Get it in Writing

Jason, There is a reason that JCAHO insists on read back of verbal orders and then documenting VORB next to it in the chart. They acknowledge that one of the primary areas for medical errors is in the verbal order process. Let us assume that the PT simply forgets a particular task he/she instructed you to perform. That leaves you exposed.

Do you document your coordination with the PT? That can act as a reminder for the PT when they go back to document the instructions they gave to you. The safest route for you though is to respectfully decline to begin a new treatment until the paperwork is completed. That is what I would do.

I have been in these positions, and from experience, will never touch a patient again unless the paperwork is complete. Cover yourself first!

If the PT isn't up on the paperwork and it lingers, it could come back to bite you as well as the PT. To the point of fines or loss of your liscense. My policy is to error on the side of caution. If my PT doesn't complete paperwork, then he/she will have to treat that patient until its done. Once that paperwork is up to date, I'll treat as long as I have an active plan of care and goals that can be reached.

Any PT/PTA should have enough mutual respect not to put the other in a position that could professionally destroy the other.

Again, from past experience, I'll never treat a patient until that paperwork is complete!!!! My advise is to make it your policy too.

Medicare and your state board will side with you if your company demands that you treat without a written plan of care. Just ask, I did.

It depends on the relationship the PT and PTA have.  It takes faith to completely trust the PT but since both PT's and PTA's have a license both should take responsible care in protecting themselves.  If in doubt about whether you should see a patient or not, wait for the paperwork.