Reference check questions for physical therapists

A physical therapist decides what is wrong, what to do about it and how hard to push, then writes it down in a way that has to satisfy a payer and guide the next clinician. Most of that is invisible in an interview. You hear how the candidate describes their approach. You do not see whether their plans changed when a patient stalled, whether their notes were done the same day, or whether the units they billed matched the care they gave.

The people who shared a caseload with the candidate saw all of that. A rehab manager reads their evaluations and handles their audits. A physical therapist assistant carries out their plans and knows how clear those plans were. For a new graduate, a clinical instructor watched them treat patients for weeks and wrote a formal assessment. Ask each reference which setting they saw the candidate in, because outpatient, acute care, rehab and home health ask different things of a therapist. For every question below, request de-identified examples of the candidate’s work, excluding patient names and identifying details.

Who to ask

• A rehab manager or clinic director who read the candidate’s evaluations and notes, and reviewed their productivity and audits.
• A physical therapist who shared the caseload, for clinical reasoning, hand-offs and how the candidate covered for colleagues.
• A physical therapist assistant they supervised, for how clearly the candidate directed care.
• For a new graduate, clinical instructors from their clinical education, especially the final placement.

Questions to ask, by competency

Choose the competencies that matter most for the position and two or three questions from each. Ask every reference the same set, and when an answer is a rating, ask for the example behind it.

Clinical reasoning

The evaluation sets everything after it: the goals, the plan of care and what the assistant carries out. A therapist who cannot adjust a plan wastes visits the patient may not get back.

1. How sound were the candidate’s evaluations and plans of care? Leaving out patient names and identifying details, what de-identified example shows how they changed a plan when progress stalled?
2. When a patient’s symptoms did not fit the expected picture, what did the candidate do? Did they ever send a patient back to the physician?
3. On the scale you use for your own staff, where would you place the candidate’s clinical reasoning? Without patient names or identifying details, what de-identified example of their decisions supports that rating? (rating)

Documentation and billing

A therapist’s notes justify the care to payers and tell the next clinician what was done. The units billed have to match the treatment given.

1. How timely and complete were the candidate’s daily notes and progress reports? Did any have to be finished or corrected days later?
2. Did the candidate’s billed units and minutes match the care you saw them give? Was their documentation ever questioned in an audit?
3. How did the candidate respond when a productivity target conflicted with what a patient needed?

Patient safety and engagement

Therapy moves people who are weak, in pain or at risk of falling, and the therapist decides how much a patient can safely do on a given day. It also works only if the patient keeps coming and keeps doing the exercises.

1. How did the candidate manage fall risk during transfers and gait training? If a patient fell during their session, what did they do afterward?
2. In acute care or home health, how did the candidate decide a patient was not safe to treat that day, for example after a change in vital signs?
3. How did the candidate keep patients coming back and doing their home exercise programs?

Directing assistants and working with the team

Physical therapist assistants and aides deliver much of the care under the therapist’s plan, and the quality of that care rests on how clearly the therapist directs it.

1. How did the candidate direct physical therapist assistants and aides? Did the assistants know what the candidate expected for each patient?
2. How did the candidate communicate discharge recommendations to case managers, nurses and families?

Close the reference

End every reference the same way: ask whether they would hire or work with the candidate again and why, what support would help the candidate do their best work, and whether there is anything else you should know. The general question bank explains why the first of these matters most.

Checks a reference does not replace

• The license or compact privilege. The Bureau of Labor Statistics notes that every state licenses physical therapists, that licensing includes passing a qualifying exam and that some states also require a law exam and a criminal background check. Confirm the license with the state board. In a state that belongs to the Physical Therapy Compact, a therapist licensed in another member state may practice with a compact privilege, so confirm the privilege and the home-state license behind it.
• The federal exclusion list. The HHS Office of Inspector General says health care employers should screen new hires and current employees against its List of Excluded Individuals/Entities, and that hiring someone on the list can lead to civil monetary penalties.
• Specialist certifications the role requires, with the board that issued them.

Warning signs to follow up

• References describe high productivity and say nothing about patient progress or judgment.
• Hesitation when you ask whether the candidate’s billed units matched the care given.
• An assistant describes unclear plans, or treating patients the candidate had not seen in weeks.
• Notes routinely finished days after the visit, or progress reports written to the template rather than to the patient.

One warning sign is a reason to ask another question, not a verdict. Reference check red flags covers how to check a concern fairly.

Questions to leave out

Ask only about the work. Before an offer, the EEOC’s guidance says an employer may not ask a third party, such as a former employer, any question it could not ask the candidate directly. Leave out health, medical leave, age, family plans and other protected characteristics. What to leave out has the full list.

This article is general information, not legal advice. Confirm the requirements that apply to your organization, and in your state, with your counsel or HR policy office.