June 23, 2008
Google throws its hat into the electronic medical records arena
Search behemoth Google is making its initial foray into the electronic medical records (EMR) business with the recent launch of Google Health. (Also see the FAQs). This service goes toe-to-toe with Microsoft's Health Vault in the race to become the web's dominant player. Some large health plans such as Kaiser Permananete have been rolling out EMR programs to members. And...May 28, 2008
Docs Give Grading System a Failing Grade
The Group Insurance Commission (GIC) in Massachusetts came up with a nifty idea: let's grade physicians based upon efficiency and competence; we'll reward those with high marks and penalize those who are (relative) failures. (The GIC administers health plans for public sector employees.) The GIC worked with the MA Medical Society (MMS) and a number of insurance carriers to come...May 16, 2008
Post Traumatic Stress Disorder: Not in This Army!
Norma Perez is a psychologist who leads the post-traumatic stress disorder (PTSD) program at a medical facility for veterans in Temple, Texas. As we read in the Washington Post, she is pretty busy with claims. Given that veterans with a PTSD diagnosis are eligible for up to $2,527 a month in disability benefits, she came up with a great way...April 22, 2008
Workers Comp: An Obligation to Get Better?
In conventional medicine, people are generally free to choose their care, up to the limits of their coverage. They can opt for certain procedures or decide to forego them. For the most part, adults are independent players in the medical system, acting in accord with their own wishes. In the final analysis, our health is an individual concern, factoring in,...March 31, 2008
The Best Health Care in the World: Part Five: A recap, a few questions, a conclusion and a modest proposal
This series is meant to paint a realistic, well-sourced and objective portrait of American health care early in the 21st century as compared with that of our 29 partners in the Organization for Economic Cooperation and Development (OECD, all of us comprising the most developed democracies in the world), and to examine how workers' compensation fits into that mix. We've...March 19, 2008
The Best Health Care in the World - Part Four: Do the Statistics Tell the Whole Truth?
We have seen that America spends more on health care than other developed democracies around the world for outcomes that, on the whole, are no better than those achieved by the average OECD country. Our health care "system" perpetuates ever-increasing spending without delivering results to justify the expense. Moreover, because of our country's isolation, both geographically and culturally, few Americans...March 17, 2008
The Best Health Care in the World - Part Three: What Do We Get for the Money?
In Part One of this series, we began looking at some of the many cost disparities between group health and workers' compensation. In Part Two, we compared US health care costs with costs in the other 29 member-countries of the Organization for Economic Cooperation and Development (OECD). OECD countries, all democracies, are considered the most economically advanced in the world....March 13, 2008
The Best Health Care in the World: Part Two - What does it cost?
In 1992 I became a Trustee of a major, tertiary care, teaching hospital in Massachusetts. For Trustee indoctrination, new Trustees spent a week in a classroom learning about every facet of hospital life. One morning we were briefed by the hospital's CFO. I was astonished to learn that the hospital had 27 different billing systems, one for each insurer and...March 11, 2008
The best health care plan in America
In 1986, US workers' compensation medical costs were 44% of total incurred loss dollars. Ten years later, the percentage had grown to 48%. By 2006, medical costs amounted to 58% of total loss costs. And today, nearly a third of the way through 2008, they hover around 60%. The annual workers' comp medical cost rate of growth is nearly double...March 6, 2008
Wonk, Wonk: Health Wonk Review is Here
Health Wonkery runs a wide gamut this week: we have big Pharma front and center with cowardly marketing, poison in the pills and a controversial study that finds a racial factor in whether meds are taken properly; we have extremely divergent views on health care reform, from single payer and a big role for government to status quo and no...February 19, 2008
PPOs: Size Matters but Quality Rules
Our colleague Peter Rousmaniere has a fascinating article on PPOs in the current issue of Risk & Insurance magazine, entitled "Has Competition Vanished?" Coventry has become the 900 pound gorilla of workers comp medical services, with 4,700 hospitals and 580,000 doctors. Through the aggressive use of acquisitions and partnerships, Coventry is approaching monopolistic status. The question, of course, is what...February 14, 2008
Pro Football and Workers Comp: A Violent Collision?
