The thing patients are least often told
Who actually treats you
New York draws hard lines between a physical therapist, a physical therapist assistant and an unlicensed aide. Most patients have never heard the lines exist, let alone which side of one they were on last week.
Only a licensed therapist may evaluate you or change your plan. A licensed physical therapist evaluates you, writes your programme and changes it. A physical therapist assistant may carry out that programme under on-site supervision but is barred by law from evaluating you, interpreting anything or altering the plan. A physical therapy aide is unlicensed and may not provide physical therapy at all — an aide books appointments and cleans equipment. If you have ever been handed to somebody in a polo shirt who counted your repetitions while the therapist worked in another room, you have seen the thing this rule exists to stop.
There are three kinds of person you might meet on a physical therapy gym floor, and the law treats them very differently. A physical therapist holds a licence, evaluates you, and is the only one of the three who may write or alter your plan of care. A physical therapist assistant also holds a licence and may carry out that plan under on-site supervision, but is barred by section 6738(a) of the Education Law from evaluating, testing, interpreting, or planning or modifying your programme. A physical therapy aide holds no licence at all and may not provide physical therapy services.
None of that is obscure. It is also invisible from a waiting room, because all three are likely to be wearing the same polo shirt, and because nobody introduces themselves by their licence status.
What each is allowed to do
The physical therapist: everything. Evaluation, diagnosis within the physical therapy scope, the plan of care, every change to it, reassessment, and discharge. If your programme is different this week from last week, a physical therapist made that decision.
The physical therapist assistant: delivery of the plan, under on-site supervision, meaning the supervising therapist is physically present in the facility and readily available. Not evaluation, not interpretation, not progression. One therapist may supervise no more than four assistants, which is a ratio worth remembering when a gym floor looks busier than that arithmetic allows.
The aide: clerical and non-patient work. Booking, cleaning equipment, laundering towels, setting up a room. An unlicensed person may not provide physical therapy, and being shown an exercise by somebody who is counting your repetitions from a printed sheet is not an efficiency, it is the thing the rule exists to prevent.
Why it matters clinically rather than merely legally
The value of the hour is in the noticing. Whether your knee is tracking differently on the ninth repetition than the first, whether you have started guarding the shoulder again, whether the compensation you had stopped doing has crept back — those are the observations that change the programme, and they require somebody qualified to change it.
A well-run assistant model is genuinely fine, and we are not going to pretend otherwise. What is not fine is the arrangement where the licensed therapist evaluates you for eight minutes, disappears into another room, and the hour you are billed for is spent with somebody who is not permitted to adjust a single thing about what you are doing.
How this practice is arranged
Five licensed physical therapists, five treatment rooms, and sixty-minute appointments. You see the same named clinician every visit, and if that person is away you are told before you arrive rather than reassigned on the day and informed at the desk.
We employ no physical therapist assistants at present. That is a size decision rather than a principle — a larger practice with a proper supervision structure can use assistants well — and if it changes, this page changes with it and says who is who.
Our front desk is staffed by people who book appointments and answer telephones, and who do not treat anybody. That is the whole of the aide role and it is a perfectly good job; it is simply not physical therapy.
What to ask, at any clinic
“Are you a licensed physical therapist?” It is not rude and the answer is a matter of public record. New York licences are checkable on the Office of the Professions register by name.
“Who decides what I do each week?” If the answer is anybody other than a licensed physical therapist, something is wrong.
“Will I see the same person each visit?” Continuity is not a luxury in rehabilitation. The person who measured you at visit one is the person best placed to notice what has changed by visit six.
In order
How this works in practice
You book with a named clinician
Not with the practice. The booking page shows five diaries because there are five therapists with five rooms.
That clinician evaluates you
Sixty minutes, one to one. The plan of care is written by the person who examined you.
The same clinician treats you each visit
Continuity is the mechanism, not a courtesy. Small changes are only visible to somebody who saw the previous version.
Only that clinician changes the plan
By law and in practice. If your programme is different this week, a licensed physical therapist decided it should be.
If they are away, you are told beforehand
With the option to move the appointment rather than see somebody who has not met you.
Questions we are actually asked
Who actually treats you — frequently asked
Will I see the same therapist every visit?
Yes. You book with a named clinician who has their own room and their own diary, and that is who you see. If they are unexpectedly away we telephone you rather than reassigning you at the desk, and you can move the appointment instead.
What is the difference between a physical therapist and a physical therapist assistant?
Both are licensed in New York. Only the physical therapist may evaluate you, interpret findings, and write or change your plan of care — section 6738(a) of the Education Law specifically bars an assistant from all four. An assistant may carry out an existing plan under on-site supervision, and one therapist may supervise no more than four assistants.
Can a physical therapy aide treat me?
No. An aide is unlicensed and may not provide physical therapy services at all. Aides do clerical and non-patient work — booking, cleaning, setting up. If somebody unlicensed is running you through exercises, that is not a shortcut, it is a breach of the rule that exists to protect you.
Do you use assistants here?
Not at present. Five licensed physical therapists, five rooms, sixty-minute one-to-one appointments. That is a decision about the size of this practice rather than a criticism of the assistant model, which works well where the supervision is real. If it changes, this page will say so.
How can I check somebody's licence?
The New York State Education Department's Office of the Professions maintains a public register you can search by name. It is the same register on which our own licence number would appear — the one printed as zeroes throughout this site, because this is a demonstration practice and a real number belongs to a real person.
Read next
Related reading
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.