The De-Initialization of PT

This may be the most important document published all year in PT. I have uploaded a copy of the article here.

Download Flynn-Articulations-2008-PTIdentityCrisisInitials.pdf

Let’s start a “de-initialization” campaign across the profession. It’s way past time for us to shed our initials and realize our brand as a Physical Therapist…the best profession on Earth. At an absolute most, we should be "PT" plus our highest post professional academic degree.

Tim pokes good fun at me, but I am sad to say there are far worse offenders than me. Also, I am taking some very active steps towards my recovery from a state of utter insecurity and have been regularly attending weekly IA ("Initials Anonymous") meetings. The results have been terrific. I happy to announce that I have let my CSCS, NSCA-CPT, and ACSM Health & Fitness Director certifications lapse into the grave. As far as ABPTS board certification and fellowship training, these are absolutely important and something we want to be pervasive, but let's not represent them with ridiculously silly initials that absolutely no one outside our profession recognizes (and there are so many different ones that we confuse them!). Urge ABPTS and the AAOMPT to get rid of these silly initials. Let's start describing who we are using plain and simple language.

In fact, please advise if you see my initials laundry list anywhere to help me further clean up the mess I've made of my professional identity. With some focused marketing and plain language descriptions, consumers might just figure out who we are.

I suspect this will evoke vigorous debate. Let's have at it. Please forward the link to any of your colleagues who suffer from the same identity disease and help them get started on their own road to personal recovery.

John D. Childs, PT, PhD

Comments

[Julie Whitman]

I have to add one more thing to this message. Why on earth do we run around at professional conferences with silly little streamer on our nametages saying "speaker", or "fellow", etc? Granted we are at conferences with ourselves when we do this, but is all of this show really needed? Why not just have your simple nametage that says who you are, where you are from, etc? Just my take.

[Patrick]

Funny, I was just talking about this to our team the other day and we agreed it has come to the point of being silly. I am a board certified PT and have received resumes not knowing credentials of my colleages. I have also spent some time explaining this system to MDs to whom I am marketing. At the end of the day, it waters down what we do, takes away the professionalism of PT and gets plain silly. It seems to me, all for the want of an ego stroke.

[todd]

Far worse offenders than you John? Now I've had my chuckle for today.

[John Childs]

Yep, here's one for you that had me beat:

PT, DHSc, MMSc, ATC, OCS, FAAOMPT, CSCS

I bet there are some still longer. Let's continue to see examples to see if anyone can beat this one.

John

[Jeff Hathaway]

When explaining my lack of initials have said in the past "I am just a PT" - wow... never thought about how that can sound. Very proud of those 2 letters but I understand the need for the knowledge that comes with some of those additional initials for clinicians. I guess we need to let the results of that additional knowledge speak for itself!

[John Childs]

Jeff:

You raise some good food for thought. The issue is not at all about the need to pursue further training. Where it makes sense, we should definitely do so. 95% of physicians are board-certified, with many other fellowship-trained. This model will be our model going forward. However, like medicine, we don't need initials to describe this training. Fellowship status defined by initials is for the most part an honorary designation. "Real training" such as residency and fellowship training doesn't need intials and is subsumed within being "just a PT". Good stuff.

John

[Selena Horner]

I'll play devil's advocate. I do agree that some of the alphabet soup is a pain and is very confusing. I do believe that there can be a time and a place for the alphabet soup - it just depends on the target population and how friendly the presentation (meaning explain the alphabet soup).

When I have a patient that is heading to Arizona or Colorado or Florida or Arkansas for the winter and there will be an obvious need for that patient to continue services in that location, I always assist the patient in choosing the next physical therapist to continue care and assist in making the arrangements for it to smoothly occur. My first step is to get a zip code and "Find a PT." In those instances, I really appreciate quickly seeing a name and the alphabet soup. I can focus on a few therapists, check websites, make some phone calls (discuss a little treatment philosophy because there is so much treatment variation) and then provide the patient with a few options. In other words, the alphabet soup helps reduce my time in helping the patient and allows me to make blink decisions. Of course, the only research out there is in orthopaedics which suggests that a physical therapist with an OCS has musculoskeletal knowledge similar to an orthopaedic surgeon.

