JIM MATTOX 

Attorney General 

Supreme Court Building 

P. 0. BOX 12546 

Austin, TX, 76711. 2546 

512,4752501 

Telex 9101674-1367 

Telecopier 512/475-0266 

714 Jackson, Suite 700 

Dallas, TX. 75202.4506 

2141742.6944 

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El Paso, TX. 79905-2793 

915/533-3464 

,M), Texas, Suite 700 

Houston, TX. 77002-3111 

7131223-5666 

606 Broadway, Suite 312 

Lubbock, TX. 79401-3479 

606/747-5236 

4309 N. Tenth, Suite 6 

McAllen, TX. 76501-1665 

512/662-4547 

200 Main Plaza. Suite 400 

San Antonio, TX. 76205-2797 

5121226-4191 

An Equal OppOrtUnitYI 

Affirmative Action Employer 

The Attorney General of Texas 

January 15, 1986 

Honorable James S. McGrath 

Criminal District Attorney 

P. 0. Box 2553 

Beaumont, Texas 77704 

Opinion No. JM-421 

Re: Whether a public agency may 

offer physical therapy services 

without employing a licensed 

therapist if such services are 

offered by or under the supervision of a licensed physician 

Dear Mr. McGrath: 

You have ask&l the following question: 

To what extent can a public agency offer 

physica:. therapy services without employing a 

licensed therapist, so long as such services are 

offered through a licensed physician, through 

direct t'reatment or by direction to his nursing 

support staff to give such treatments? 

The physic&t therapy licensing act contains the following 

definition of "phy~~ical therapy": 

'Physicitl. therapy' means the examination, treatment , or instruction of human beings to detect, 

assess, prevent, correct, and alleviate physical 

d1sabW.t.y and pain from injury, disease, disorders, or physical deformities and includes the 

adminisi:ration and evaluation of tests and 

measurements of bodily functions and structures in 

aid of diagnosis or treatment ; the planning, 

adminislxation, evaluation, and modification of 

treatment: and instruction, including the use of 

physica:. measures, activities, and devices for 

preventl.ve and therapeutic purposes on the basis 

of approved test findings and the provision of 

consultirt:ive, educational, and advisory services 

for the purpose of reducing the incidence and 

severity of physical 

Physica! therap; - 

disabilitv and nain. 

shall also include the delegation 

of selegtive forms of treatment to supportive 

personnc?. with assumption of the responsibilities 

p. 1919 
Honorable James S. McGrath -- Page 2 W-421) 

for the care Of the patient and continuing 

direction and supervision of the supportive 

personnel. The ;lse of roentgen rays and radium 

for diagnostic z,nd therapeutic purposes, and the 

use of electrkity for surgical purposes, includlng cauterization, are not authorized under 

the term 'physical therapy' as used herein, and a 

license issued Hereunder shall not authorize the 

diagnosis of dieeisses or the practice of medicine 

as defined by lnr.. (Emphasis added). 

V.T.C.S. art. 4512e. 51(l) I 

The physical therapy 1Lcensing act sets out certain prohibitions 

on the practice of physica:L therapy: 

(a) A persor. may not practice or represent 

himself as able to practice physical therapy, or 

act or represent himself as being a physical 

therapist unless he is licensed under this Act. 

(b) A person may not act or represent himself 

as being a physical therapist assistant unless he 

is licensed undr: this Act. 

Id. 97. - 

The act, and thosla prohibitions, however, do not apply to 

a licensee of another state agency performing 

health-care serr!:ces within the scope of the 

applicable licnlsing act, an occupational 

therapist who confines his practice to occupational therapy, a certified corrective therapist 

who confines hi:; practice to corrective therapy, 

and a speech pz.thologist or an audiologist who 

confines his prsctice to the treatment of communication disorders. . . . 

Id. 56(l). - 

The definition of "practicing medicine" in the Medical Practice 

Act clearly subsumes the p'ractice of "physical therapy." 

