It would be my opinion from working in the public health system in the past that therapists become disenchanted with their professional remit. What they could do and what they have time to do are sometimes very different. What they know to be effective and what they can provide based on resources and length of treatment time/sessions can also be far from ideal. Unfortunately you also get your share of chronic treatment seekers in that environment as they don't have to pay directly for it. This further leads to diminished moral within the hospital staff.

It is nice to see these days that cleaver and forward thinking departments are looking at new ways to improve moral. Group exercise and rehab programs are are good way to keep numbers up and provide more time to achieve results.

It is up to departments to present these ideas to any people who refer to them and get them involved in order to keep/foster a team approach to patient care.