More on the DPT.

To the Editor:

I read with interest the letter from Konrad Kuenstler, one of our members in the Texas Chapter of the American Physical Therapy Association, that was published in the July issue of the Journal. Clearly, Mr Kuenstler feels passionately about the issue of moving aggressively to the doctorate in physical therapy (DPT) to allow us to invoke the term "doctor." He has raised this issue within the chapter, and, although his viewpoint has not generated a groundswell of support from either the rank-and-file membership or the chapter leadership, we are pleased to see his willingness to pursue the issue. We will be stronger as an organization for having created the forum for this dialogue.

There were a couple of points made in Mr Kuenstler's letter to which I feel duty bound to respond as the spokesperson for the chapter. He raised the question of"[w]here were the American Physical Therapy Association (APTA) and the Texas Physical Therapy Association (TPTA)" during the Texas Workers' Compensation Commission (TWCC) guideline changes. He specifically mentioned changes to reimbursement rates for physical therapists who are involved in impairment rating activities. What is not reflected in his question or comments is the tact that the Association filed suit against the TWCC in 1992 over the proposed medical fee reimbursement guidelines because of their apparent inequity in dealing with physical therapists. This litigation and the discussions that ensued continued for over 3 years. The Association invested over a quarter of a million dollars, which ultimately resulted in a much more favorable reimbursement standard for the physical therapy profession. It is now possible for our members who choose to focus their services on patients receiving Texas Workers' Compensation to make a living. It is our humble opinion that without the aggressive representation from the Association, the current state of affairs would not exist.

Mr Kuenstler also commented, "The Texas Physical Therapy Association thought they had achieved a great victory when they prevented other health care practitioners from being able to say they do physical therapy." This comment was then extended to question the benefit derived from this advocacy effort because without the recognition as "doctors" is a hollow result. Our GAC volunteers and our leadership feel quite strongly that this legislative outcome enhanced our profession's integrity to our profession and created a real-world environment that has had very tangible results for our members. Gone are the days when physicians, osteopaths, chiropractors, massage therapists, podiatrists, and other health care professionals could hold themselves out to the public as providers of physical therapy. Gone are the days when other health care practitioners could advertise physical therapy services or bill for physical therapy under the "physical therapy" benefits of health plans. If a person wants to provide physical therapy services in Texas, that person must hold a valid license from the state physical therapy licensure board. To our way of thinking, this achievement meets all of the criteria of a "success."

Barbara Sanders, PhD, PT President, Texas Physical Therapy Association 400 W 15th St, Suite 805 Austin, TX 78701