Workers Comp Doctors Caught In The Middle

January 27, 2007

All,

The following are two emails posted on an occupational physicians'

chatboard. It give a bit of insight into the challenges faced by workers comp

physicians under today's health care system.

Sharon

I identify with you as well as with Max Craven. Because of the secondary

gain issues with work comp, some employees play the system. Due to costs of

recordable injuries, some employers press return to work or try to get the

claim disallowed. Overall, my guess is that this occurs the minority of the

time, around 15% (just a guess). Most injured workers are anxious to get

back to work and most employers do a good job working with the doc and the

injured worker. WC insurers vary from pro-employee to pro-employer, even

among the case managers within the same company. Lawyers are, well, lawyers.

Due to the number of players, I tell folks that if I am getting yelled at

equally by the insurer, the employee and the employer, I'm probably where I

should be.

Regardless of how good I hear the economy is doing on the evening news, many

companies and even more employees have to pinch pennies. This encourages

each to push harder for their own agenda - probably why you are " wearing

thin " , I feel it too. All I can do is to try to do my best, practice good

medicine, support both the employer and the employee as appropriate, do the

tough love thing with return to work, and keep empathy and sympathy in

balance. Oh yes, thick skin helps too.

[occ-env-med-l] Qualms

After many years of treating worker's compensation problems, I continue to

struggle with the reality that I am not treating patients, I am providing

medical services to insurance claimants. At times I feel that it is almost

unethical to be part of a system that creates adversarial relationships

which obstruct my efforts as a physician. I tell myself that if I do my

best, I can make a difference. Lately, my rationalizations are wearing thin;

they are no longer assuaging my deep misgivings. Do others struggle with

these same issues?

Sincerely,

MD, MPH

Recommended Posts