This is a topic that I feel passionate about yet struggle with. Let me explain.
I grew up in inner city Philadelphia in what I would call a middle class family. My parents provided a wonderful home for my sister and I to grow up in. We had health care, plenty of food, a good education, and very loving and supporting parents. It wasn’t until I was in college that I realized my family struggled financially at times while I was growing up. When I talked to my mom about why she never took me to a PT after the few times I broke or sprained my ankle she said two things that struck a cord with me. First thing she said was that our general practitioner said it wasn’t necessary. The second thing she said was that our insurance didn’t cover it and they could not afford the $100 charge per visit. I then talked to her about the value of PT and asked her if it would have changed her mind. She said sometimes no matter how you explain it, or how valuable it may be, other necessities like food and gas for the car to get us to school come first. I can’t argue that.
On the flip side, having a business degree and seeing how my family struggled, I aim to provide more for my own family in the future and I know that if I were to provide pro bono care for everyone, I wouldn’t make as good of a living as if I provided PT care to those who could financially afford it.
In the APTA code of ethics it states that “APTA members provide pro bono physical therapy services and/or support organizations that meet the health needs of people who are economically disadvantaged, uninsured, or underinsured” You can read more about APTA pro bono care here.
How do we as ethical practitioners balance making our own living (to pay back our loans!) and serving those that are not as fortunate as ourselves? Let’s talk about it on Wednesday June 5 at 9pm EST!
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A great topic!
I can say from my area of the U.S. the POPTS will see medicaid and refer any PT services out. They rarely see the uninsured for surgery but PT services are also referred out. The private practice clinics will not see medicaid or the uninsured. You can’t make a profit without payment. You don’t keep the doors open without payment.
I work in specific hospital system for this reason. We are the only providers to see everyone, regardless of their ability to pay. This is why I left private practice. I was tired of being prodded to see someone longer/more visits (bill, bill, bill) or seeing multiple people without giving my divided attention (which they deserve! Would you like your MD to have two other people sitting on the treatment table with you?)
Over fifty percent of my practice is under or uninsured and I couldn’t be happier.