In Switzerland, still physiotherapy has to be perscribed by the doctor in order to be paid by health insurance. The amount of sessions is regulated and if it exceeds the “normal” amount for a diagnosis the doctor has to define why physiotherapy is still needed.
I had a case in private practice where I had the impression, that my patient wasn’t doing how we agreed on over a longer time period. I felt that I had to raise a little pressure on her to get her doing her exercises and to be able to tell the doctor that we are on the right/the wrong or on any track at all. I needed some way of results, not to be standing still.
On the one hand, the physiotherapist, has to be effective and bring good results. Otherwise we “lack quality”. On the other hand under the ethic principle of benefice I should do good to the patient and support her instead of putting pressure with the risk of her having enough of someone telling you to do exercises. And under the principle of autonomy I should respect the way she chooses therapy.
Within this system of health insurance and the need to show good results of therapy, can we care only? Or where are we ethically placed?
What do you think?