The debate over whether physiotherapists in India can use the ‘Dr.’ prefix has once again come into the spotlight, sparking heated discussions across the medical and allied healthcare communities. The issue, which has been lingering for years, intensified after the Directorate General of Health Services (DGHS) issued and then withdrew a controversial directive in September 2025.

The back-and-forth not only reflects the growing identity struggle of physiotherapists in India but also highlights the legal, ethical, and public safety concerns tied to professional titles in healthcare.

The Initial Directive: DGHS Bars Physiotherapists from Using ‘Dr’

On September 9, 2025, DGHS Director Dr. Sunita Sharma issued a letter to the Indian Medical Association (IMA) president, Dr. Dilip Bhanushali, clarifying that physiotherapists are not entitled to use the prefix ‘Dr.’

According to Dr. Sharma, physiotherapists are not trained as medical doctors, and using the title risks misleading patients and the general public, potentially leading to quackery.

The letter cited multiple legal precedents:

• Patna High Court and Madras High Court rulings,

• Advisory orders by the Tamil Nadu Medical Council (2016),

• And a 2020 Bengaluru Court ruling,

all of which held that unless physiotherapists are enrolled in the State Medical Register, they cannot use ‘Dr.’ or practice modern medicine.

Furthermore, the directive referenced the Indian Medical Degrees Act of 1916, which explicitly prohibits the use of the ‘Dr.’ prefix without a recognized medical qualification. Violation of this law can attract penalties under Section 7 for contravention of Section 6 and 6A.

Objections from the Medical Fraternity

The IMA, along with the Indian Association of Physical Medicine and Rehabilitation (IAPMR), strongly opposed the National Commission for Allied and Healthcare Professions (NCAHP) decision earlier in April 2025 that had recommended physiotherapists be allowed to use the prefix ‘Dr.’ and suffix ‘PT’.

Key objections included:

• Risk of Misdiagnosis: Physiotherapists are not trained to diagnose medical conditions, some of which may worsen with inappropriate physiotherapy interventions.

• Prescriptive Authority Concerns: There is a fear that physiotherapists might begin prescribing medications, despite not being qualified medical professionals.

• Public Misleading: The use of ‘Dr.’ could mislead patients into assuming physiotherapists are medical doctors, blurring lines between paramedical and medical practice.

IMA President Dr. Bhanushali warned that such ambiguity could encourage unqualified practice, ultimately endangering patient safety.

NCAHP’s Recommendation and Physiotherapy Curriculum 2025

The controversy stems from the Competency-Based Curriculum for Physiotherapy (2025) released on April 23, 2025 by the NCAHP, under the Union Ministry of Health and Family Welfare.

The curriculum recommended that physiotherapists could adopt the title “Dr.” as a prefix and “PT” as a suffix, in recognition of their academic qualifications and professional standing.

This move, however, was seen by medical associations as an overreach, contradicting the 2007 Paramedical and Physiotherapy Central Council Bill Ethics Committee decision, which explicitly restricted the title ‘Doctor’ to practitioners of: Modern Medicine, Ayurveda, Homoeopathy, Unani and excluded nursing, physiotherapy, and paramedical professionals.

A Sudden Withdrawal: DGHS Changes Stance Within 24 Hours

In a surprising turn, on September 10, 2025, just one day after issuing the ban, the DGHS withdrew its own directive.

In a communication addressed to the NCAHP Chairperson, APMR Secretary at AIIMS Nagpur, and the IMA President, DGHS clarified that the matter “requires further examination and deliberations.”

This withdrawal has left the healthcare community divided and confused. Was the withdrawal driven by political pressure, representations from physiotherapy associations, or a recognition of the growing importance of physiotherapy in India’s healthcare system? The government has not clarified.

Legal and Ethical Context

The legal framework around professional titles in healthcare remains clear:

• Only registered medical practitioners of recognized systems of medicine can use the ‘Dr.’ prefix.

• Physiotherapists, while highly skilled in rehabilitation and mobility sciences, are categorized as allied health professionals, not physicians.

However, the ethical debate is more nuanced. Physiotherapists undergo extensive academic training, often completing postgraduate and even doctoral-level studies (PhD). Many argue that the denial of the ‘Dr.’ prefix undermines their academic credibility, even if they don’t practice medicine in the conventional sense.

Recognition of Physiotherapists’ Contributions

Amid the debate, physiotherapists continue to play a crucial role in non-drug-based treatments for mobility, pain management, and rehabilitation.

On World Physiotherapy Day (September 8, 2025), Prime Minister Narendra Modi publicly acknowledged their contributions:

“World Physiotherapy Day is an occasion to appreciate the efforts of all those associated with the practice of physiotherapy. It is commendable how they contribute to the wellbeing of people, especially the elderly, by ensuring mobility, dignity and a better quality of life.”

This recognition underscores the essential role physiotherapists play, particularly in elderly care, post-surgical rehabilitation, and sports medicine.

Striking a Balance Between Recognition and Clarity

This debate is less about professional ego and more about clarity for patients. The title ‘Dr.’ carries immense weight in India, where the public largely associates it with medical doctors who prescribe medicine and diagnose illnesses. Allowing physiotherapists to use the prefix without adequate public awareness could indeed create confusion and even open doors to quackery.

However, physiotherapists deserve greater professional recognition for their academic rigor and their indispensable role in healthcare. Perhaps the solution lies in creating a distinct, respected title—such as “Physio Dr.” or a standardized designation like “PT”—that distinguishes them from medical doctors while still honoring their expertise.

This would safeguard public trust while avoiding the marginalization of physiotherapy as a profession.

Final Thoughts

The DGHS’s contradictory directives in September 2025 have reignited a long-standing debate over whether physiotherapists should be allowed to use the ‘Dr.’ prefix. While medical associations stress patient safety and legal clarity, physiotherapists seek recognition for their academic and professional contributions.

As the matter undergoes “further examination,” one thing remains certain: India urgently needs a clear, consistent, and inclusive policy that respects the unique roles of different healthcare professionals while protecting patients from misleading titles and practices.

The outcome of this debate will likely shape not just the identity of physiotherapists in India, but also the broader conversation around how allied healthcare professions are valued in the country.

With inputs from agencies

Image Source: Multiple agencies

© Copyright 2025. All Rights Reserved. Powered by Vygr Media.