Pending License, Protected Title, and PTA Supervision
Dr. Elena Marsh earned her DPT in 2021 and has held an active Massachusetts physical therapist license for three years. She relocated to Nashua and submitted a New Hampshire license application 10 days ago; the Board's online verification still shows 'pending' and no license number has been issued. Her new employer, an outpatient orthopedic clinic, has 12 patients scheduled for her next Monday. The clinic director tells her to begin treatment under 'pending license' status, to supervise a PTA with two years' experience, and to use 'Dr. Marsh, PT' on the clinic website and on a telehealth platform that will serve two patients located in New Hampshire. Dr. Marsh has completed no New Hampshire jurisprudence or ethics continuing education, and her Massachusetts license is current with no discipline. The clinic's marketing consultant asks whether the DPT title alone permits her to describe herself as a physical therapist in New Hampshire.
1. May Dr. Marsh examine and treat patients in New Hampshire before her license is issued?
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No. New Hampshire requires an active license to practice physical therapy; a pending application is not a license. Unless the Board has issued a temporary permit or license, Dr. Marsh may not examine, evaluate, treat, supervise a PTA, or provide telehealth to patients physically located in New Hampshire. The DPT degree does not confer practice authority, and 'PT' and 'physical therapist' are protected titles. She may complete non-clinical onboarding, orientation, and training that does not involve patient care. The clinic should not schedule her. She should verify her application status with the Board and ask whether any temporary authorization exists. Practicing on a pending license exposes her and the clinic to Board discipline, insurance problems, and possible criminal penalties.
2. What should she do about the PTA supervision and the clinic's marketing?
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She must not supervise the PTA until she is licensed. Supervision of a PTA is part of physical therapy practice and requires an active New Hampshire license. The website and marketing must be corrected immediately; listing 'Dr. Marsh, PT' would misrepresent licensure. She may use 'Dr.' if the DPT was earned, but she must not imply that she is a licensed physical therapist. Telehealth patients physically in New Hampshire require New Hampshire licensure. The clinic director should be told in writing that she cannot start. Once licensed, she must still ensure that delegated tasks are within the PTA's scope and that supervision complies with Board rules.
3. If the clinic ignores the license status and a patient is harmed, what are the likely consequences?
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Unlicensed practice can lead to Board discipline, denial or delay of her New Hampshire license, civil liability for her and the clinic, and possible criminal penalties. The clinic could face claims for negligent credentialing or supervision. An insurer may deny coverage for unlicensed services. The safer course is to wait for the license, document the employer's request and her refusal, and avoid any patient contact. She should also keep evidence of her application and any Board communications. If pressured, she should escalate to the clinic's compliance officer or legal counsel.