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

[Guest guest]

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.