The Ministry's 30-session limit victimizes patients: Quota rule hinders treatment

Patients with physical challenges resulting from injury, disability, illness, or aging can sometimes face obstacles to receiving the physical therapy and rehabilitation services they need. Due to the regulation in the Health Practice Communiqué (SUT), which states that "a patient will receive coverage for a maximum of 30 physical therapy and rehabilitation sessions from the same area within the last year," the Social Security Institution (SGK) does not cover the cost of more than 30 sessions. Consequently, patients are forced to pay additional out-of-pocket fees for treatment exceeding 30 sessions.

Patients asked, "Thousands of lira are being charged for just one session. How can we pay that amount?" Physical therapists also stated that 30 days of physical therapy might be sufficient for a patient, but in some cases, additional treatment might be necessary, and arrangements should be made accordingly.

PRIVATE PARTY IS BURNING POCKETS

According to the SUT regulations, a patient can receive a maximum of 30 sessions of physical therapy and rehabilitation for the same area or 60 sessions for two different body parts within a year, covered by the Social Security Institution (SGK). Patients who require more than 30 sessions of physical therapy for the same area are required to pay an additional fee. Patients who are waiting for an appointment and then pay an additional fee are also forced to pay additional fees, which can amount to thousands of lira. Fees for a single session at some physical therapy centers in Istanbul range from 500 lira to 4,500 lira, depending on the procedure. When examination fees are added, patients face bills totaling thousands of lira.

Physical therapists said, “If the doctor makes the correct diagnosis and treatment, results can be achieved in 20 sessions of physical therapy. However, sometimes this can vary in patients who undergo surgery. The government doesn't make any exceptions here. Let's say there's a shoulder problem, the patient undergoes 30 sessions of physical therapy before surgery. Because they don't respond, they have to undergo surgery. Intensive physical therapy may be required again after surgery. In that case, the government can say, 'You've lost your rights.' In other words, the Social Security Institution (SGK) can issue new regulations in such cases to prevent patient grievances.” Sevim Tanrıverdi, a patient receiving treatment at a public physical therapy hospital in Istanbul, described her ordeal with the following words: “Last year, on October 11th, I fell. My shoulder was shattered, and I had surgery. I have a platinum plate and 22 pins in my arm, and I have to undergo physical therapy. I received 30 days of physical therapy, but it wasn't enough, and my doctor wanted me to take 20 more days. However, I learned that I was entitled to 30 days and that I had to pay extra for 20 sessions. I can't move my arm, and the pain is intense.” My doctor said, "Let's give you physical therapy again, but this time, we need to give you hot physical therapy." So I went to the hospital in August, got my registration, and was told, "We'll call you." When they didn't call me until October, I went back to the hospital and asked. They explained that they hadn't called because they were out of space and that someone had canceled their appointment, saying, "Come back tomorrow, we've scheduled your appointment, and we'll start treatment." The next day, I was told I had to go to the cashier. "Why?" I asked. "Your 30-day physical therapy period is over," they said. "I've had surgery, and my treatment needs to continue. Why am I having to pay?" I asked. They quoted me a fee of 780 lira for one session. Twenty sessions cost close to 20,000 lira. Last week, the hospital called and said they'd rescheduled my appointment for January 23rd. It's the start of the new year, and my rights start again. A patient who's had surgery and a patient with arthritis are not the same. I'm in pain, I need treatment, but I can't. They're forcing people to go private. In short, they say, "If you have money, go and get it done privately."

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The cost of savings cannot be charged to the patient.

Istanbul Medical Chamber President Prof. Dr. Osman Küçükosmanoğlu also stated that the Social Security Institution (SGK) doesn't provide realistic payments for areas like eye, dental, and physical therapy, saying, "They pay very low fees. For example, they don't pay for things like dental implants, and what they do pay is very low. Physical therapy is one of these. It's always a procedure designed to squeeze more money out of the patient's pocket. Physical therapy isn't a discretionary procedure. Some procedures can be vital. This logic shouldn't be followed. Furthermore, this field is very open to abuse, but the patient shouldn't be held responsible for the savings in healthcare."