Saying “No” to Patients for Cost-Related ReasonsAlternatives for the Physical Therapist

Physical therapists express their respect for patients by providing competent, compassionate care. Constraints may be imposed on realizing this ideal when treatment must be refused or discontinued because patients lack the financial resources to pay for physical therapy services. The purposes of this article are 1) to review key features that have contributed to the current high cost of health care, 2) to describe approaches being proposed to curb costs, and 3) to suggest ways physical therapists can have a constructive role in creating rational cost-containment policies that are consistent with professional ideals. Seven activities by which physical therapists can become involved at the health care policy level are discussed.