Are rich Filipino therapists evil nepo babies?

Many occupational therapists (OTs), physical therapists (PTs), and speech-language pathologists (SLPs) have rich parents. Many of them acquired properties in the previous century by daring to venture into new business opportunities. On the other hand, some therapists descended from old money families. These are clans that have kept their wealth for more than one hundred years. The latter’s resources birthed the Philippines’ spiritual and cultural landscape which made it distinct from other countries. Hence the old aristocracy’s trademark is not the possession of Birkin bags, but either a passion for heritage conservation or a deep sense of spirituality — or both!

Many of these rich therapists are using their resources to benefit the community. They put up therapy clinics and special education schools that cater to the needs of persons with disabilities (PWDs). They teach at universities, conduct research, and do charity work. 

Because they are good stewards of their money, it doesn’t make sense to funnel the bulk of their wealth towards the pockets of corrupt politicians through heavier taxation. The taxes will only fund the luxury lifestyles of contractors and government officials who will shortchange the masses with their substandard services and ghost projects. In the worst case scenario, we might even end up like Maoist China or North Korea! History is a testament to the fact that such wealth redistribution doesn’t work. It is therefore better for the rich therapists to keep the lion’s share of assets that they’ve gained through HONEST means because of their track record of using their resources to help the community. 

Noblesse Oblige

However, there are many changes that I’d like the wealthy therapists to implement. Since they have the safety net for creative risks, they must take the initiative to change the systems that marginalized our fellow Filipinos — even if it means making way for something better by tearing down the old order that gave them their privilege. 

In the allied health world, this involves transforming our service delivery models to give access to high-quality, culturally responsive therapy services across the socio-economic strata. Very few here in the Philippines can avail of these services due to the skyrocketing prices and the limited number of clinicians. Hence, the rise of pseudo-therapists! But it’s not enough to jail the fake therapists. It’s also very detached and elitist of us licensed practitioners to talk down on our financially struggling clientele for questioning why our fees are so high, especially if we’re not producing better patient outcomes. 

Bayanihan for Therapy

We rehabilitation professionals were trained to operate on certain assumptions of how therapy must be delivered. But the perpetual shortage of licensed practitioners and the pseudo-therapists' relentless poaching of our therapeutic approaches are manifestations that many of our ivory tower ideas translate poorly in the Philippines.

So instead of imposing what we’ve learned from our Westernized education, the most privileged of us therapists should take the lead in developing programs that are aligned with the needs that Filipinos themselves have identified. This is not an impossible dream because we therapists have done this in our community-based rehabilitation (CBR) settings (Sagun, et al., 2025). 

Through CBR, we’ve proven that we therapists can work with various stakeholders to provide affordable therapy services to low-income groups. Therapy has become more accessible because community-based therapists have trained paraprofessionals to competently provide interventions under the allied healthcare workers’ supervision. Instead of importing treatment protocols and all sorts of equipment from the West, therapists in CBR settings maximize the resources that the communities have and implement approaches that the locals find effective. Moreover, health education in CBR is delivered in the local language using teaching strategies that are helpful in training Filipino laypersons. 

The True Privilege

But while CBR is an excellent step in the right direction, we shouldn’t stop there. Therapy services even in private practice must be indigenized to improve their effectiveness and cultural sensitivity. Once again, the people who have the safety net for taking such a creative risk are the wealthy therapists. God’s financial blessings to them come with the responsibility of transforming the healthcare system for the better to serve the oppressed. What a great privilege! 

REFERENCE:

Sagun, K., Mendoza, T.C., & David, A.A.I. (2025). Embracing bayanihan: Navigating occupational therapy practice in the community. In M. Sy, R.C. Pineda, & C. Fischl (Eds.), Occupational Therapy in the Philippines: Theory, Practice, and Stories (pp. 123-138). Routledge.