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Section Reorganization Redux

As we all struggle with the new realities of practice—including demands for increased productivity and evidence of outcomes—it has become clear that business cannot be conducted as usual.

Practitioners who are under pressure to become more productive need assistance from educational institutions, which now more than ever must educate physical therapists to be problem solvers who can function uniquely within the health care system, who can provide services that no one else can provide. In addition, practitioners need better guidance regarding what works, and that means more clinical research. Ironically, even though we recognize these dual needs, we have done little to examine what we can do organizationally to foster the development of more relevant education while also increasing the quantity and meaningfulness of clinical research—research that in most professions is produced primarily by faculty members.

Part of the problem is that we lack an organizational structure within the APTA sections that fosters teamwork and communication. Section leaders meet on a regular basis, and their efforts to coordinate projects are admirable, but section members—those active participants in issues vital to practice—do not, in my view, interact sufficiently across sections. This may be the unavoidable price we pay for advanced knowledge and specialization, but perhaps we have gone too far.

As the demand for physical therapists in clinical settings decreases, perhaps there will be less of a faculty shortage, but I believe that even if we were to cut in half the number of education programs, we still would not have enough qualified faculty. By "qualified," I mean a cohort that includes active clinicians and active clinical researchers, a group that can educate in a manner that prepares professionals who will be worthy of respect and worthy of the responsibilities we seek in practice.

In May 1993, the Journal published the following Editor's Note. The arguments I made then seem even more relevant now. The Note stimulated discussion by some section leaders, but there were was little follow-up. We reprint the Note with the hope that this time we can have a wider discussion, one that involves not just section leaders but also members of the profession who today must participate in strategies for change and growth. We welcome your dialogue.

Specialties have grown, skills have been nurtured, and in general the profession has been advanced through the activities of the special interest sections of the American Physical Therapy Association (APTA). But the time has come for change. The current alignment of sections keeps apart essential constituencies, impeding progress, growth, and consensus building. Efforts at change have failed in the recent past, but the issues underlying the necessity for change have grown more critical, and they will not simply go away.

Currently, some sections organize around a type of practice (eg, Orthopaedics and Pediatrics) and others around practice settings (eg, Veterans Administration), whereas still others deal with role delineation (eg, Administration). The mixture is at best curious. More disturbing, however, is that when the sections meet together, there is a tendency for us to divide and separate. While to some extent this is reasonable because it allows people with common interests to focus, this division increasingly hinders some needed communications and the development of beneficial interactions. The issues I am about to raise here relate to more than just two sections, but they are, in my view, most critical as related to these two. Specifically, I believe it is time to disband the Education and Research Sections and to allow their members to form a new entity outside of the section structure.

The Education and Research Sections of APTA have been potent forces in shaping the face of our profession, but many have questioned whether these sections can now rightly speak for those interested in research and education and whether the sections can continue to assist our growth in these critical areas. The question is bound to raise the defensive ire of the many persons who have ably led both sections, but perhaps as a former president and current member of the Research Section and as a current member of the Education Section I can assure all those concerned that my desire for change relates not to the actions of individuals, but rather to the structural limitations imposed by the current system. Education and research are fundamentally linked—each is a role of the academic physical therapist, a physical therapist who should also have a primary area of content expertise.

Consider what now occurs when sections meet at our Combined Sections Meeting. Where should a faculty member who conducts research and practices in orthopedics spend time? At meetings of the Pediatrics or Neurology Sections, for example, you will see some of our country's most outstanding faculty and researchers. Their absence from activities of the Research and Education Sections and the loss of their potential contributions to these sections are profound and costly. Similarly, those attending Education Section sessions are denied the opportunity to discuss curricular issues with academicians busily involved in the Research Section or with content experts who attend practice-focused meetings. Extensive interaction and dialogue are denied by the existing structure. The sections dealing with practice would benefit from the presence and participation of researchers and educators—and so would the researchers and educators. There are enough walls dividing faculties from practice and researchers from teachers; we can do without those of our own creation.

Under the current system, content competes with process. Education and research are more than just process areas, but they are certainly not primary physical therapy content areas; they are areas applied to physical therapy content. The current system arbitrarily separates. Full-time tenure-track members of physical therapy faculties should have an area of content, and they should also be conducting research. Under the current system, however, they can choose to socialize and to interact in a content section, in the Research Section, or in the Education Section. Even if they join all three, active participation in all three is impractical. The collegiality and interaction we are seeking have thus become casualties of structure. More importantly, we are not, through the current structure, valuing the necessity of content, and we are also losing that essential link among researchers, educators, and practitioners.

Clinical educators active in the Education Section also suffer because of the existing structure. They often interact only with those who feel comfortable in the Education Section and not with those who are active in the practice-related sections or the Research Section. This limits the development of each group and denies the formulation of agendas that address common interests. There should be a means by which academic and clinical faculties can be free to maintain active interest and participation in sections relating to their primary areas of content. There should also be a means by which the destructive dichotomy between researchers and teachers can be eliminated and replaced by an arena in which teaching, scholarship, and clinical education issues are equally welcome.

What is needed is an association of academic physical therapists that meets outside of the section environment. This new organization should remain within APTA auspices, but it should be given the freedom to cast a wide net that captures those who care not only about conveyance of information and skills, but also about the generation of new knowledge. In view of the paucity of research in physical therapy and the growing faculty shortage, the value of this proposition should be apparent. The potential to develop better faculty and curricula could be extraordinary.

Since their inception, sections have been a powerful influence within our association. Two leading sections now face an even greater challenge. The question is whether they can recognize the needs of today and take us beyond a formulation based on past realities, whether they can set aside parochial interests and comfortable relationships in favor of a new partnership in which divergent groups merge and nurture one another in the interests of the entire profession. I challenge the leadership of both sections to engage in a dialogue on this issue—a dialogue with their members, with one another, and with the rest of the profession—and I challenge all of us in APTA to consider the benefits of restructuring our sections.

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This Article Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rothstein, J. M Search for Related Content PubMed PubMed Citation Articles by Rothstein, J. M Related Collections APTA: Other All Editorials Jules Rothstein Social Bookmarking                      What's this?