Chad Hennings spent nine years as a lineman for the Dallas Cowboys. He accounted for 28 sacks, 6 fumble recoveries, 4 return yards and 1 touchdown in 107 games before retiring after the 2000 season. He also suffered permanent damage to his back. The question is whether or not his work-related back injury is compensable under the Texas workers comp...January 7, 2008
Surgical Implant/Ethical Bypass: The Story of Dr. Chan
The Insider has often speculated about the thought process of medical providers, so we are very interested in case of Dr. Patrick Chan, a neurosurgeon working out of Searcy, Arkansas. The Canadian trained doctor has pleaded guilty to charges of demanding and accepting kickbacks from surgical implant maker Blackstone Medical of Springfield MA, a subsidiary of Orthofix International. Dr. Chan...December 4, 2007
Awake in the Dark: The link Between Shift Work and Cancer
In yesterday's post, Julie Ferguson mentioned a recent study that directly links night shift work with certain forms of cancer. The International Agency for Research on Cancer (IARC) is about to list shift work as a "probable" carcinogen. This will put shift work into the same category as anabolic steroids, ultraviolet radiation and diesel engine exhaust. The potential number of...November 15, 2007
New Health Wonk Review, ably hosted by Maggie Mahar
Maggie Mahar of Health Beat has posted a fresh edition of Health Wonk Review, which is ready for your perusal. With the political season upon us, HWR has been quite lively of late, as participants debate the various health plans that candidates throw into the public arena. This week is no exception, with posts commenting on ideas put forth by...November 14, 2007
Mental Health Parity: Not in Workers Comp
There is a bill pending in the US Congress to require parity between mental and physical health benefits. The bill is a follow up to similar legislation passed in 1996, which was severely limited in scope: Employers did not have to provide any mental-health benefits. Copays and deductibles could be higher for mental-health expenses. Visits could be limited. And small...November 1, 2007
No "Trick or Treat" for Health Wonks
The "anti-Halloween" edition of Health Wonk Review is up, hosted by Hank Stern at Insureblog. It's truly amazing. If you've never sampled this pot-pourri of health-related blogs, now is the time. It doesn't get any better than this witches's brew of historic events and contemporary thought. Bravo, Hank. (And no, I did not know that it was on this day...June 14, 2007
Health Wonk Review #34
For the latest reads on health policy issues - everything from Armageddon to the uterus - head on over Health Business Blog. David Williams has done a masterful job in compiling the latest Health Wonk Review. David's blog is always worth a read, too. We enjoyed the recent podcast and transcript of an interview with Rudy Rupak, Founder and President...May 29, 2007
Ashes to Ashes, Dust to Compensability?
Felicia Dunn-Jones was a civil rights lawyer who worked one block away from the World Trade Center. She fled the office on 9/11, inhaling dust from the falling towers. She was covered with ash laced with asbestos and other hazardous material as she ran for safety. Now, nearly six years later, over five years after her death, New York City...May 16, 2007
Workplace disabilities are on the rise
Unhealthy worker lifestyles and an aging work force may portend trouble on the horizon for the nation's employers. A recent article in The Wall Street Journal points to the disturbing trend of long-term worker disabilities that are accelerating at a rapid pace. This comes at a time when employers may be facing labor shortages with the impending retirement of the...May 15, 2007
OxyContin: On the Fault Lines of American Healthcare
Three executives of Purdue Pharma have agreed to pay fines totalling $635 million to resolve charges relating to the marketing of Oxycontin. The company admits to understating the risks involved with this potent drug and to deliberately misleading doctors and the public about its addictive qualities. From 1996 to 2001 the company claimed that Oxycontin was a "miracle" drug, safer...May 1, 2007
Managing Pain: Dr. Feelgood's Hard Time
A jury in Alexandria VA recently found Dr. William Hurwitz guilty of 16 counts of drug trafficking, determining that he prescribed massive quantities of medicine to patients in chronic pain. The 12-member jury acquitted Hurwitz on 17 other trafficking counts, but Hurwitz faces up to 20 years in prison for each count on which he was convicted. He will be...April 24, 2007
Obesity in Workers Comp: Duke Sounds the Alarm
Duke University recently published a study of its own employees, which found a significant link between obesity and the cost of workers compensation. The analysis found that obese workers filed twice the number of workers' compensation claims, had seven times higher medical costs from those claims and lost 13 times more days of work from work injury or work illness...February 28, 2007
Health literacy: employees at risk
Last week, Ezra Klein put the issue of health literacy back on our radar screen with a link to a recent Washington Post article, A Silent Epidemic. The article discusses the complexity of the health care system, and how a huge swath of the population is unprepared to effectively engage that system because of functional illiteracy, language, or culture. The...February 8, 2007
