Assistants, aides, and the importance of certification

We have been advertising for physical therapist assistants recently, and I have been a little shocked at the high volume of calls we received from non-licensed people who believe they are qualified for the position. It is quite common to hear callers state "Well I worked as a physical therapist assistant and am not licensed but I am qualified for your position." I have never received similar calls when we advertise for occupational therapist assistants.

New York State regulations that govern PT practice on this issue are quite clear. They state:

  • New York State law restricts the practice of physical therapy to licensed physical therapists or certified physical therapist assistants. Individuals who are not licensed or certified may not provide physical therapy services. Aides may perform non-patient related activities such as secretarial, clerical and housekeeping tasks. Additionally, aides may act as an extra set of hands for the physical therapist or physical therapist assistant who is actually providing the treatment.
The occupational therapy regulations are quite similar and we don't get confusion about OTAs - so why is there such confusion from PTA candidates who believe that they are qualified and report that they have job experience as assistants?

My working assumption is that so many people calling for the job are not lying - and they must have been used in illegal capacities in previous jobs. That is concerning for the PT profession.

I went to the Bureau of Labor Statistics site to do a little research on this issue and found contributing confusion. BOTH the pages for OT Assistants and PT Assistants are entitled "XXX Assistant and Aides." I was a little shocked at some of the salary and work site data that was listed for 'aides' and it makes me wonder. Either people confuse the terms 'aides' and 'assistants' when they are reporting their job titles, or there are an awful lot of unlicensed people doing the jobs of assistants and making a pretty reasonable salary. That is unfortunate for the true assistants who are licensed.

So what is the truth - as it is not discernible in the statistics??? Is there a lot of illegal use of aides to do assistant work? Do regulatory bodies care about the confusion and are they 'looking the other way' and allowing non-licensed people to do work that was previously protected for licensed professionals? And as there is no similar confusion at the occupational therapist and physical therapist levels is this a sign that the public does not believe that the assistant level is important to certify or regulate?

I believe that as long as we have educational programs, certifications, and laws that we should follow them. But if there is a latent disinterest in upholding the laws - isn't it appropriate to throw this issue on the table for discussion?


Cheryl said…
I think that there used to be a certificate program or some such thing that entitled a person to be a PTA as we have people who don't have an associate's degree but were grandfathered in under the old regulation. They are now licensed, however. Some places also do use their aides more like assistants (illegally)... I think a name change would be helpful for everyone involved.
Anonymous said…
Hi, I am a COTA in a sub-acute hospital rehab. No tech performs what can be called OT treatment at my facility, we are very careful about that. However the same can not be said for the PT techs.
They go in rooms alone and perform ROM, place splints, do edge of bed exercises, standing, etc. In the gym they ambulate patients, help them in the parallel bars and range them on the mats. I have seen them place hot packs or ice packs which is a thermal modality only a licensed professional is allowed to do. Every once in a while, this becomes a touchy area, and it stops. But, it always starts again. No wonder some feel they are PTA's.
Chuck said…
One of the problems is that SNF Part A Medicare rules allow minutes of therapy provided by aides to be counted on the MDS. Another problem is that the use of aides in other part A settings is not addressed so it is unclear how aides are being used. Of course state laws address the use of aides (aka unlicensed personnel) but it is not clear if licensure boards are looking at those issues if there are no complaints. Finally, many state licensure laws specifically exempt aides from the licensure requirements so the Boards don't have jurisdiction over the aides themselves but rather can go after the supervision therapist or assistant.

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