There are patients who were injured years ago and simply have done nothing with their lives. They are sometimes referred to by the not-so-flattering term of “old dogs.” They are patients that actually reached their current level of disability 3+ years ago, but they languish within the system.
In most cases, their physician has been astute astute enough to realize that they have limitations, specify a percentage of disability and know that the individual cannot benefit from additional care.
Then someone else becomes involved, sends them back through a repeat of all tests and care that have already been completed, and the patient is back in the system. This can occur multiple times, and it leaves the patient believing that health care is now their “job;” it is what they do with all of their time, and there must be something wrong that needs fixing.
How does this occur? This is simply lack of strength on the part of those who are treating the patient. Some would say it is also a lack of accepting responsibility for the patient. A truly strong clinician will tell the patient what is, and what is not, wrong, and place some/all of the responsibility for coping upon the patient. The individual need not, and should not, spend their life in the patient role. This dependency rarely occurs in the private sector.
Other doctors will feel guilty/concerned and continue to offer the patient everything from chiropractic care, to massage and (in one recent case) spiritual healing. Some of this is greed, but most of it is simply avoidance of drawing the line.
It is the responsibility of all involved to help the patient accept when additional care will truly not significantly benefit them.