{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/physical-therapist-aides/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Physical Therapist Aides", "soc_code": "31-2022", "category": "Healthcare Support", "us_employment": 48150, "median_annual_wage": 35240 }, "verdict": "EXPOSED", "risk_resistance": 48, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 16, "embodiment": 18, "liability_shield": 2, "trust_premium": 8, "judgment_accountability": 4 }, "reasoning": { "task_resistance": "At 16 rather than 19, because guarding a patient during parallel-bar gait training, wrapping hot packs, and transferring someone from wheelchair to mat table cannot be done remotely — but the front-desk block of your shift (booking follow-ups, chasing authorizations, typing the PT's dictated notes into the EMR) is genuinely automatable, which is what keeps this off the ceiling.", "embodiment": "18 reflects that nearly every duty happens with hands on equipment or on a person in a room that changes hour to hour — spotting an unsteady total-knee patient, dragging ultrasound units and gait belts between bays, mopping up after whirlpool — and the only reason it isn't 20 is that the clinic floor is a controlled indoor space, not a roof or a roadside.", "liability_shield": "2 because no state licenses PT aides — you work under the PT's or PTA's direct supervision, your interventions are not separately billable under Medicare Part B, and if a patient falls during a transfer the claim lands on the supervising therapist and the clinic, not on a credential you hold.", "trust_premium": "8 because patients on a 12-visit plan of care see you more than anyone and will ask for the aide who sets the traction right and remembers their shoulder, but they were referred to the practice and the therapist, and when you leave the plan of care continues with whoever is on the floor that day.", "judgment_accountability": "4 because the PT's plan of care specifies the exercise, the reps, and the modality settings; your calls are narrow ones — pausing when a patient reports pain and reporting it up the chain — and you are not permitted to modify a program, progress a patient, or interpret a response as a clinical finding." }, "rationale": "The work is overwhelmingly physical and in-person: setting up hydrotherapy and traction equipment, cleaning treatment areas, helping patients on and off tables, walking them between exercise stations, launder and stock. Almost none of that is text or screen work AI can touch, and no robot handles an unsteady post-surgical patient in a busy clinic. The exposure is on the other side: aides are unlicensed, make no clinical calls, and their clerical share — scheduling, insurance paperwork, note transcription for the PT — is exactly what AI absorbs first, which trims hours rather than eliminating the role.", "outlook": "The hands-on core is durable and demand grows with an aging population, but the clerical half of the job gets automated away and employers increasingly hire licensed PTAs instead of aides — expect flat pay and pressure to credential up.", "what_would_raise_it": { "levers": [ { "dimension": "task_resistance", "change": "The clerical tier (scheduling, prior-auth forms, transcribing the PT's note) is the part AI absorbs; if clinics fully hand that to ambient documentation tools like Nuance DAX or Heidi, the remaining defined job is entirely hands-on patient transfer, gait assistance, equipment setup and turnover — a task mix with almost no automatable residue. This raises the score while reducing total hours per aide.", "plausibility": "already happening", "would_add": 2 }, { "dimension": "liability_shield", "change": "State practice acts that convert 'aide' from unregulated helper into a registered/credentialed support role with a defined scope and mandatory line-of-sight supervision — the model already in Texas, Louisiana and several other boards' rules on unlicensed personnel. If more boards adopt registration plus a named supervising PT whose license is on the line for delegated tasks, the role acquires a thin but real regulatory anchor that prevents substitution by untrained or unstaffed labor.", "plausibility": "plausible", "would_add": 4 }, { "dimension": "liability_shield", "change": "Insurer or CMS conditions of participation requiring a documented trained human present for patient transfers and ambulation in outpatient PT settings — analogous to safe-patient-handling mandates already legislated in states like California (AB 1136) and Washington for hospitals. If extended to outpatient rehab, staffing a trained aide becomes an audited requirement rather than a cost choice.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "Explicit board or employer scope language making the aide responsible for recognizing and escalating red flags during exercise (syncope, chest pain, fall risk change) rather than merely executing, paired with required competency sign-off. This exists informally; codifying it in written delegation protocols makes the escalation call an owned consequential judgment.", "plausibility": "plausible", "would_add": 3 } ], "ceiling_note": "Even with every lever, this caps in the low-to-mid 60s. Embodiment is already near maximum and cannot rise. Trust premium has no realistic route: patients pay for the licensed PT's name on the plan of care and rarely know an aide from an assistant, so there is no buyer willing to pay a premium specifically for a human aide. The core vulnerability is not machine capability but that the role is cheap, unlicensed, and hour-trimmable — automation of the clerical share cuts hours per aide even as the physical work stays untouched." }, "adjudication": null, "employment_history": { "points": [ { "y": 2017, "emp": 49290, "wage": 25730 }, { "y": 2018, "emp": 47260, "wage": 26240 }, { "y": 2019, "emp": 49270, "wage": 27000 }, { "y": 2020, "emp": 45790, "wage": 28450 }, { "y": 2021, "emp": 42390, "wage": 29200 }, { "y": 2022, "emp": 42800, "wage": 31410 }, { "y": 2023, "emp": 42390, "wage": 33520 }, { "y": 2024, "emp": 44010, "wage": 34520 }, { "y": 2025, "emp": 48150, "wage": 35240 } ], "from": 2017, "to": 2025, "change_pct": -2.3, "comparable_from": 2019, "spans_soc_revision": true }, "pivots": [ { "slug": "lifeguards-ski-patrol-and-other-recreational-protective-service-workers", "title": "Lifeguards, Ski Patrol, and Other Recreational Protective Service Workers", "verdict": "SAFE", "risk_resistance": 68, "median_wage": 33580, "overlap": 71, "skills_to_close": [ "Learning Strategies", "Monitoring", "Speaking" ] }, { "slug": "exercise-trainers-and-group-fitness-instructors", "title": "Exercise Trainers and Group Fitness Instructors", "verdict": "EXPOSED", "risk_resistance": 61, "median_wage": 47160, "overlap": 70, "skills_to_close": [ "Instructing", "Speaking", "Equipment Selection", "Learning Strategies" ] }, { "slug": "psychiatric-technicians", "title": "Psychiatric Technicians", "verdict": "SAFE", "risk_resistance": 67, "median_wage": 45130, "overlap": 56, "skills_to_close": [ "Social Perceptiveness", "Speaking", "Coordination", "Monitoring" ] } ], "license": "https://cookedindex.com/terms" }