August 24, 2005

Don't let medical providers "discount" your injured workers

We talked a bit about "framing" on Monday - the depersonalization that can occur when people are lumped into broad categories or stereotypes, and how that pigeonholing can set the trajectory for future behaviors and events. Thus, an injured worker can make the leap from being your best employee to a rather suspicious "claimant" in one fell swoop. So it was of some interest when, in doing our weekly medical blog rounds, we came upon a post that related to the transformation and depersonalization that often occurs when one becomes "a patient."

Rita Schwab at MSSPNexus points us to a story in The New York Times about the degrading shift from person to patient* that often occurs when one crosses the threshold into a hospital. Rita comments that, often, " ... the courtesies that help lubricate and dignify civil society are neglected precisely when they are needed most, when people are feeling acutely cut off from others and betrayed by their own bodies."

She excerpts this incident from the article:

"Mary Duffy was lying in bed half-asleep on the morning after her breast cancer surgery in February when a group of white-coated strangers filed into her hospital room.

Without a word, one of them - a man - leaned over Ms. Duffy, pulled back her blanket, and stripped her nightgown from her shoulders.

Weak from the surgery, Ms. Duffy, 55, still managed to exclaim, "Well, good morning," a quiver of sarcasm in her voice.

But the doctor ignored her. He talked about carcinomas and circled her bed like a presenter at a lawnmower trade show, while his audience, a half-dozen medical students in their 20's, stared at Ms. Duffy's naked body with detached curiosity, she said. "

If you or a family member has been hospitalized recently, you may identify with some of the stories and issues discussed in the article. It made me recall The Doctor, an old film in which William Hurt played a successful but brusque surgeon who learned what it feels like to have the tables turned after he gets cancer.

(* If the NYT article is archived, you may be able to access it from here with free registration.)

What happens when your injured workers visit the doctor?
Employers need to give some thought to what happens when their injured workers become patients. As Rita points out, this is a very vulnerable point for your employee and the medical milieu can be a highly confusing and frustrating labyrinth. In addition to all the regular depersonalization inherent in encounters with the medical world, employees who seek care under the banner of workers comp can be made to feel like they are somehow less worthy, second-class patients. And in a sense, they are - workers comp rates are generally discounted by fee schedules and network negotiations; further, some providers are reluctant to be involved in what they see as a potentially contentious case.

Employers that truly care about the recovery of their injured workers would do well to assume the role of patient advocate. This entails advance planning by seeking out and meeting the quality medical providers near your facilities and making these doctors familiar with your organization and your return-to-work programs. In representing your work force, you have more buying power and more influence to ensure timely service and priority care than any one individual walking in off the street would. If an employee is experiencing frustration or confusion during the course of treatment, you want to know that and be in a position to help resolve those issues whenever possible. If you don't pay attention to those frustrations, an attorney would be glad to!

Hands-on advocacy
Often, employers think that managing the relationship with providers is the job of the insurer or the contracted network, but we would argue that this is not a relationship that can be "outsourced" on the day-to-day managerial level. Employers need to be an active participant in this relationship, and to ensure that injured employees get top quality care and service. And we would add that a good place to begin is to be more concerned with quality than with discounts when seeking out a network or a doctor -- in fact, we often encourage employers to pay more to ensure good service. Cheap medical care is no bargain; a few extra dollars spent early might be the best bargain of all.



The duty of care as a patient has shifted to that of a consumer. The medical profession does not look at patients as people but a group of symptoms at best or potential litigants at worse. The burden is on us to ask questions about the diagnosis, tests, and treatment because of this. Being "cared for" is a thing of the past. Shame on us.

Im in Oklahoma.Ive done everything and gone eveywhere the company doctors have ask.Two doctors they ask to read my MRI referred me to a surgeon in OKC.This is there docs,he said looking at the MRI with another doc in the room ,we need to do this surgery as soon as possible ,THIS MAN HAS TO BE IN EXTREEM PAIN.They sceduled for two weeks from that day.Now I live 100 miles from the hospitol so I week back down 100 miles for the lab work the following week.Then the day before I was suppose to be in OKC at 9:30 in the A.M.the insurer Gallager Basset calls me at 3:45 p.m. saying they have cancelled my surgey.That I have to travel another 1oo miles to Tulsa for another opinion this is now 4 opinions ALL THERE DOCS.Well to make a long story short I was sent to a workers comp mill.The waiting room looked like a luandry mat waitng room it was degrading just to be seen in there and to evryone suprise this man said I totally dissagree with everything that every other doc has said.Ther is no way I would ever suggest a surgery from an MRI unbelieveable.Now the surgeon in OKC says we need to rescedule and move on but the insurer Gallager Basset says well have to think about this.Along with not being able to care for my family Ive traveled 6oo miles including round trips Im off work and Im hurting .Im having to beg for work comp checks like a person trying to get sothing for nothing.This is what you get when you do everything that they say.All I want is to be fixed and go back to work.What have I done to deserve this????????Im a good person .A christan man WHY!!!If someone has an answer I would love to hear it.I have three disc compressing into the spinal canal Im not a doc and I found them on the MRI without any help.ther c2 c3 c4 I wouldnt wish this pain on anyone,BUT MY MIND IS CHNGING MORE AND MORE EVERYDAY.I know I shouldnt say that but this is very trying..Thank for any help from anyone .klassyman42@aol


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About this Entry

This page contains a single entry by Julie Ferguson published on August 24, 2005 11:34 AM.

News roundup: health, safety, HR, and other stories from the blogosphere was the previous entry in this blog.

NH doc under scrutiny for trying to save woman's life is the next entry in this blog.

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