Truth Behind APTA’s Campaign Against POPTS. Accessed on Monday September 8th, 2014. http://www.aaos.org/news/aaosnow/nov12/managing3.asp
2. Childs JD, Whitman JM, et al. A description of physical therapists’ knowledge in managing musculoskeletal conditions. BMC Musculoskeletal Disorders. 2005, 6:32.
3. Childs JD, Whitman JM, et al. Knowledge in Managing Musculoskeletal Conditions and Educational Preparation of Physical Therapists in the Uniformed Services. Military Medicine. 2007 172. 4:440.
4. Davenport TE, Watts HG, et al. Current Status and Correlates of Physicians’ Referral Diagnoses for Physical Therapy. J Orthop Sports Phys Ther. 2005; 35:9; 572-579.
5. Moore JH, Goss DL, et al. Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers. J Orthop Sports Phys Ther. 2005; 35:2; 67-71.