There was a bill for

my uncle yesterday. It was for "physiotherapy". Fair enough. If he needs it, he needs it. He is fortunate he can afford to pay for it.
I wondered however what this "physiotherapy" was actually about. It appears that my uncle is being charged a large sum of money for someone to come in and "massage" his legs.
Now my uncle has extremely poor circulation, a combination of a number of medical issues, heart disease and diabetes among them. His feet have been a deep purple-red colour for some years now. His skin is tissue paper thin with age. It has also been abused by hours of sun baking on the beach.
So, what good will someone do massaging his legs for a few minutes once a week? I will not assume I know. I will consult the physiotherapist we have in the family. She will know or she will, I suspect, say that someone is making money in an unethical manner.
It will not be the first time such a thing has happened and it will not be the last. Some time ago I was sorting out the medication for an elderly friend into a "pill pack" - one of those trays where the patient only needs to take out what is in each compartment instead of undoing bottles and blister packs. It was a job normally done by her daughter but her daughter was away at the time and I had undertaken to do it.
To be sure that I was doing the right thing I asked my friend what each of the medications she was taking was for. She knew what two of them were for but she had no idea what the other three were supposed to do. I knew what one of them was for and I could guess at another but the fifth, an extremely expensive item, puzzled me. I said nothing to her but I made an inquiry of my own GP as I happened to see him that week.
When her daughter returned I mentioned it to her. "Mum was over that months ago - more than a year ago."
Her daughter was concerned. It had never occurred to her to question the prescription. Why should it? She trusted the medical profession to do the right thing but now questions were asked. The drug was removed. It saved several hundred dollars a year. It is not something I can take credit for. I was merely curious and concerned to make sure I was doing the right thing.
Why would a doctor go on prescribing something not needed? All too often they are overworked. They have a limited time for each patient. I am normally in and out of the doctor's room in a few minutes. I would rather he spent time with the elderly or the very young. If I really need it I know my doctor will give me time.
But the physiotherapist is apparently not overworked. There is clearly an arrangement with the nursing home. I have no doubt someone comes in and sees several patients at one time. They may well do some good. If the treatment was preventing pressure sores or markedly increasing my uncle's circulation I would welcome it - but the fully qualified nursing staff are watching for diabetes related pressure sores. I am not sure how my uncle reacts to the massage of his legs.
The massage service is almost certainly not assisting my uncle's physical welfare. It may be doing something for his psychological welfare. If it is, we will leave it there.