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James Gordon observes the evolution of physical therapy

He challenges the profession to continue strengthening its infrastructure or risk becoming a footnote in history

James Gordon lectures
James Gordon delivers the 45th Mary McMillan Lecture. (USC Photo/Sara Villagran)

James Gordon received the highest honor bestowed by the American Physical Therapy Association when he delivered the 45th Mary McMillan Lecture at the association’s annual conference.

Gordon, associate dean and division chair for the USC Division of Biokinesiology and Physical Therapy, is the fourth Trojan to have that distinction, following in the footsteps of Margaret Rood (1969), Helen Hislop (1975) and Carolee Winstein (2009).

Deriving inspiration from Hislop’s speech, “The Not-So-Impossible Dream” — a game-changer for physical therapy with its push toward research and knowledge creation — Gordon used a part of her quote, “If greatness is a goal, it will take great thinking and consummate honesty to achieve it,” for the title of his lecture.

Gordon acknowledged that the speech coincided with the 40th anniversary of his having received a bachelor’s degree in physical therapy from the State University of New York Downstate Medical Center, and he noted the quantum leap the profession has made since.

We have fallen victim to the false assumption that advances in the clinical science of physical therapy are inevitable, that new knowledge comes from a well.

James Gordon

“Not in his wildest psychedelic dreams would our 1974 RPT [Registered Physical Therapist] have imagined that a physical therapist would ever graduate with a Doctor of Physical Therapy degree,” he said in his speech. “The DPTs who graduate in 2014 have so much more knowledge, skill and expertise than the RPTs who graduated in 1974 that it almost seems a different profession.”

Underscoring the profession’s evolution, Gordon compared a 1974 Physical Therapy journal to one from 2014, noting that only 12 percent of the articles were of original research 40 years ago whereas 78 percent are today. He also pointed out that the number of physical therapy educators with PhDs had increased 25-fold in the 40-year gap, according to the Commission on Accreditation in Physical Therapy Education.

Maintaining forward momentum

The profession’s leap forward, though, is not inevitable, he cautioned.

“We have fallen victim to the false assumption that advances in the clinical science of physical therapy are inevitable, that new knowledge comes from a well — or a spigot — and that we merely pump the handle or turn the faucet to obtain new discoveries that will improve our clinical interventions.”

It is physical therapy’s transition to a three-pronged mission — education, clinical practice, and research and scholarship — that has helped the industry maintain its forward-moving momentum, he said. But that growth engine could effectively stall as harsh economic realities and ever-increasing education costs force institutions to cut costs by slashing, or cutting altogether, research budgets.

“Our mission in professional education is not to prepare students for practice as it was carried out in the past nor even as it is carried out in the present,” he argued. “Our mission is to educate our students for practice as it will be carried out in the future, five and 10 years from now. Only if we are actively engaged in creating that future can we be strong and effective teachers.”

To keep the profession from splitting into two tiers — cheap, smaller institutions focused on only patient care delivery and larger institutions focused on research and scholarship — Gordon made some suggestions on how to keep the profession from becoming a footnote in history.

He argued for fewer programs with larger faculties, an objective and comprehensive study of physical therapy education and a rigorous accreditation process for all educational institutions, noting the importance of professional organizations like the Commission of Academic Physical Therapy Education, the American Physical Therapy Association and the Foundation for Physical Therapy in achieving these goals.

“Through our efforts today, we design and build the foundations and frameworks that will make it possible for a strong and vibrant and creative profession to emerge in the next decade, in the next 40 years, in the next century,” he said. “The decisions we make today and in the next few years will shape academic physical therapy and enable — or not — our profession to achieve greatness.”

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James Gordon observes the evolution of physical therapy

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