>Would you also go after the car mechanic who advocates service plans and intervals exactly as per manufacturer spec? Those Medicare intervals are not arbitrary, they're based on a version of best practice that makes it difficult to criticize practitioners who try to comply.

Again, a shaky analogy.
The mechanic's recommendation has an additional burden.
I have to pay the bill so I'll look more closely at the recommendation.

When the rehab guys says.. "Well, Medicare pays for it.." that burden is lightened considerably.


>
>Bill, sorry to hear about your wife and not wanting to comment on specifically- but speech therapists also provide swallowing assessment and therapy such as might be helpful for somebody on a feeding tube, especially if it causes distress. Also consider that healthcare workers often are driven by a desire to assist that sometimes with the best of intentions crosses from prolonging life to postponing death, or providers looking for some service- any service- that can be offered in sympathy to somebody who is in distress. It may well be appropriate to confront trainees with this so they can see it in themselves and offer a few kind minutes of listening and gentle laying on of hands rather than pinging of signals from machines and a barrage of annoyingly cheerful but hopeless therapy attempts.

The last thing I wanted to do was to impugn the integrity of my wife's caregivers.
Those people are the closest things we have in this life to angels. I can't imagine that they'd treat their own mothers with more care than they gave my wife.
The young lady who was the speech therapist could also see immediately that my wife wouldn't benefit from the therapy so she stopped the therapy, which was disturbing to my wife and spent her time trying to soothe her.
After my wife died I went back to thank them all, and she got special thanks.
But that wasn't my point.
My beef was with the administrators who prescribed these things that were often painful to my wife for no apparent reason other than that Medicare would pay for them.
After a week of this nonsense, they told me that my wife hadn't benefitted from the therapy.
It seemed obvious to me that she wouldn't benefit, but like most spouses in that situation I was numb and I went along with it.