From booking to discharge
How we work
Six steps, and the fourth one is the one that matters: we reassess against the first visit's measurements at visit four, not at visit ten, so a course that is not working gets changed rather than extended.
You book a slot, or you telephone
Sixty minutes, with a named clinician, at a time on the calendar that is genuinely free — the booking page shows each therapist's own diary rather than a generic grid. You do not need a doctor's referral to start, unless the claim is Workers' Compensation, No-Fault or Medicare, in which case you do from the first visit. If you are not sure which of those you are, telephone and we will work it out with you before you book.
The first visit is mostly questions
What you cannot do, when it started, what makes it worse, what you have already tried and what happened. Then an examination aimed at reproducing your problem rather than at cataloguing your body. You will leave the first appointment knowing what we think it is, what we think the course looks like, and what would make us change our mind.
You get a number of visits, at the start
An estimate, in writing, of how many appointments this should take and what it means if it has not moved by then. Every condition page on this site publishes that range too, before you contact anybody. An estimate can be wrong and we will tell you when ours is; what it cannot be is absent, because an open -ended course is how a plan of care becomes a subscription.
Most of the work happens when you are not here
Three or four exercises, written down, with the sets, the load and the days. This is the part that actually changes tissue, and clinic time exists to make it possible and to check it is being done correctly. A programme of eleven exercises is a programme nobody completes, which is why you will not be given one.
We reassess at visit four, not at visit ten
The same measurements taken at the first visit, repeated. If they have moved, we carry on and progress the load. If they have not, we change the plan or we send you back to a physician — and we say which, plainly, rather than booking another block and hoping. Direct access here also runs out at ten visits or thirty days, so this conversation happens well before the law forces it.
You are discharged, on purpose
With the programme that got you here and the version that keeps you there. We do not schedule maintenance appointments for people who no longer need treatment, and we do not sell blocks of visits in advance — the sentence “you are better, stop coming” has to be free to say.
Why most of the work happens when you are not here
This is the part people find counter-intuitive, and it is the single most useful thing on the page. Tissue adapts to load applied repeatedly over weeks. One supervised hour a week is not enough repetitions to change anything on its own — what the hour does is establish what you should be doing, check that you are doing it correctly, and increase it when you have earned the increase.
Which is why you will be given three or four things rather than eleven. A programme of eleven exercises is a programme nobody completes, and an eleven-item sheet that is done twice is worth less than a three-item one that is done daily. We would rather give you less and have it happen.
And you will be asked at every visit whether you actually did them. Not to catch you out — because a programme that is not being followed needs changing, and the useful question is why. Too long, too painful, too boring, or too unclear are all fixable, and all four are common.
The visit-four reassessment
At the first appointment we write down what you cannot currently do. Not a pain score out of ten — the actual tasks: the socks, the stairs, the shift, the shelf, the distance before it starts. At visit four we measure the same things again.
If they have moved, we carry on and progress the load. If they have not, we change the plan or we send you back to a physician, and we say plainly which. What we do not do is book another block and hope, and the reason for putting the checkpoint at four rather than ten is that four leaves time to do something about the answer.
No referral needed to start — for ten visits or thirty days. New York lets a physical therapist treat you without a doctor's referral for ten visits or thirty days, whichever runs out first, provided the therapist has been licensed at least three years. Every clinician here qualifies. After that limit the law requires a referral from a physician, podiatrist, dentist or nurse practitioner before treatment continues — and we will have raised it with you well before you reach it rather than on the day. Two things people are rarely told: an evaluation on its own does not spend one of the ten, and direct access does not apply to Workers' Compensation, No-Fault or Medicare, all of which need a referral from the first visit.
When to stop and see a physician the same day. Some things are not ours to treat, and the useful skill is recognising them quickly. Unexplained weight loss, night pain that does not change with position, fever with back pain, a sudden change in bladder or bowel control, progressive weakness, a history of cancer with new bone pain, or trauma with a suspected fracture all mean we stop and send you to a physician the same day. We would far rather make that call ten times unnecessarily than miss it once.
Sixty minutes, one to one, with the therapist you chose
Book an appointment
The booking page shows each therapist's own diary rather than a generic grid, so a slot you can see is a slot that is genuinely free. Most people do not need a doctor's referral to start — New York's direct access law runs to ten visits or thirty days — though Workers' Compensation, No-Fault and Medicare each need one from the first visit. If you are not sure which of those you are, telephone and we will work it out before you book.