{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/physical-therapists/",
  "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 Therapists",
    "soc_code": "29-1123",
    "category": "Healthcare",
    "us_employment": 267330,
    "median_annual_wage": 102760
  },
  "verdict": "SAFE",
  "risk_resistance": 86,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 19,
    "liability_shield": 17,
    "trust_premium": 17,
    "judgment_accountability": 18
  },
  "reasoning": {
    "task_resistance": "Manual therapy, joint mobilization, and gait retraining can't be delegated to software — the parts that can (documentation, HEP handouts, initial outcome-measure scoring, prior-auth letters) are maybe a fifth of the workday, which is why this sits at 15 rather than 18: the eval interview, goal-setting, and progress-note reasoning are increasingly template-and-LLM assisted even though the treatment itself isn't.",
    "embodiment": "You are physically under a 200-pound patient during a sit-to-stand transfer, feeling for end-feel at a stiff shoulder capsule, and catching someone whose knee buckles on a ramp — 19 rather than 20 only because a slice of practice (telehealth follow-ups, wound-care consult review, some pediatric parent coaching) happens without your hands on anyone.",
    "liability_shield": "Every state licenses PTs under a practice act, you carry your own NPI and malpractice policy, and in direct-access states there is no physician co-signature between you and a missed red flag — the plan of care has your license number on it, which is why this is 17 and not the 12 of a role where a supervising MD absorbs the exposure.",
    "trust_premium": "A 12-visit episode for a rotator cuff repair means the patient sees you two or three times a week for six weeks and tells you about their pain, their fear of re-tearing, and whether they actually did the exercises — adherence is the treatment effect, and it comes from that relationship, held just short of 20 because staffing models rotate patients across PTs and techs and patients still come back.",
    "judgment_accountability": "You decide when a post-op knee is ready to progress load, when a new-onset unilateral calf pain means stop and send to the ED for DVT, and when to discharge against a payer's remaining visits — those are consequential calls made in the room with incomplete information, which is 18 rather than 14 because a wrong one causes immediate physical harm."
  },
  "rationale": "The core of the job is hands-on: palpating tissue, guiding a post-surgical knee through range of motion, spotting a stroke patient's gait deviation in real time, and adjusting load mid-session based on how the body responds. AI can draft the SOAP note, pick exercise templates, flag insurance-authorization language, and triage outcome data — all real time savings, none of it the treatment. State licensure plus personal accountability for patient safety during mobilization means a licensed human signs the plan of care and takes the fall if a patient falls.",
  "outlook": "Demand grows with an aging population while AI absorbs documentation and exercise-prescription drudgery; the main pressure comes from payers pushing volume onto assistants and app-based home programs, not from AI replacing the clinician.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "Medicare's therapy supervision rules tightening rather than loosening — e.g. CMS reversing the 2022 PTA general-supervision allowance or the de minimis modifier policy, so that billable therapy minutes require direct on-site licensed PT presence rather than assistant delivery with remote oversight. Equally, state practice acts adding explicit language that AI-generated exercise prescriptions or telehealth home-program plans require a named licensed PT of record who retains personal liability for adverse events (falls, post-op dehiscence).",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "If direct-access referral authority keeps expanding (all 50 states now have some form; the fight is over imaging referral and unrestricted evaluation), the PT becomes the first-contact differential diagnostician who must rule out red flags — cauda equina, DVT, fracture, cardiac referral pain — without a physician gate. That shifts consequential ambiguity onto the PT rather than the referring MD.",
        "plausibility": "already happening",
        "would_add": 1
      },
      {
        "dimension": "task_resistance",
        "change": "Documentation, prior-auth narrative, HEP handout generation and outcome-measure scoring are the routine tier and are being absorbed first (Netsmart/WebPT ambient scribe products). If that tier is stripped out, the residual day is palpation, manual therapy, real-time load titration and gait retraining — the part with no software substitute. Score rises because the denominator shrinks, not because AI got worse.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "Growth of cash-pay/out-of-network manual therapy and performance clinics where the buyer is explicitly paying for one-on-one hands-on time with a named clinician rather than insurance-reimbursed group treatment — visible in the cash-based PT segment and in the backlash against high-volume 3-patients-per-hour clinics. Also observable if payers begin covering app-delivered exercise (Hinge Health, Sword) as the default and hands-on care becomes the premium tier patients top up for.",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "At 86 the headroom is arithmetic more than substantive — embodiment at 19 and judgment at 18 are effectively maxed. The realistic risk here is not displacement of the licensed PT but volume compression: digital MSK programs substituting for the low-acuity caseload that currently supports clinic economics, shrinking the number of PT jobs while leaving each remaining job more resistant. A rising resistance score and a falling headcount are compatible."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 225420,
        "wage": 86850
      },
      {
        "y": 2018,
        "emp": 228600,
        "wage": 87930
      },
      {
        "y": 2019,
        "emp": 233350,
        "wage": 89440
      },
      {
        "y": 2020,
        "emp": 220870,
        "wage": 91010
      },
      {
        "y": 2021,
        "emp": 225350,
        "wage": 95620
      },
      {
        "y": 2022,
        "emp": 229740,
        "wage": 97720
      },
      {
        "y": 2023,
        "emp": 240820,
        "wage": 99710
      },
      {
        "y": 2024,
        "emp": 248630,
        "wage": 101020
      },
      {
        "y": 2025,
        "emp": 267330,
        "wage": 102760
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 18.6,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}