>>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.
>>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.

In 2015 administrators still need a physician to attest appropriateness as well as therapist documentation of care and benefit. Consider a future in which the physician is an employee tasked with signing off a default barrage of therapy options to maximize revenue for their facility employer. There are some who will: some decades ago I learned that one of my colleagues signed blank prescriptions for use by eye clinic nurses and another signed disabled parking certificates for the parents of infants who needed foot surgery. As in every profession there are some who seek an easy life...