How to Focus on Treatment, Not on Your Title

Recently, a physical therapist queried on Twitter something like, “How do we distinguish ourselves as PTs when personal trainers are also calling themselves PTs?” Essentially, “if someone else is using our professional moniker, how will patients know the difference?”  The tweet, to me, oozed frustration, a bit of fear, confusion, hostility, and underestimation.  I’ll unpack all of them and reassure all providers as to why acronym confusion isn’t something to which you need overreact.  This post is written with physical therapists in mind, but the logic applies to any profession.

"Someone's using my title."

1. You’re frustrated.

If you’re a physical therapist, you worked a helluva lot of years for the designation DPT or PT.  That acronym is a badge of honor, an accomplishment.  Seeing someone else, like a trainer at your gym, use the initials “PT” feels unfair.  It may feel like it diminishes your accomplishment or waters down your brand.

As a professional service provider (essentially, this means any of the “licensed professions” like accountant, lawyer, doctor, physical therapist, hair stylist, veterinarian), the value of your license and your title has been pounded into you.  You pay dues, undergo licensure background checks, and follow your licensing board’s rules.  It’s unfair when someone who doesn’t play by those rules interferes with your livelihood! 

As an attorney, I’ve felt this.  So-called “consultants” frequently hold themselves out to offer services that they’re not legally allowed to perform.  Sometimes, another professional views it as within their scope of practice to perform some aspect of lawyering, and sometimes that triggers a sense of frustration in me – essentially a sense of “leave the lawyering to the lawyers!”  I get it.  Everyone who is licensed to practice their profession gets it.

2. You’re a bit fearful.

If someone with far less education and training can use your professional initials, could that impact your business, and thus your income stream, and thus your ability to support your family?  That’s scary, but it’s also a bit of a catastrophic view.

3. You’re a bit confused.

Have you wondered to yourself if another profession is rightfully using the initials PT, or if your investment in your professional training was worthwhile?  Are you confused about your scope of practice and how that interacts with other professions, like personal trainers?  That’s all reasonable and makes sense.  Remember, though, that healthcare isn’t a one-size-fits-all or a one-stop-shop business.  Patients benefit from variety and teamwork in their providers, so some overlap and synergy with other professions is actually a benefit.  More on that in a moment.

4. You’re feeling hostile to the other profession.

You’re a PT, and to you, that means a physical therapist.  It doesn’t not mean a personal trainer, and you feel downright irritated when you see John Doe, PT listed as a coach at your gym, only to discover he has about 5 fewer years of education than you.

Whew. Did it feel good to get that off your chest?  Excellent.  Now leave it there.

The other profession is value-adding to your patients.   Just like how you’re value-adding to their clients.

5. You begin underestimating your own value, and/or you underestimate the value of the other professional.

If a personal trainer calls herself a PT and “coaches” a client through an ankle injury, are you actually the fool who wasted three extra years on a DPT degree?  Where is your value to your patients?  With insurance and healthcare costs rising, perhaps you fear that patients’ estimation of your value will begin to diminish.

Perhaps not.  Instead, maybe you feel that the other professional (here, a personal trainer) adds little value to your patients’ health.  If they want to lift heavier or run faster, you are in the best position to help them.  You are a movement expert, according to that DPT degree on the wall.

Ok…moving on…

Hopefully the above discussion touched on some of your feelings about overlapping acronyms.  Now, let me quell your concerns.

1. Patients care little about acronyms.

Before I needed physical therapy, I did not know that “PT” stood for physical therapist, nor did I care.  In fact, I had a personal trainer, and I called her my PT without her ever identifying as such.  It’s how I abbreviated it on my calendar and how I texted my husband about where I’d be (“at the gym w/ my PT!”).  That title carried absolutely no value with it.

Now, when I speak to groups about my physical therapist (who I normally call “my PT”), I’m careful to actually call her “my physical therapist.”  That’s because I’ve had audiences who don’t know what “PT” stands for.  The same goes for conversations with friends or family.  I can’t tell you how many times I’ve been asked: “What’s your ‘PT’ mean?”

This concern is of value to you because of the work and accomplishment that the initials “PT” represent, but they don’t carry that same value for your patients.

2. Don’t convey your insecurities over professional competitiveness to your patients.

This means, don’t tell your patients that hiring you is a better choice than a personal trainer.  It makes you seem petty and insecure, when you have an extraordinary skill that is fantastically value-adding!  I love my physical therapist, and I have the highest respect for the profession.  The best way to imbue that sense of professional loyalty and appreciation in your patients is to simply do a good job treating them.  Don’t tell them about what makes you great – show them.  Help them rehabilitate and accomplish their goals, and you’ll make them physical therapy loyalists for life.

Once, I had a primary care provider, Dr. Jane Smith, who was a Doctor of Osteopathic Medicine, or a DO.  In visiting with a specialist physician one day, I mentioned that I was under the care of Dr. Smith, and the specialist felt the need to ‘splain and unload on me.  “Dr. Smith is a DO, not an MD like me.  They’re still called doctors [snicker, snicker], but their training is different.  I recommend that you get an MD as your primary.”  Here’s the thing: my DO felt no need to assert her profession’s dominance over my MD’s profession, and that was appealing to me.  Dr. Smith’s focus was on my wellness, whereas the specialist’s focus seemed to be on professional competitiveness.  That made me think less of her ability to help me and had the reverse of her intended effect – it strengthened my confidence in my DO while diminishing my confidence in my MD.  Because, she must have some weird insecurity about DOs infringing on “her” profession to give me that mini-speech, right?

