Malpractice is in our midst.

Patients deserve the best-quality care, and any therapist worthy of a license would take offense at seeing care delivered by inappropriate and poorly trained personnel. Apparently, we do not bring this same high standard to our educational enterprise. We now stand on the threshold of what I call the "deprofessionalization" of physical therapy. Implicit in our actions of accrediting and nurturing inappropriate educational environments is our acceptance that therapist training is at the technician, rather than at the professional, level. This is what occurs when more and more faculty members are not qualified to teach in academic settings. The result, I can assure you, will affect every aspect of practice and injure us all and our patients most of all.

In attempts to fill open faculty positions, schools are recruiting personnel who, though they might be well intentioned, bring to their tasks little or no advanced training and none of the skills necessary for an academic career. They not only often lack terminal degrees, but they also have contributed little to the scholarship of practice. What makes a person qualified to be a faculty member? Some would argue that anyone with a license can be a faculty member. I think not! We all know academic faculty do more than teach. Practitioners with licenses may indeed be qualified and gifted teachers, and their services should be used in our academic endeavors, but that does not mean they can function as academic faculty. In the academic setting, faculty members must be able to participate in faculty and university governance, teach, counsel, contribute to new knowledge, critically evaluate new information, and shape curricular and educational policies. We have taken the old medical adage of "see one, do one, teach one" to new heights.

Only in fields devoid of a body of knowledge and a scientific basis is it considered acceptable for faculty to have no training beyond that of an entry-level practitioner. The issue is not elitism nor a desire to have every school churning out research. The issue at this point is minimal levels of credibility. As this school year begins, more people than ever before will be studying to become physical therapists, but that is a mixed blessing. The issue I address is not a personnel shortage, real or imagined, in caregivers, but a real and critical shortage in competent faculty, a shortage exacerbated by those who seek profit from school development and glory and ego satisfaction in roles for which they are ill equipped.

New physical therapy programs proliferate as our faculty shortage becomes more acute. To staff these programs, personnel are obtained who lack academic credentials and proven records of clinical teaching. More problematic is that to administer these programs, directors are recruited who lack appropriate degrees, are devoid of experience in academic environments, and show little inclination for bridging the gap between scholarship and practice. Many directors of developing programs lack the credentials to even be tenure-track faculty in quality educational institutions. Many have never even held academic positions before they became school directors, and few are prepared to be mentors to a new generation of faculty.

There are those who say a school director or program chair needs above all to be an administrator. I would argue that those who would make that suggestion misunderstand the nature of the academic environment and show ignorance of the real role of a school director. A school director needs to be competent in all aspects of our enterprise, including teaching, research, and service (in our case, that means practice). The leadership in academic and clinical departments should never be entrusted to bureaucrats but rather to competent leaders who can nurture and be mentors to those who they attempt to guide.

Make no mistake, the purpose of developing new education programs is rarely for the public good, rather it is for institutional benefit. Private schools view our education programs as sources of income, a not-surprising development in view of the meager investment these programs make. Because of our minimal accreditation standards, such programs often begin with little support for research and scholarship and with minimal ties to clinical settings. Inherent in such actions is a diminution of our standing and our credibility.

Difficult times call for people to rise to the occasion. In a profession where there are too few faculty members, and fewer still who conduct themselves in accord with the expectation of the academy, we need leaders and people with courage. We need people who can recognize the obvious, that if there is a shortage of therapists, school proliferation is not the answer because it is wasteful of faculty), and other resources. We need people who are willing to forego personal gain and who comprehend that they will not be ready to assume faculty positions until they have obtained the proper training. More importantly, we need people who are equipped to lead and train a new generation of academicians who will take us into the next century.

We mortgage our future when those who guide our education programs are not prepared. What will happen to the promise of developing a scientific foundation for practice in this era of accountability if we entrust our scholarship to those without preparation? This should be an issue for every practitioner.

The time has come to look seriously at the schools that exist and those that are developing. More is not better! What we need are adequate numbers of therapists equipped for the professional level of practice that our patients need. Educating such personnel takes the efforts of academicians with appropriate credentials for teaching in institutions of higher education, and it takes their efforts combined with those of clinical personnel. Each is needed, and neither should be considered more important than the other. The issue is not the hierarchy of academic and clinical faculty members but rather the appropriate role of each. en academic faculty act as clinical faculty or when clinical faculty act as academic faculty, we commit educational malpractice, because each group is then performing outside of their area of competence.