Lead PT, Lead
There are some therapists who are born to lead and bring a dynamic quality with them during evals and treatment sessions. Others are hesitant to make decisions and will prefer the "wait and see" method in regard to patient care. I have worked with both types.
Since I don't like to hold a PT's hand when discussing patient care and progression, those who are hesitant to make decisions can be frustrating to work with. I would rather work with a PT who will make a decision based on the most recent data available and then make changes during a reassessment. Those who are hesitant to lead should take leadership courses or improve their clinical decision-making through education. I've often stood by while a PT vacillates between several options. When pressed to make a decision, he doesn't, and I'm treating the patient with no clear goals or objectives from the PT who is my supervisor.
When I have made decisions based on my own clinical judgments and presented these to the PT who doesn't lead, I was met with disdain. Therefore, no hand-holding with the PT when decisions need to be made.
There are a handful of PTs I would follow anywhere because I know they have the patient's best interests in mind during every treatment session. They observe me while I'm treating the patients and will make simple suggestions to improve my outcomes because they know if I do well, they will do better. Like a symbiotic relationship, when one thrives, the department thrives.
Those PTs who are hesitant to lead a PTA to better quality patient care should read up on what it takes to be a leader and direct others. Also, read up on what exactly a PTA can do in your state. PTAs have a lot to offer to improve a department and make a success of every treatment, but since we're not able to make completely independent decisions without the PT's approval, we need skilled guidance to ensure a patient's success.