Yikes.  Physical therapy is far too valuable for the profession to lose a single patient to these types of chest-puffing competitiveness.

3. Patients are best served by a multidisciplinary team.

I cannot say this enough – you alone are not a patient’s best team, because you alone do not constitute a team.  Patients are best served by a multidisciplinary group who can best serve their diverse needs.  And, yes, all patients’ needs are diverse – even your patient with the simple sprained ankle.

Through my recovery from pelvic pain, my team consisted of a pain-focused gynecologist, a pelvic floor physical therapist, a yoga instructor (who’s also a physical therapist), a primary care provider, and a talk therapist.  But, I was a pretty complex case.  Instead, look to the case of my friend who recently slept funny and awoke with his neck so tight that he could hardly move his head.  He saw his doctor, who prescribed pain meds and physical therapy.  My friend didn’t fill the pain meds prescription but did see his physical therapist.  He felt 80% better after the physical therapist, and stopped at a compounding pharmacy on the way home to have the pharmacist make an over-the-counter dose Ibuprofen pain relief cream.  That helped another 10%.  He felt 100% better, though, after a session of yoga, which got him comfortable stretching and moving again.  And, voila – that was his team.

Often, providers who feel like they’re treating a patient alone are doing so within the context of a team anyway.  Your patient is going to yoga classes at the gym, jogging with her local new-mommy running club, or receiving antidepressants from her primary care physician.  By embracing, rather than resisting, the multidisciplinary nature of your patients’ needs, you can actually increase your patients’ perception of your value by helping them achieve their maximum function sooner!

4. Don’t be possessive; value your patients’ choices.

I’m a healthcare attorney, and there are healthcare “consultants” out there who charge more per hour than me, who don’t have law degrees or licenses, and whose messes I often end up cleaning up.  They don’t understand the laws to the degree necessary to give advice about them, and I’ve seen them muck up my clients’ understanding of the practice of physical therapy or the applicable legal requirements.

In this situation, I try to remember two things.  First, I remember that my dog, Crosby, was the “good dog” at his daycare center, because he never possessively peed upon another dog’s fresh urine spot.  Why did this make him good?  Maybe, as the smallest dog in the class, he should’ve done some possessive peeing to establish his importance!  Problem is, that probably wouldn’t have made the class pit bull (literally) respect him any more.  And, it would’ve caused a much larger problem… small-dog possessive urinators tend to get peed upon.  His best friend was a possessive urinator, and just as soon as he’d lift his leg over a pee spot, a larger dog would lift his leg over that dog, landing him in the bathtub for a de-stenching and scrub down.  Crosby was smart – by avoiding possessiveness and earning respect a different way, he was never once peed on at daycare.

The second thing I remember about my clients whose business has been mucked up by non-lawyers is that they chose to hire that person.  By criticizing that other professional, I won’t make myself any friends in my clients, and I may drive business away.  Instead, I establish my worth by doing good work.  If asked directly, I kindly and calmly and cheerfully point out that they’ll now save money by using me, and that we’ll get this mess fixed-up in no time!  “No worries – I’ll take care of it from here!”  It’s a no-judgment zone, just like your clinic should be.

If you shame your patients for seeing a physical trainer or acupuncturist or energy healer for their sprained ankle before seeing you, you’ll likely just drive them into the office of another provider.  In fact, you may as well just drive them there yourself.  It’s unattractive and not confidence-inspiring for the patient to hear you put down their other providers.

5. No one’s trying to steal your stuff.

Have you considered that the personal trainer at the gym may not know that he’s “stealing” your initials?  More likely than not, the “theft” is an innocent one.  He probably refers patients to physical therapy when a dysfunction prevents them from falling within the realm of his skill, and he probably only calls himself a “PT” because that’s what the other trainers, or his training teachers, or his own trainers have called themselves.  It’s not an affront to you; it has nothing to do with you.

If you feel like a trainer’s use of PT dilutes your professional identity, then consider changing something within the realm of your control.  Change your email signature and business card to John Doe, DPT; or to John Doe, Doctor of Physical Therapy; or to John Doe, Physical Therapist.  I promise you that patients skip over your initials the same way you skip over mine.  They often mean little to those outside the profession, so descriptive titles are much more helpful anyway to building a professional identity.

6. Do something about it.

If none of my other suggestions or reassurances resonate with you, my final piece of advice will.  If you don’t like something, then change it.  I personally suggest ideas 1 through 5 over this last one – they leave the most time to focus on patient-care and strengthening your actual reach and impact as a physical therapist (which, in my view, are crucial to professional branding).  But, if that’s not good enough, then you’ll need to change how professionals’ titles are applied.  This may include talking to your legislators to add “PT” to a list of designated titles that only a licensed professional can use, or it may include talking to local personal trainer certification programs to ask that they adopt a different moniker.  Or, it may include a letter-writing campaign to local gyms and trainers, imploring them to change their title to avoid the impression that they’re practicing physical therapy and to prevent patient confusion.

 

But, if it were up to me, you’d just focus on delivering your awesome PT-care to patients, lobby for direct access, and become more well-known for being the rockstar profession that you are…not for infighting with other wellness professionals.  Because, while I have some awesome trainers and yoga teachers and climbing instructors in my life, I only have one PT.  And, in her treatment of me, she’s proven her value a thousand times over, and the loyalty and professional respect I hold towards her was cultivated without her ever saying a sideways word about any other professional.

Questions? If you have questions about anything practice-related, including the terminology you can use to describe your practice, email Erin at erin@jackson-legal.com.  This blog isn't intended to ever serve as a substitute for real legal advice.

 

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