American Medicine: An ethical dilemma?

American Medicine: An ethical Dilemma?

I head back for my 2nd semester of PT school in just a few short days, but my moral compass is off. I find it bothersome that in this vocation, the money it yields as an income, is a result of expensive healthcare. Is Physical Therapy a noble profession? Sure. Is it suitable to live a comfortable live? Sure. However, in treating patients they get a nice bill in the mail which pays my bills.

I picture it like this given that I have learned in my first semester that the BioPsychsocial model can play largely into a patients pain. In other words, occupation, socioeconomic status, stress, family support, diet, smoking, tobacco etc.

A patient receives his bill for PT and intends to pay it in full, but his landlord just jacked his rent up unexpectedly and his car broke down yesterday etc. Now what? He adds on the approximately 220 Billion dollars of Medical Debt in America. I realize this example is somewhat niche, but these are problems real people face. I just treated this patient, but their pain is back because they are stressed as hell.

I remember during my first semester working with a patient whom I GUARANTEE is dead by now. A few things stood out to me vividly.

1 - The active therapist whom I was under asked the asked the patient where they plan to return following discharge from the Hospital. The patient replied home in which we then figured out where home was. This was merely false hope and only set the mood in the room for this current moment in time. The patient was never going home. I knew this, and if they were to go home, it was to be surrounded by loved ones during passing.

2 - Despite the state of this patient, we performed a minimal amount of physical therapy, but it was performed nonetheless. This of course, means a bill. I remember leaving this patients room and thinking “well…. their chances of living didn’t improve, but now they get a nice bill in the mail”

Overall, it’s just really frustrating that insurance has both the clinician and the patient by the neck, and the reason this career offers a good salary is because healthcare here is expensive.

I ponder on the idea that I would find greater appreciation for what I do in a country of which I can treat patients without ruining their bank accounts.

What are your guys thoughts on this?