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Not all patients are on disability

A recent conversation with my sister inspired me to write this post. She is a physical therapist who often rants about how patients with chronic pain or chronic illness don’t work and are just on disability. I know she’s far from the only health care provider with the same belief. She and her coworkers spend time ranting and complaining about their patients who don’t work and use the therapy sessions as “social hour.” Providers on the forums Reddit chime in with similar rants and disparaging remarks about their patients, who they think all just want to sit at home and collect disability checks.

It recently dawned on me why providers such as my sister have a biased attitude toward patients with chronic pain or chronic illness. Their hours are not worker-friendly. Most providers’ hours mirror those of other workers, 9 to 5 or 8 to 4. Is it any wonder, then, why the patients our health care providers see most often are on disability?

Patients who work full-time do not have the time to see providers, let alone physical therapy sessions twice a week. Most of these working patients have limited paid time off (PTO) and must balance the needs of their employer. Patients who work do not have the luxury of leaving work early to arrive 15 minutes prior to the appointment, only to find themselves waiting 30 minutes or longer for their scheduled appointment. A patient who is an hourly worker loses not just time but also their pay when forced to wait for extended periods of time for their appointments. Patients who work must ensure coverage in their absence, and if they return much later than planned, that can impact others’ schedules and workloads, require the patient-employee to take more paid time off, unpaid leave, or lose wages and work longer hours to make up for the lost time.

If providers offered earlier hours or extended their hours until evenings, these patient-employees would be able to see their providers, attend the recommended physical therapy sessions, and continue to work, making it easier to pay the copays or meet the often highly unaffordable deductibles. Providers, in turn, would encounter patients they may better be able to relate to – working professionals like themselves.

While it’s true that there are many providers who do offer extended hours, most of these providers are out of network or practice concierge medicine, which means greater out-of-pocket expenses for the patient. Many patients with chronic illness or chronic pain find such practices inaccessible given their high medical expenses. Even for those patients who work, in-network providers are more affordable. Unfortunately, most such providers rarely have extended hours.

If health care providers want to have more professionals as their patients or clients, I recommend the following: Be available early morning and late in the evening; have weekend hours; send text updates to inform patients of any long wait times; don’t assume their patient has time to wait; and, treat the patient with respect and acknowledge that their time is important too.

Benita Talati is a patient advocate.

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