Physical therapy students learn human anatomy in a lab class as part of their coursework

When someone asks if there’s a doctor in the house, a group of USC-trained physical therapists will soon be able to answer in the affirmative.

Next spring, the 85 members in the Department of Biokinesiology and Physical Therapy’s first doctoral class will graduate with a Doctor of Physical Therapy degree, making USC one of only three physical therapy programs in the country to offer the doctoral degree.

The new degree program reflects significant changes in the 53-year-old department’s structure and focus that has taken place over the last two years.

But the change wasn’t instituted so that physical therapists can call themselves “doctors.”

In fact, said department chair Helen Hislop, they are being discouraged from calling themselves doctors in the clinical setting. “It would be too confusing to patients,” she noted.

Rather, said Hislop, the department was motivated to change from a masters to a doctoral program by two factors: the changing health care environment and an explosion of information.

“As science grew, and as the demands of the physical therapist broadened, we couldn’t put out a PT in two years that knew what our faculty believed they needed to know, or could practice at the level required by the medical community,” she said.

Driven somewhat by the changes inspired by managed care, she said, “One of the big differences in the health care environment is that you don’t get to see your patients as often or as long as we used to do in the past.”

In the past, a physical therapist might be able to spend several sessions evaluating and designing a treatment plan for a patient. Today, “you may have 20 minutes to do an evaluation and you’ll see the patient only four times. That means you have to evaluate accurately. In four treatments they’re going to have to do what they could do with unlimited treatments in the past, so they have to be better clinicians.”

In changing from a masters to a doctoral degree program, coursework has expanded from two to three years and includes significantly more basic science, such as cell biology and molecular biology. Students take five instead of two anatomy classes. Also added: courses in clinical decision-making and differential diagnosis. “It’s not as a physician diagnoses a disease, but to diagnose an anatomical disorder, disorders of human motion, which is what we treat.”

Here, again, the changing health care environment mandated the changes. “These days patients are often referred by non-physicians,” noted Hislop. “If you are treating a back problem, the PT had better be able to know whether there is truly a problem within their scope of practice, or whether it’s something much more serious that they shouldn’t be treating. In obstetrics and gynecology, you have to know whether a back pain is from a pregnancy or from a true back injury.”

To facilitate the expanded program, the department has been recruiting and adding new faculty-nine new members in the last two years.

Also, Hislop said, many research programs are now basic science-oriented and are intended to add to general knowledge that can later be applied to clinical practice. Those programs range from studies of embryonic motion to studies in oral motor control.

In fact, the department is in discussions with Stanford University to create a center to study the mechanisms and effectiveness of manual therapy. Stanford has an open magnetic resonance imaging machine “that you can stand in and do exercises and see in detail muscle and skeletal involvement,” said Hislop.

The USC department hopes to determine in a serious scientific way why certain physical therapy treatments work. “When we treat lower back pain, we do something called a ‘facet glide.’ But we want to establish exactly what it is, what the proper technique is, how it works and how you can prove that it works,” she said.

“And that’s just one example. Our goal is to improve clinical care with supportable data.”