It's Health Wonk Review day - 25 and counting
David Harlow of HealthBlawg is the excellent host of this week's Health Wonk Review and he notes that it is our silver anniversary, the 25th edition. We have a fine host for such a momentous occasion, too - his post is a thing of beauty, he has done a masterful job of providing context for all the entries. For those...February 5, 2007
The Saga of Ted Johnson: Sports Medicine with a Bitter Taste
Ted Johnson was a linebacker for the New England Patriots. His specialty was stopping the run. As any viewer of the recent NFL playoffs knows, run stoppers use their heads: first, to think strategically -- where to go in the course of a given play - but then literally: torpedoing head first into the body of an opposing player. That's...January 25, 2007
Wonk! Wonk!
The latest edition of Health Wonk Review, hosted by Jane Hiebert-White at Health Affairs, is up. Jane has done a terrific job of weaving together many disparate threads, all timely and all resonating with interesting implications for risk management, insurance, business and government. There are plenty of viewpoints among the talented participants. Whether your interest is national and state policy,...January 19, 2007
NFL Preview: Bigs Hits, Big Trouble
As we head toward the climax of the football season, with just four teams left on the path to the Superbowl, we read in the New York Times (registration required) that the big hits we cheer for may be causing permanent damage. In November, Andre Waters, a 44 year old former safety for the Philadelphia Eagles, killed himself. He may...January 12, 2007
Treating Strains and Sprains: Don't Just Sit There, Get Moving!
Gina Kolata has a provocative article in the New York Times (free registration required), which outlines a very proactive approach to the treatment of strains and sprains. Dr. William Roberts, a sports medicine specialist, says "we want to keep you moving." Dr. James Weinstein, an orthopedic surgeon, hurt his back while lifting a box. He was in a lot of...January 3, 2007
The quiet crisis of diabetes in the workplace
If you were spending more time lounging with family and friends on the day after Christmas than reading the paper, you might have missed an important health article in The York Times about the tangle of laws confronting diabetics in the workplace. According to the article, diabetes accounts for nearly 5 percent of the 15,000 annual complaints that the Equal...December 21, 2006
Conventional Health and Workers Comp, Part Two: Why Health Care Under Comp Costs More
We recently blogged the beginning of a national dialogue on universal healthcare. Because we focus our attention on the workers comp perspective, we pointed out that any national health plan will come up against - and in some ways run contrary to - the long-established, state-based workers compensation systems. The National Council on Compensation Insurance (NCCI) recently published a study...December 15, 2006
The Wyden Bill for Universal Health Care:The (Hidden) Comp Dimension
Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning. Winston Churchill, November 1942 When it comes to universal health insurance, we'll have to push the Churchill quote back even further. Senator Ron Wyden (D-Oregon) has proposed a new bill that at least brings us to...December 1, 2006
Where There's Smoke, You're Fired, Revisited
In March of 2005 we blogged the issue of firing people who smoke. At that time, we wrote about the strict non-smoking policies of Weyco, a company in the health care field. When you're in health care, prohibiting smoking is a logical extension of your fundamental business. But what if you're in the lawn care business? Can you still fire...November 8, 2006
Cover-All's Cover Up: Big Time Premium Fraud in California
Cover-All, Inc, bills itself as the nation’s largest full service flooring installation and refinishing contractor. They have over 1,500 employees in 30 states. Here's how they describe themselves: We're the people who install floors for Home Depot in 17 states. The Home Depot utilizes Cover-All's residential installation services for all trades exclusively in over 300 stores across the country. Our...October 11, 2006
Employers increasingly turning to on-site medical clinics
In an effort to control skyrocketing medical costs, many employers are now providing on-site access to primary medical care. A recent article on workplace medical clinics in the Orlando Sentinel discusses the national trend and how it is in evidence in central Florida. "According to a recent survey by the global consulting firm Watson Wyatt, 22 percent of large companies...October 3, 2006
Sign of the times: medical tourism
If the term "medical tourism" hasn't crossed you radar screen yet, it will soon because tens of thousands of your fellow citizens are now traveling to India, Malaysia, Thailand, and Turkey to have surgery performed at bargain basement prices. There are even medical tourism agencies cropping up to help prospective travelers match the right destination with their medical needs and...October 2, 2006
"Crackberry" Addicts: One More Email for the Road...
