Excellence in Academic Physical Therapy: What Is It and How Do We Get There? INTRODUCTION The purpose of this lecture is to honor Pauline Cerasoli. The best way to honor her - as well as those past generations of leaders and visionaries who have brought us to this point in our profession s development - is to accept the challenge that they have handed down to us. They have passed us the baton. If we look very carefully (and use our imaginations), we can see some words printed on that baton: "Pursue excellence!" Since this word - excellence - is the subject of my lecture, perhaps we should begin by considering its definition. My dictionary defines excellence as "the state, quality or condition of excelling; surpassing others; superiority; pre-eminence."1 This makes us a bit uncomfortable, doesn't it? Excellence seems to be defined by the notion that we achieve excellence in some sort of competition with others. But the pursuit of excellence should not make us uncomfortable, if we understand that excellence is not merely a state; it is rather a process, or more properly - a continual striving to be better, to be the best that we can be. In striving to achieve excellence, it is not the surpassing of others that is important, it is the surpassing of ourselves, or, more properly, of what we have previously accomplished. Excellence should he considered as an important value, and a goal to be pursued* This is what our past generations of leaders, including Pauline Cerasoli, teach us. This is the legacy that they pass on to us. We should note that 90 years ago last month, the physical therapy profession was born in the United States. On January 15, 1921, 30 former reconstruction aides met at Keen's Chop House in New York City to form the organization that we now know as the American Physical Therapy Association (APTA).2 This was the true birth date of the profession. What went before (for example, reconstruction aides) was a gestational period. On this date, the profession developed an organization and an identity. Over the ensuing 90 years, physical therapists with vision and hard work and courage built the profession that we know today. Our past generations of leaders have brought us, at least in a metaphorical sense, to the proverbial mountaintop, where we can see the "promised land." There is no better description of that promised land than Vision 2020 (Figure 1). It envisions that by the year 2020, physical therapy will be provided by ". . . doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access . . . ."3 In other words, the promised land is full direct access for consumers and full partnership in the US health care system for physical therapists. Since Vision 2020 was first written and adopted by the APTA in 2000, there has been a tendency to look at it as if it were guaranteed, but it is far from that. What will get us there, and beyond? We face critical challenges to achieve that promise and an uncertain future, given the political, economic, and social turmoil of our times. Indeed, there is significant potential for radical changes in the health care system that do not necessarily include us. Given the risks and challenges, what is it that will allow us to achieve this goal: recognition as practitioners of choice and full partnership as autonomous professionals? The principal argument that I am making in this lecture is this: The essential characteristic of a profession that would achieve such recognition is a strong academic foundation. AN EXAMPLE: ACADEMIC MEDICINE To begin making this argument, I would like us to consider the development of the medical profession in the united states. Specifically, I ask the following question: Why has the medical profession achieved clear supremacy or dominance in our health care system? I would argue that academic medicine is the foundation of that success. …
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