Our colleague Peter Rousmaniere, a regular contributor to Risk & Insurance Magazine, raises an interesting issue in a recent column. How do you establish productive lines of communication with the employee's own doctor, especially when you meet with resistance? Peter presents the recommendations of Joseph Fortuna, an occupational physician working for (pension-troubled) auto-parts manufacturer Delphi.
One of the most challenging aspects of communication is simply getting the employee's doctor on the phone. Fortuna advises talking first to the key administrative person in that doctor's office. Provide the office with the information they really need. This means faxing them the job description, along with possible accommodations that can be made for any medically necessary restrictions. If the employer is well known in the community (as Delphi certainly is), use this as part of your leverage. But even the names of lesser known employers who are motivated to bring people back to work would be helpful. The medical provider really needs to know that the employer is connected to the recovery process -- a call from an insurance adjuster carries less weight than one from an occupational doctor or the employer.
The Right Questions
Fortuna aptly points the occupational doctor -- and the employer -- toward asking the right question. All too often, a question is phrased in a way that produces an unsatisfactory response. For example:
Don't ask: "Can Mr. Jones return to work?"
Ask: "Have you specifically instructed Mr. Jones to stay out of work?"
Wrong question: "When can Mr. Jones return to work?"
Right question: "Can Mr. Jones return to work on Monday?"
Wrong question: "What are Mr. Jones's restrictions?"
Right question: "Can Mr. Jones return to work with a ten-pound lifting restriction?" (If the doctor answers "no," follow it up: "How about a five pound lifting restriction?")
In his role as an occupational medicine specialist, Fortuna often has to make calls to a treating physician. If he doesn't hear back promptly, he works through an orderly sequence of calls that increases the likelihood of a call back. Because his approach would work both for doctors and employers, I have added in parentheses some variations of his questions targeted for employers.
Day one: "Please ask Dr. X to call Dr. Y concerning Mr. Jones."
(If the employer is calling: "Please ask Dr. X to call us concerning our [valued] employee, Mr. Jones.")
Day three: "I am Dr. Y, an occupational-medicine physician in city A. I need to speak with Dr. X concerning patient Jones's work restrictions. I have a signed medical-information release from him. I need to speak to Dr. X by (day six) so that Mr. Jones's benefits will not be interrupted."
(If the employer is calling: "We need to speak to Dr. X concerning our employee, Mr. Jones. We have a signed medical release from him. We need to speak to Dr. X by (day six) so that we can get Mr. Jones back to work. Mr. Jones is an important member of the team."
Day five: "This is Dr. Y. I am still trying to reach Dr. X about Mr. Jones. I left messages on (day one) and (day three), but have not received a call back. Please ask Dr. X to call me as soon as possible."
(If the employer is calling: "This is Mr. Jones's employer calling again. We left messages on (day one) and (day three), but have not received a call back. We are very anxious to bring Mr. Jones back to work, so please have Dr. X call us by (day 6).")
You can see that Fortuna's questions attempt to build a line of communication where there is resistance. I particularly like the proactive slant built into the questions. It's less a matter of assuming the doctor has the answer than of guiding the doctor to the answer you (and the employee) really need. Savvy advice - well worth a try when the employee's doctor is reluctant to participate in the return-to-work process.