Clinically, if the alphabet soup is used and an explanatory list is included in an eye-appealing way (especially on business cards or even on documentation), you never know what doors may open or what opportunities may present themselves. In my mind, the better questions to ask oneself are when is the alphabet soup used, how is it used and why is it used?

In my community, I want prospective patients to care enough to compare - I do my best to share my clinical qualifications in a consumer friendly way, along with my outcomes. I don't want prospective patients to base their decisions only on convenience and location.

[Roderick Henderson, MPT, OCS]

I agree in principle with your comments. I've accumulated an increasing number of initials and keep asking myself if I really need all of them.

For marketing purposes, I continue to list my OCS and CSCS credentials because they do spark questions from patients and gives me the opportunity to outline my expertise in a given area.

However, we do have to ask ourselves when enough is enough. The medical model is the template and we should gradually move toward this end of simply stating PT following our name. Hopfully I will get there one day, but not just yet. Thanks for bringing this out.

[Eric Furto]

I have to respectfully disagree with you on this one John. If we strive to be specialists of the musculoskeletal system, something has to set a precedent for this statement. I agree that Doctors typically use MD as their primary and only title, but a vast majority of them specialize in one field of medicine or another. For Physical Therapists, the PT is similar to the MD, but the certifications/fellowships indicates our specialty – similar to that of cardiology, urology, gynecology, etc. Those specific MDs chose a specialty path for their careers, and can now market themselves accordingly. I think the same should apply for us as well. At a time in our profession where fellowships/certifications/residencies are not mandatory, we should let the patient know that extra time was taken in order to provide the best quality care for the patient. We are all Physical Therapists; however, I can tell you that I will not be treating many Women’s Health patients. Thanks to the specialization and certification processes, I can identify a specialist and refer on with the best care of my patients in mind. Similar to that of Physicians – referring to specializing Physicians.

As anyone who has competed a certification of any type, they are well aware of the time and finances they committed to providing better care to their patients in a specific area. I do not believe that PTs are driven to accumulate titles simply for the alphabet soup (at least I would hope not), but in order to learn more and provide the utmost quality and specialized services possible. It is my opinion that we should be able to inform the patient that they are receiving skilled care that is backed by continuing education/certification and that they made the right choice in choosing PT over other medical alternatives.

Thanks John for posting on this very interesting topic!

[John Childs]

Eric:

I am in 100% agreement with everything you just said. I absolutely see the value of specialization via residency and fellowship training. This is not the point at all, and we should market the heck out of specialty training. Hopefully residency training in a specialty area becomes an absolutely essential aspect of anyone's clinical practice in the next 10-15 years, just as has occurred in medicine where 95% of physicians pursue residency training.

The issue I am raising is completely isolated to our profession's tendency to "decorate" our credentials with all the alphabet soup (bad) that follows from completion of our specialty training (absolutely good). Physicians do not "accessorize" their credentials with a long laundry list of initials, but they definitely market their training in the form of plain language describing who they are. The initials are extremely confusing and dilute the value of our professional regulatory credential of "PT", hopefully soon-to-be "DPT". In the large majority of cases, when you see physicians using alphabet soup behind their names (and most don't use them anyways), these indicate special membership status or are honorary in nature. You don't get any "initials" in medicine when you complete residency and fellowship training. What you do get is a big framed certificate to hang behind your desk that says "Board-Certified in..." or "Fellowship-trained in...". This means something to patients. The alphabet soup is completely meaningless and wreaks of professional insecurity. You don't need initials to market specialty training, and they cause more harm than good. Good discussion.

John

[Bob Schroedter]

How about this one?

PT, DHSc, MMSc, OCS, FAAOMPT, MTC, PCC, CSCS

[John Duffy]

A couple years back I was guest lecturer here in Pittsburgh for a knee/ankle course. On the PowerPoint, I had "PT, OCS, RSG, CFD" and others. Nobody even asked what they were. RSG means "Really Swell Guy" and the other was "Cool F--kin' Dude"
Much of what I see after a PT's name means nothing to me except perhaps the APTA specialty info. I also learned years ago that most MD's don't care either, and some make fun of it. I'd post what they said OCS and CSCS stand for, but I am sure it would be edited!!!