Re: [occ-env-med-l] FW: Doctors feel push to downplay injuries Group tells OSHA of p

[Guest guest]

First, Do No Harm......

I commend Dr. Mc Lellan for speaking out and admitting what we here

at know to be true. Being one who is employed by a

major HMO, I know this " downplaying of injuries " to be true first

hand on both fronts, as I sometimes had to be a part of the practice

of mis-treatment or under-treatment. And, when it was brought to the

attention of my " higher-up " I would get a shoulder shrug. I was even

threatened at one point with a charge of insuboardination. And while

knowing this was common practice, I never dreamed that I myself would

end up being one of the worst cases of willful neglect to properly

diagnose and the mistreatment of my illnesses, along with misconduct.

I think it would most certainly be fitting for Sharon Kramer to sit

aside Dr. Mc Lellan and attest to Congress, the treatment or lack

there of, by telling even just a few of our experience's of horrors.

" All that is required for the triumph of [evil] is for good men to

do nothing. " Edmund Burke

--- In , " tigerpaw2c " <tigerpaw2c@...>

wrote:

>

> Doctors feel push

> to downplay injuries

> Subject: Doctors feel push to downplay injuries Group tells OSHA of

> pressure by companies

>

>

> WORKPLACE SAFETY

>

>

> AMES ALEXANDER

> aalexander@...

> Special Report | The Cruelest Cuts

>

> NEW YORK --A leading group of occupational doctors is taking the

> unusual step of speaking out publicly against pressure from

> companies to downplay workplace injuries.

>

> To outline their concerns, the physicians have sent a letter to

> federal workplace safety regulators and held a conference session

in

> New York City on Monday. They're also planning to testify before

> Congress.

>

> If successful, their campaign could affect the treatment of injured

> workers and might help change how the government assesses workplace

> safety.

>

> " Our members feel they are being methodically pressured ... to

under-

> treat and mistreat, " said Dr. McLellan, president of the

> American College of Occupational and Environmental

> Medicine. " ...This is a grave ethical concern for our members. It's

> a grave medical concern. "

>

> His group represents 5,000 doctors; some treat workers referred to

> them by employers, while others work directly for companies.

>

> Employers are supposed to record all injuries requiring time off

> work or medical treatment beyond first aid. It's an honor system,

> and the injury logs are used by regulators and others to gauge

plant

> safety. Low injury rates allow companies to avoid scrutiny from

> workplace safety regulators and may help managers earn four-figure

> bonuses.

>

> In a hotel meeting room in New York, doctors said this helps

explain

> why some employers urge them not to treat injuries in a way that

> would make them reportable. A cut, for instance, must be recorded

if

> the worker gets stitches, one doctor told the room of more than 60

> colleagues. But if the doctor simply covers the cut with a bandage,

> it doesn't have to be reported.

>

> Workplace injury and illness rates -- a key factor in determining

> whether regulators inspect a company -- have been declining

> nationwide in recent years. But some experts suspect that's partly

> because employers aren't reporting all on-the-job injuries.

>

> McLellan, an associate professor at Dartmouth Medical School in New

> Hampshire, says he thinks employers are " vastly underreporting " the

> extent of workplace injuries.

>

> " Players in the system may willfully produce records that don't

> reflect reality, " he said in an interview.

>

> He said he grew more concerned about corporate pressures on doctors

> in September, during a conference in the Carolinas. Since then, he

> said, he has heard from dozens of doctors.

>

> That led him to contact the U.S. Occupational Safety and Health

> Administration, and he expects to discuss his concerns with top

> agency officials next month. His group will likely propose that

OSHA

> more vigorously investigate the accuracy of company injury logs. It

> may also ask regulators to rely on a broader array of workplace

> safety measures -- and to rewrite rules so that companies have

fewer

> incentives to underreport.

>

> McLellan also wants occupational doctors to testify before

> congressional committees examining workplace safety.

>

> Ethical physicians sometimes lose business to those who bend to the

> wishes of employers, some doctors and workers' compensation lawyers

> say.

>

> In the Carolinas and some other states, injured workers generally

> must visit doctors approved by their employers if they want

workers'

> compensation to pay for the treatment. Companies incur higher costs

> for compensating workers for medical care and lost wages when

> they're injured on the job.

>

> Employers tend to send workers to doctors who can help them keep

> costs low and productivity high, according to attorneys who

> represent injured workers. Doctors become popular with companies if

> they rarely order time off work for injured employees, or if they

> seldom recommend costly treatments or conclude injuries are work-

> related, those lawyers say.

>

> " If you get past the infirmary and sent to a doctor, you're getting

> sent to a doctor that lives on the plant, " said lawyer

Davila,

> who until recently worked in Columbia, S.C.

>

> Atlanta lawyer Bruce Carraway has represented more than 400 injured

> poultry workers and says that in more than half of those cases,

> independent physicians gave different assessments than the company

> doctors.

>

> Dr. phus Bloem, an orthopedic surgeon from Rocky Mount, said he

> used to get referrals from Perdue Farms. But in the 1990s, the

> company became unhappy that he usually recommended surgery for

> workers with carpal tunnel syndrome.

>

> " Their top doctor once visited me and complained that I was too

> expensive, which I took as pressure to review my approach, " Bloem

> said. Not long afterward, the referrals stopped.

>

> Dr. Merrill, Perdue's chief medical officer, said the company

> had discovered that many workers who got less invasive treatment --

> such as splinting, exercise and ibuprofen -- fared better than

those

> who got surgery. " We had a better way to treat folks, " he said.

>

> But Bloem wondered whether health concerns were the only

factor. " In

> the end, " he said, " the money wins. "

>

> In their quest to keep injuries off logs, company officials without

> medical training sometimes provide inappropriate treatment, doctors

> at the New York conference said.

>

> Dr. Peggy Geimer, corporate medical director for a chemical company

> in Connecticut, spoke of the " tremendous amount of pressure " on

> company staff to provide treatment beyond their level of expertise.

>

> She recalled how one supervisor dealt with an injured worker who

> spilled an acidic chemical on his arm: He applied potash, which is

> sometimes used to clean up chemical spills -- unaware that it would

> only make the burn worse.

>

> McLellan said he doesn't recall his group ever before taking such a

> strong stance on the issue. As one doctor at Monday's conference

put

> it: " We need to treat the patient. Not the log. " -- Staff Writers

> Garloch and Franco Ordonez contributed.

>

> -- Ames : 704-358-5060

>

> Many injuries unreported in poultry industry

>

> In a recent investigation of working conditions in the poultry

> industry, the Observer found that many on-the-job injuries aren't

> being reported.

>

> One N.C. poultry company, House of Raeford Farms, has repeatedly

> failed to record injuries on government safety logs. The newspaper

> also found that some company first-aid attendants have prevented

> poultry workers from receiving care that would cost the company

> money.

>

> House of Raeford says it follows the law, provides good care and

> strives to protect workers.

>

> A record-keeping expert for the U.S. Occupational Safety and Health

> Administration told the Observer that his agency is allowing

> employers nationwide to vastly underreport the number of workplace

> injuries. The true rate for some industries, including poultry

> processors, is likely two to three times higher than government

> numbers suggest, Bob Whitmore said.

>