What the DGHS said—and why it matters
A letter went out in the morning. By afternoon, it was pulled back. On September 9, 2025, the Directorate General of Health Services (DGHS) told medical associations that physiotherapists cannot use the 'Dr' prefix because they are not trained as medical doctors. The note, signed by DGHS Director Dr. Sunita Sharma and addressed to Indian Medical Association (IMA) National President Dr. Dilip Bhanushali, cited existing laws and court orders. Hours later, the DGHS withdrew the directive, saying the issue needs more examination.
At the center of the dispute is something more than a title. Medical bodies such as the IMA and the Indian Association of Physical Medicine and Rehabilitation (IAPMR) had objected to the use of 'Dr' by physiotherapists, warning it could mislead patients into thinking they are consulting a physician. They pointed to the risk of scope creep—prescribing medicines or making primary diagnoses without the training or license to do so.
The DGHS letter leaned on the Indian Medical Degrees Act, 1916, and referenced court decisions from Patna and Madras High Courts and Bengaluru courts, along with directives from the Tamil Nadu Medical Council. The common thread in these rulings: unless a practitioner is registered to practice modern medicine, they cannot claim the privileges associated with it—or use designations that might confuse patients.
There was also a curricular twist. The National Commission for Allied and Healthcare Professions (NCAHP) had, in April 2025, approved a physiotherapy curriculum that allowed the 'Dr' prefix. The DGHS letter asked that this be stripped from the "Competency Based Curriculum for Physiotherapy – Approved Syllabus 2025" and suggested a more suitable title for physiotherapy graduates and postgraduates. That instruction is now in limbo after the withdrawal.
For now, the government’s position is simple: the matter is under review. But the tension is real—between professional identity, public safety, and the fine print of India’s health laws.
The law, the syllabus, and the grey areas
Here’s the legal backdrop. The Indian Medical Degrees Act, 1916, regulates how medical titles and qualifications are granted and displayed. The larger medical licensing regime now runs under the National Medical Commission framework. Allied health professions, including physiotherapy, are overseen by the NCAHP. These regimes don’t always speak in one voice, and that’s where friction begins.
In practice, Indian courts have taken a patient-first view on titles. If a designation or signboard can mislead someone into believing a practitioner is a physician, it’s a problem. That’s why medical councils have routinely warned against any usage that blurs lines—whether it’s allopathy, homeopathy, or allied health.
Physiotherapists train for rehabilitation, mobility, and musculoskeletal care. In India, they typically earn BPT and MPT degrees, and some pursue PhDs. Those with research doctorates can use 'Dr' as an academic title in general settings, but the trouble starts inside clinics where patients may assume 'Dr' means physician. The debate today is less about academic freedom and more about clinical clarity.
The NCAHP’s April 2025 move to allow the prefix in the physiotherapy curriculum was meant to recognize advanced training and professional standing. But medical associations argue that a title cannot outrun the license. Their concerns are concrete: signboards, prescriptions, and consent forms. If a patient walks into a clinic, sees 'Dr', and assumes physician-level training, the communication has failed—even if the practitioner never intended to mislead.
The DGHS letter also flagged the suffix 'PT'. On its own, 'PT' is meant to indicate the profession—physiotherapy. Combined with 'Dr', it can confuse people unfamiliar with the system. That’s the heart of the current pushback: not an attack on physiotherapy itself, but on any marker that could blur roles at the point of care.
There’s also a global context. In some countries, physical therapists complete a Doctor of Physical Therapy (DPT) program and use the title with clear disclosures that they are not physicians. India doesn’t run DPT as the norm. So importing a title without the same training framework—and without strict signage rules—invites disputes. This is why regulators are cautious.
Medical groups have pressed two practical limits: no prescribing rights for physiotherapists and no primary care practice. They say physiotherapy should be referral-based, especially for complex or undiagnosed conditions. Physiotherapists, on the other hand, often argue that direct access speeds recovery for routine musculoskeletal issues, reduces hospital load, and reflects global practice trends. Both sides are responding to real-world problems—patient safety on one hand, timely care on the other.
Colleges and hospitals are caught in the middle. If the curriculum carries a title that regulators won’t accept, admission brochures, ID cards, and HR policies become a mess. New graduates don’t know what to print on their signboards. Patients face mixed signals.
So what happens next? A few likely steps:
- A formal review that brings DGHS, NCAHP, and medical councils to the same table.
- Clear do’s and don’ts for titles on signboards, prescriptions, and digital profiles.
- Scope-of-practice reaffirmations: what physiotherapists can do independently and what needs a referral.
- Curriculum edits, if needed, to align training with whatever title policy emerges.
If regulators want a middle path, they might consider strict disclosure rules: allow certain professional titles only when followed by the exact qualification and a visible descriptor like "Physiotherapist (Non-Physician)." Another pathway is to reserve 'Dr' for physicians in clinical settings while keeping academic usage for PhD holders in non-clinical contexts. None of this is simple to enforce, but it’s clearer for patients.
The immediate takeaway is that the DGHS’s hard stop has turned into a pause. The directive that said no to the physiotherapists Dr prefix has been withdrawn for now, but the concerns it raised aren’t going away. Expect a tighter rulebook, sharper signboards, and fewer grey zones. Until then, the title remains under review, and the system waits for a single, unambiguous line.