From the Pond: Virtue

“The rich man — not to make any invidious comparison — is always sold to the institution which makes him rich. Absolutely speaking, the more money, the less virtue; for money comes between a man and his objects, and obtains them for him; and it was certainly no great virtue to obtain it.”

In 4 years, I plan to open my own physical therapy clinic.

In the state where I will practice, reimbursement is poor: less than $40 per visit for patients covered by workers compensation/no-fault insurance and no more than $50 per visit from any private insurance company. Still, PT-owned practices continue to thrive.

But at what cost? Most clinic-owners require their therapist’s to provide “care” to 3-4 patients per hour. Others only have therapists available for evaluations and re-evaluations, leaving the patient in the hands of physical therapy assistants (PTAs) for day-to-day “treatment”. Hands-on care and one-on-one time with the patient is reduced in some settings, abolished in others. Working in home care now, I am no longer in a position to judge these clinics, or their owners. I can only judge myself and my own inadequacies when I tried to care for my own patients with such high expectations of productivity.

When I decide to open the doors to my own clinic, I need to determine how I wish to run my practice; what I want at home will dictate what I do at work. Do I want a bigger house? Would I rather have a waterfront home? Perhaps a home with more property or privacy? Will I buy a boat and (if so ) what kind? Would I prefer a wristwatch of better quality than my Timex? Will I be tired of driving used automobiles with small 4-cylinder engines?

My lifestyle at home will decide how many patients I must see per hour, how many times I must see a patient per week, and how many hours I must work per day/week.  It will determine if I have the privilege of treating my patients myself, or if I must necessarily hand-over their care to another – less qualified clinician – after completing their evaluation.

In the end, I will have to choose between selling myself to my clinic or something else altogether…being virtuous.

*quoted passage from Walden


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