In 2000, the American Physical Therapy adopted Vision 2020 as a projection for excellence in physical therapy care:
“By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, activity limitations, participation restrictions, and environmental barriers related to movement, function, and health.” (http://www.apta.org/vision2020)
While there has been substantial development in practice and education since the introduction of the Vision 2020 document, the profession continues to mature and change in a myriad of ways. If we are to be effective as experts in movement and function within a health care system faced with challenges posed by spiralling costs, problematic access, and ever increasing need, we must carefully reflect on our individual growth as well as our field's evolution toward true professionalism. The operational definitions of the elements of Vision 2020 serve as markers of development, for each of us as an individual health care professional, as well as for our profession as a whole. From the perspective of Editor of the Journal of Geriatric Physical Therapy (JGPT), these are the questions I believe we should ask ourselves:
Autonomous Physical Therapy Practice: In caring for older adults, across the continuum of care settings, how consistently are we using our knowledge, skills, and professional judgment to provide best possible care for those we serve? What are the system-related and personal factors that constrain our ability to practice in an autonomous and collaborative manner? How can we best communicate about the problems we encounter, and what possible solutions can we be a part of developing?
Direct Access: At this point in time, in 47 of 50 states (94%) in the United States, consumers can seek and receive care from physical therapists for impairments that impact on movement and function without first needing referral from a physician. Has this positive change increased access to care to the extent that might be possible? What factors continue to make access to physical therapy challenging for older adults? In what ways can physical therapists, as advocates for the older adults we care for, be agents of change to enhance access to care?
The Entry Level DPT, and Responsibility for Life-long Education: The transition to the DPT as point of entry into the profession is nearly complete; according to the Commission on Accreditation in Physical Therapy Education, 208 of 210 entry-level professional programs now grant a clinical doctorate in physical therapy. While this reflects growth of the body of knowledge required for effective generalist practice, it does not mean professional education is completed at graduation. How effective are the strategies that each of us use to “stay current” with the diverse and complex options for disease management (medical, surgical, pharmaceutical)? How can we access and incorporate the evolving science behind neuroplasticity, motor learning and motor control, and health promotion and wellness neuroplasticity, into effective physical therapy for the older adults we care for?
Evidence-Based Practice: Given the number of submissions to this journal alone (and the growing number of journals relevant to the care of older adults) evidence that has the potential to guide practice is abundant! How effective are we in evaluating the quality of the evidence that is available to us? How well developed are our skills in searching for, understanding and interpreting the body of evidence, in all of its dimensions, to translate research into practice? How can practice drive formulation of clinically important research endeavors?
The JGPT is proud to announce that we have recently met a major developmental milestone as a journal, related to making peer-reviewed evidence published in the JGPT more accessible. We have recently been accepted for indexing in 3 of Thompson Reuters indexes. Now in addition to being indexed and abstracted in Medline/PubMed, CINAHL, EMBASE, and AMED, JGPT will also be searchable in (beginning with Vol 32  2009) Science Citation Index Expanded (also known as SciSearch), in Journal Citation Reports/Science Edition (which will provide an impact factor for JGPT within the next year), and in Current Contents/Clinical Medicine.
Practitioner of Choice: How close are physical therapist to the goal of being recognized as the preferred providers for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health? What must we do to help both consumers and peers in health care recognize our unique contribution?
Professionalism: How well and how consistently do we demonstrate core professional values by aspiring to and wisely applying principles of altruism, excellence, caring, ethics, respect, communication, and accountability? How effectively do we interact and collaborate with our professional colleagues to achieve optimal health and wellness for the individuals we care for and communities in which we practice?
There has been much change for the better (on the whole) within our profession, and for this publication, in particular, in the years that I have had the privilege to serve as Editor. I would like to express my heartfelt thanks to Associate Editor Dale Avers, PT, DPT, PhD, who has served as the team leader for the peer review of case reports, qualitative studies, and special interest papers submitted to the JGPT since 2008, as she steps down from this post to pursue other professional opportunities. Dr Avers' vision, energy, and professionalism have been invaluable (priceless!) to the Journal since its inception, and especially in the tenure of this Editor-in-Chief. Dr Avers will continue to serve on the Journal's Editorial Board and as a manuscript reviewer.
Join me in welcoming Bernadette Williams-York, PT, DSc, GCS, who will be stepping into the role of Associate Editor. Dr Williams-York is the Associate Dean of the College of Health Sciences and Professor and Chair of the Department of Physical Therapy at Alabama State University. Welcome Aboard!
Michelle M. Lusardi