But you can blame a lot of this on governmental regulation and Medicare to start with. A hospital has to watch its bottom line. Most are not huge money makers; a lot struggle to even stay open. I'm not up on the latest info, but the last time I worked inpatient as a physical therapist they were in the process of bringing in DRGs, or diagnostic related groups, basically meaning that Medicare paid the same for any patient admitted for a cholecystectomy unless there were complications and you could add another diagnosis code to his list.
Of course, the Medicare payout wasn't near enough to include the additional nursing staff required for the assorted other health professionals that had been cut.
Bottom line- mandate the number of nurses and the hospital's either going to close, make cuts elsewhere (housekeeping?), or soak the insurance patients even more.
Therefore, if the patient needed a physical therapist's skill to get him out of bed and walk, the hospital got the same amount of money as if they didn't. Since most of the patients we were walking could be just as easily walked by a nurse, PTs were phased out for most problems other than orthopedic ones, thus adding to the nursing workload.
Don't get me going about PT's. Insurance companies could save a lot of money if they used physical therapists more! They throw anti-inflamatories and pain meds at patients instead of providing therapy to solve the basic problem.