Professions

Nine professions that share patients, techniques and vocabulary. They are regulated in four different ways, and the difference decides who you answer to.

9 professions4 regulation models

By how they are regulated

Grouped by the regulation model each credential follows. The model, not the profession, decides which bodies you deal with.

State license

A license from a state board is what authorizes practice. Each state sets its own requirements, and a national exam, where there is one, is a step toward the license rather than a substitute for it. There is no national license.

DCChiropractorDoctors of chiropractic diagnose and treat conditions of the spine, joints and nervous system, most often with manual therapy, exercise and education.PTPhysical therapistPhysical therapists restore and maintain movement and function across the lifespan, through exercise, manual therapy and education.PTAPhysical therapist assistantPhysical therapist assistants deliver treatment under the direction and supervision of a physical therapist.LMTMassage therapistMassage therapists use touch and soft-tissue techniques to relieve pain, aid recovery and support wellbeing.

National certification, then a state credential

A national body sets the entry standard and certifies people who meet it. States then regulate practice on top of that, by license, certification or registration depending on the state. The two layers are separate obligations, each with its own renewal.

OTOccupational therapistOccupational therapists help people do the everyday activities they need and want to do, after injury, illness or disability.OTAOccupational therapy assistantOccupational therapy assistants deliver occupational therapy under the supervision of an occupational therapist.ATAthletic trainerAthletic trainers prevent, assess and treat injury and illness in active people, from the sideline to the clinic.

National certification

One national body issues the credential and sets its renewal rules. No state board licenses it, so the requirement does not change when you move. Employers and the field, rather than state law, decide where it is expected.

CSCSStrength and conditioning specialistStrength and conditioning specialists design training to improve athletic performance and reduce injury risk. A national certification, not a state license.

Several national certifications

Several national organizations certify practitioners, each with its own exam and renewal rules. No state board licenses the work. Employers decide which certifications they accept.

CPTPersonal trainerPersonal trainers coach individuals and groups through exercise for health and fitness. Certified by several national bodies; not licensed by states.

At a glance

The national bodies behind each credential. States add their own requirements on top.

Professions, credentials and national bodies
Profession	Credential	Regulation	Program accreditor	Entry exam
DC, ChiropractorChiropractor	DC	Licensed by state boards	CCE	NBCE
PT, Physical therapistPhysical therapist	PT	Licensed by state boards	CAPTE	FSBPT
PTA, Physical therapist assistantPhysical therapist assistant	PTA	Licensed by state boards	CAPTE	FSBPT
OT, Occupational therapistOccupational therapist	OTR	Certified nationally, regulated by states	ACOTE	NBCOT
OTA, Occupational therapy assistantOccupational therapy assistant	COTA	Certified nationally, regulated by states	ACOTE	NBCOT
AT, Athletic trainerAthletic trainer	ATC	Certified nationally, regulated by states	CAATE	BOC
LMT, Massage therapistMassage therapist	LMT	Licensed by state boards	None recorded	FSMTB
CSCS, Strength and conditioning specialistStrength and conditioning specialist	CSCS	Certified nationally, no state license	CASCE	NSCA
CPT, Personal trainerPersonal trainer	CPT	Certified by several bodies, no state license	NCCA	None recorded

Full names, links and the steps in order are on each profession's hub and in Get licensed.

License vs certification

Two words that are often used as if they meant the same thing. They do not.

License

Permission from a state government to practice a profession. Where a license is required, practicing without one is against the law.

Issued by a state board
Defines a legal scope of practice
Renewed with the state, on the state's schedule
Does not carry over automatically to another state

Certification

A credential from an organization, usually national and non-governmental, saying you have met its standard, typically by passing its exam.

Issued by a certifying body
Shows a standard was met; does not by itself authorize practice
Renewed with the certifying body
Follows you between states

Compare two professions

Education, exams, regulation and scope, side by side, for professions that overlap.

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With

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The comparison of chiropractor and physical therapist is published.

All published comparisons