‘, - 

TRE~ATTORNEYGENERAIOF TEXAS 

AWeTIN. Tlss4el 787ll 

JOEN I.. EILL 

*-- a-Am. 

August 12, 1974 

The Honorable James D. ,Keister 

Chairman 

Texas State Board of Physical 

Therapy Examiners 

3010 Brentwood 

Amarillo, Texas 79106 

Opinion No. H- 368 

Re: Whether “direct supervision” as used in 0 6 of 

Article 4512e. V. T. C. S., 

requires physical presence 

of supervising physician to 

exempt therapist from 

requirement of license. 

Dear Chairman Keister: 

You have asked us whether “direct supervision” as used in 5 6 of 

Article 4512e, V. T. C. S. (Acts 1971, 62nd Leg., ch. 836, p. 2542) requires 

the physical presence of a supervising physician in order to effect an exemption from its provisions for employees performing physical therapy 

services in a licensed hospital. 

Article 4512e creates the Board of Physical Therapy Examiners, 

providea for the licensing of physical therapists and regulationof the 

practice of physical ,therapy. By the express provision of §‘6 thereof, 

the Act does not apply to certain persons, including “an employee performing services under the direct supervision of a physician in a hospital 

licensed under [Article 4437f, V. T. C. S., the Texas Hospital Licensing 

Law]. ” 

Unlike a “physical therapist” [Set 1 (b)] or a “physical tberapist 

assistant” [Sec. 1, (c)l, a physical therapy aide need not be licensed [Sec. 

7] or even have an understanding of “physical therapy. I’ 

We are of the opinion that the term “direct supervision” as used 

p. 1720 
The Honorable James D. Keister page 2 (H-368) 

in Sec. 6 of this statute means “on-site’superviaion” similar to that 

required in Sec. 1 (d) when applied to persons having qualifications 

equivalent to those of a physical therapy aide. However, when applied 

to persons having qualifications equivalent to those of a physical therapist 

asistant, it meana only that the physician assumes responaibility for the 

care of the patient and the continuing direction and supervision of the 

hospital employee to whom selective forms of treatment are delegated, 

similar tom the continuing supervision and direction indicated in Sec. l(a). 

Attorney General Opinion C-795 (1966). 

We do not believe, therefore, that even “on-site” supervision 

necessarily requires the continuous and con’stant physical presence of the 

physician during the entire therapy process. If for each occasion the 

responsible physiciarrpersonally trains and instructs the hospital employee 

in the process~ to ‘be employed and remains reasonably available to inspect, 

correct, and direct the work of the employee, we think the provision will 

be satisfied though the physician may not be physically present duiing the 

entire time the services .are being administered. Bizselle v. State, 116 

S. W. 2d 385 (Tex. Crim. 1938); cf. Att~orney General Opinion H-27 (1973). 

SUMMARY 

As used in § 6 of Article 4512e, V. T. C. S., an Act 

regulating the practice of physical therapy, the term 

“direct supervision” while not requiring the continuous 

and constant physical presence of a physician during 

the entire therapy process, does conte~mplate that the 

physician undertake an active and continuing overview 

of therapeutic activities to see that his supervision 

control is in fact being implemented. 

Very truly yours, 

/-I 

Attorney General of Texas 

p. 1721 
-. . 

The Honorable James D. Keistex page 3 (H-368) 

A PRRqVED: 

DAVID M. KENDALL, Chairman 

Opinion Committee 

p. 1722