A multifaceted survey was conducted to identify the factors that academic occupational therapy (OT) programs were considering in making decisions as to whether the entry-level clinical doctorate (OTD) is a viable alternative for their institutions. The survey was sent in the summer of 2004 to program directors of all (150) occupational therapy programs in the United States. Responses were received from 111 programs (response rate of 74%). Quantitative (demographic) and qualitative (factor identification) data were compiled and analyzed. Supporting factors for the development of entry-level OTD programs included (a) coexistence of physical therapy doctorate program, (b) enhanced preparation of graduates, and (c) improved student recruitment. Impeding factors included (a) limited resources, (b) philosophical objections, and (c) lack of demand. In addition, results suggested that overall there is greater support for the OTD as a postprofessional degree. The study provided a historical record of current decision making in occupational therapy academic programs. In addition, the results of the study suggest a need for the development of national consensus regarding the place of the OTD in occupational therapy education.