On October 7, 2021, during the Fellowship Program Directors meeting at the annual AAOMPT conference in Cleveland, Dr. James Dunning raised the question of whether there is a potential conflict of interest when the Chair of the accrediting body for all OMPT Fellowship programs is also the principal, profit-taking owner of his own OMPT Fellowship program. In response, Dr. Chris Showalter publicly stated that he did not believe there was a potential conflict of interest.
Notably, we raised this “potential conflict of interest” issue on 3 separate occasions within formal letters (dated November 12, 2021, March 10, 2022, and July 23, 2022) to the accrediting body (ACOMPTE). ACOMPTE did not acknowledge or attempt to address our concerns regarding the potential for lack of impartiality when the Chair of an accrediting body is also the principal profit-sharing owner of his/her own fellowship program.
Due to ACOMPTE failing to address our concerns, AAMT developed a 3-question online survey to gauge opinions on this issue from a large sample of physical therapists. This online survey was open for 2 weeks (October 6, 2022 to October 20, 2022) and was completed by 779 physical therapists from multiple U.S. states.
The 3-question survey and the results are as follows:
1. Is there a potential conflict of interest when the Chair of the accrediting organization for OMPT Fellowships (ACOMPTE) is also the profit-taking owner of his/her own OMPT Fellowship program?
Of the 779 physical therapists that responded to question one, 90.12% agreed with this statement (i.e., believe “there is a potential conflict of interest”) by selecting “yes”, whereas 9.88% disagreed with the statement by selecting “no”.
2. Is there a potential for lack of impartiality, when the Chair of the accrediting body (ACOMPTE) for all 38 AAOMPT Recognized Fellowship programs is also a profit-taking owner of his own OMPT Fellowship program?
Of the 778 physical therapists that responded to question two, 91.65% agreed with this statement (i.e., believe “there is the potential for lack of impartiality”) by selecting “yes”, whereas 8.35% disagreed with the statement by selecting “no”.
3. Chris Showalter, DPT is the current Chair of the accrediting body (ACOMPTE) for all 38 AAOMPT Recognized Fellowship programs. He is also the principal owner of the Maitland-Australian Physiotherapy OMPT Fellowship program. Should Dr. Showalter be able to Chair an organization that accredits his own Fellowship program?
Of the 769 physical therapists that responded to question three, 84.27% selected “no” (i.e., they believe Dr. Showalter should not be permitted to Chair an organization that accredits his own Fellowship program), whereas 15.73% selected “yes” (i.e., believe Dr. Showalter should be able to Chair the accrediting body).
The Chair of an accrediting body has a significant influence and decision-making power over new accreditations of fellowship programs, re-accreditation of fellowship programs, changes in policy for all fellowship programs, the initiation of investigations (i.e., “focused-reviews”—essentially yearlong intensive audits of fellowship programs), and the placement of probationary status upon fellowship programs. With the current Chair of the accrediting body (ACOMPTE) having a known majority financial stake (i.e., the principal profit-taking owner) in his own OMPT Fellowship program (Maitland Australian Physiotherapy Fellowship in OMPT), there is the potential that decisions made by the Chair regarding his own and/or other OMPT Fellowship programs could affect his personal and business income.
Notably, on October 12, 2022, almost 11 months after we first raised the issue with a formal letter to ACOMPTE, but just 6 days after the above 3-question “potential conflict of interest” online survey was released (October 6, 2022), the FOMPT Board of Trustees sent a letter to AAMT that was addressed to James Dunning, PhD, DPT, FAAOMPT. The letter from the FOMPT Board of Trustees included the following statements:
“We are aware of your concern regarding an alleged conflict of interest with the chair of ACOMPTE being a program director of an accredited OMPT program, and owner of a continuing education company….The FOMPT board does not see a problem with the review or with the conflict of interest.”
AAMT’s response: Although the FOMPT Board of Trustees “does not see a problem”, it appears that 90.12% of physical therapists (of the 779 PTs that responded to question 1 of the online survey) believe “there is a potential conflict of interest”.
“Furthermore, please know that eligible program directors of OMPT programs and owners of continuing education companies may also serve in similar chair roles at comparable healthcare specialty accreditors such as the American Board of Physical Therapy Residency Fellowship Residency and Education (ABPTRFE), and the Council for American Physical Therapy Education (CAPTE).”
AAMT’s response: We are aware that the APTA’s accrediting body for residency and fellowship programs (ABPTRFE) has previously selected individuals that are current or prior Program Directors of residency or fellowship programs; however, we are not aware of a case wherein the Chair of ABPTRFE was the principal, profit-taking owner of his/her own residency or fellowship program while also serving as the Chair of the accrediting body (ABPTRFE).
“We have determined no further action or discussion on this issue is warranted and consider this matter of your concern to be settled, therefore we request that you respect our professional position.”
AAMT’s response: The 6 members of the FOMPT Board of Trustees (Drs. Tim Flynn, Skip Gill, Stephen McDavitt, Catherine Patla, Conrad Penner, and Michael Puniello) appear to have a very different perspective on what constitutes a potential conflict of interest compared with 91.65% of physical therapists (of the 778 PTs that responded to question 2 of the survey) that believe “there is the potential for lack of impartiality” when the Chair of the accrediting body (ACOMPTE) for all 38 AAOMPT Recognized Fellowship programs is also a profit-taking owner of his own OMPT Fellowship program. Furthermore, unlike the opinion of the 6 members of the FOMPT Board of Trustees, 84.27% of physical therapists (of the 769 PTs that responded to question 3 of the survey) believe Dr. Showalter should not be permitted to Chair an organization that accredits his own Fellowship program.
CONCLUSIONS
We now realize that neither the FOMPT Board of Trustees nor ACOMPTE (the accrediting body for OMPT Fellowships within AAOMPT) are willing to acknowledge that “there is the potential for lack of impartiality” and “a potential conflict of interest” when the Chair of the accrediting body (ACOMPTE) for all 38 AAOMPT Recognized Fellowship programs is also a profit-taking owner of his own OMPT Fellowship program.
This is unfortunate as it seems like a simple remedy to this situation could have been proposed and implemented. We believe this outcome leaves a large question mark on the integrity and impartiality of the organization that has been given the authority to accredit fellowships in OMPT.
AUTHORS
James Dunning, PhD, DPT, MSc, FAAOMPT, Dip. Osteopractic
Director, AAMT Fellowship in Orthopaedic Manual Physical Therapy
Montgomery Osteopractic Physical Therapy & Acupuncture, Montgomery, AL
Paul Bliton, DPT, OCS, SCS, FAAOMPT, Dip. Osteopractic
Associate Director, AAMT Fellowship in Orthopaedic Manual Physical Therapy
William S. Middleton VA Hospital, Madison, WI
Patrick Gorby, DPT, FAAOMPT, Dip. Osteopractic
Assistant Director, AAMT Fellowship in Orthopaedic Manual Physical Therapy
Gorby Osteopractic Physical Therapy, Phoenix, AZ
Casey Charlebois, PhD(c), DPT, MSc, FAAOMPT, Dip. Osteopractic
Director of Clinical Research, AAMT Fellowship in Orthopaedic Manual Physical Therapy
PhD Candidate, Nova Southeastern University, Fort Lauderdale, FL
Drew Cook, PT, DPT, Cert. SMT, Cert. DN
Fellow-in-Training, AAMT Fellowship in Orthopaedic Manual Physical Therapy
CEO, Mobility Fit Physical Therapy, Cincinnati, OH
OSTEOPRACTIC 