(8) 'Practictng medicine.' A person shall be 

considered to be! practicing medicine within this 

Act: 

(A) who shall publicly profess to be a 

physician or sur::eon and shall diagnose, treat, or 

offer to treat any disease or disorder, mental or 

physical, or any physical deformity or injury by 
Ronorable James S. McGrat,h, - Page 3 (m-421) 

any system or method or to effect cures thereof; 

or 

(B) who shz13.1 diagnose, treat, or offer to 

treat any disease or disorder, mental or physical, 

or any physical deformity or injury by any system 

or method and l:c effect cures thereof and charge 

therefor, direct:Ly or indirectly, money or other 

compeasation. 

V.T.C.S. art. 4495b, §1.3:3(8). Thus, a doctor who is licensed to 

practice medicine in Texar; can perform all the functions of a physical 

therapist within the scope: of his medical license. 

Also, a doctor can delegate certain medical acts to 3 qualified 

person: 

(1) a pers~1 licensed to practice medicine 

shall have the authority to delegate to any 

qualified and p:roperly trained person or persons 

acting under the physiciaa's supervision any 

medical act which a reasonable and prudent 

physician would ftnd is within the scope of sound 

medical judgmeat to delegate if, in the opinion of 

the delegating physician, the act can be properly 

and safely performed by the person to whom the 

medical act is dKLegated and the act is performed 

in its customary manner, not in violation of any 

other statute, and the person does not hold 

himself out to the public as being authorized to 

practice mediciar:. The delegating physician shall 

remain responsible for the medical acts of the 

person performing the delegated medical acts. The 

board may determine whether or not an act constitutes the prxtice of medicine, not inconsistent with thi:; Act, aad may determine whether 

any medical act may or may not be properly or 

safely delegated by physicians. . . . 

V.T.C.S. 4495b, 93.06(d)(l). 

The physical therapy licensing act is not applicable to "a 

licensee of another state agency performing health-care services 

within the scope of the z.pplicable licensing act." V.T.C.S. art. 

4512e, 96(l). Although a person acting under the supervision of a 

physician would probably not himself be a "licensee" under the Medical 

Practice Act, we think acts delegated by a licensed physician come 

within the scope of the exxption to the physical therapy licensing 

act. Obviously, the purposl! of the exception for health care workers 

licensed under other acts :.E! to make clear that health care workers 

p. 1921 
Honorable James S. McGrath -. Page 4 (J'M-421) 

who perform acts that come within the definition of "physical therapy" 

are aot violating the law 8:~ long as their acts are authorized by the 

licensing act applicable to them. As long as the requirements of 

article 4495b, section 3.116(d)(l) are met, any person performing 

medical acts under the supervision of a doctor is acting within the 

scope of the Medical Practice Act. Therefore, a person performing 

medical acts that happen to constitute "physical therapy" would not be 

subject to the physical thln:apy licensing act as long as such acts are 

authorized by the Medical I?ractice Act. 

Article 4495b, sectioi 3.06(d)(l), sets out a number of requirements that must be met in order for a doctor to delegate medical acts. 

Consequently, the propriexy of any specific instance of delegation 

would involve fact questions that we cannot answer. 

SUMMARY 

A doctor may perform medical acts that come 

within the defia:Ltion of "physical therapy" in 

article 4512e. section L(1). If the requirements 

of article 4495(>'), section 3.06(d)(l) are met, a 

person who is abt a licensed physical therapist 

but who is acting under a doctor's supervision may 

perform medical wts that come within the definition of "physical therapy" in article 4512e, 

section l(L). 

Very truly your , J A b 

JIM MATTOX 

Attorney General of Texas 

JACK HIGHTOWBR 

First Assistant Attorney Ga!neral 

MARY KELLER 

Executive Assistant Attornl!y General 

ROBERT GRAY 

Special Assistant Attorney General 

RICK GILPIN 

Chairman, Opinion Committea! 

Prepared by Sarah Woelk 

Assistant Attorney General 

p. 1922