Do managed care systems really care?

When a 70-year-old lady has a severe back pain and can hardly walk and get in and out of her car, would it be more accessible and convenient for her to drive 40 miles or 75 miles to have physical therapy?

When a 45-year-old lady has a fractured ankle and she is not supposed to bear weight on her foot, would it be better for her to drive less than 10 miles or 35 miles to have physical therapy?

With the high price of gas nowadays, would it be more accessible and convenient for patients to have physical therapy closer to their home? Would it be better for patients to come to a clinic where there is no waiting period? Would it be better for these patients to come to a clinic where they can have a one-on-one treatment?

The answer to the above questions is quite obvious. However, why are the managed care systems in the Springfield area (not) allowing their patients to have physical therapy closer to where they live? On their advertisements, they promote more accessible and convenient health care. Do they really mean what they advertise? Or is it just their marketing propaganda?

It is so frustrating for an independent physical therapy clinic not to be allowed to give the care they intend to provide to the people in the area where they practice. It is so disappointing not to see these patients solely because the HMO insurance refuses to cover the treatments.

It is not fair for a practice to be turned down and rejected for two years because these managed care systems and HMOs won't allow them to be part of their insurance network.

The question is why? Is this fair? If they really care for their patients and if they really promote more accessible and convenient health care, they will always think on what is best for their patients.

It is so frustrating to see patients drive all the way to Springfield just to have physical therapy when they can have (it) closer to their homes. It even became worse when Healthlink and Medicare patients became part of one of the biggest managed care systems in the Springfield area. More and more patients are now barred from having their treatments closer to where they live.

It is really frustrating for the patients, but what can they do? Patients should be given the option because they are supposed to have a freedom to choose. Patients know what is best for themselves, and they should always have the right to go wherever they want to have their treatments. It is not fair to patients, either.

The health care system in the Springfield area changed in the mid-'90s. The big question is, what is managed care and HMOs all about? Is it about money? What direction is it headed? Is the medical care better since all these things came about, or is it the other way around? If it is better, then great; but if it is not, then it's time to reflect.

Independent physicians, physical therapists and other health care practitioners need to be treated fairly by these HMO and managed care systems, but this is not the case.

More and more physicians in the area are now deciding to become independent practitioners. They are willing to take the risk so they can again decide for themselves. It is only when they are independent that they can decide on what is really best for their patients, and it only happens when patients can have the best medical care they deserve.

Do managed care systems really care? Are they for real when they promote more accessible and convenient health care? It remains to be seen.

Gerard P. Catapang, PT

Physical Therapy Care Springfield, Rogersville