It's only Monday, so it might be too early in the week for this. But the Insider is committed to keeping our readers informed on the latest developments in risk and human resource management. Today, we confront the physical, emotional and legal time bomb of BlackBerry addiction. We first tracked the health implications of using tiny keyboards in our "BlackBerry...September 28, 2006
Morbid Obesity: What Should Employers Do?
We recently blogged a ruling in the U. S. 6th District Court, in which the judges determined that morbid obesity is generally not a disability. The judges’s thinking in this particular case appears to have powerful implications for the ADA and for all employers with obese workers who have difficulty performing their jobs. HR professionals might be tempted to assume...July 28, 2006
Health Wonk Review #12
Tim Gee at Medical Connectivity Consulting is hosting Health Wonk Review #12 - and he has a baker's dozen of meaty posts from around the health policy blogosphere. Well worth a visit!...July 26, 2006
Summer reading: planning for the next pandemic
Pandemics seem to be the topic of the month. Risk Management's July issue contains an article by Darrell Knapp on Avian Flu: Bracing for a Pandemic, which analyzes the potential effects of a pandemic on various lines of insurance, along with action steps that insurers should take to mitigate risk. Essentially, the article states that a pandemic would strain but...July 24, 2006
The Drug Management Learning Curve and Some Snake Oil
It's Monday morning, as good time as any for thinking about drugs. NCCI has issued an interim update of its comprehensive study (PDF) of drugs in the workers comp system. They find that drugs as a percentage of total costs continue to rise, but at a slightly slower rate. There appears to be a slow but steady uptick in the...July 13, 2006
Health Wonk Review #11
Jason Shafrin at Healthcare Economist is hosting the eleventh edition of Health Wonk Review. Do you know what HSA, RHIO, and CDHC stand for? If not, you can join the ranks of the enlightened by reading today's issue - Health Wonk Review is a good way to keep current on trends and emerging issues in health care and health care...June 29, 2006
Big Pharma's Charity: It's Better to Give and Receive
Let's say someone offers to pay you to do some research about their product. You set up a non-profit research entity and deposit their hefty check. What would your goal be: to prove the product ineffective? to discourage people from using it? Not likely. But how would you determine the extent to which the source of your funds contaminates the...Health Wonk Review #10
Emily Goodson and Jack Mason at HealthNex have done a great job hosting Health Wonk Review #10, which is now up and ready for your perusal. HealthNex, if you are not familiar with it, is a blog " ... by IBMers and Friends on Networked, Patient-Centric Healthcare," covering such interesting topics as electronic health records, health information exchange, clinical transformation,...June 15, 2006
Health Wonk Review #9
We're honored to host Health Wonk Review #9 here at Workers' Comp Insider. Health wonkery is part of a long, fine tradition of social commentary on medicine, medical providers, and health care delivery systems. Witness the entertaining online exhibit from the University of Virginia Health System, Very Ill: The Many Faces of Medical Caricature in Nineteenth-Century England & France,...June 2, 2006
Announcing Health Wonk Review #8
Health Wonk Review #8 - the trailblazing issue - is posted at The Medical Blog Network. Check it out - many interesting posts from some of the best and the brightest in the health wonk blogosphere. Kudos to Dmitriy Kruglyak who has done a superb job hosting. Note that he has introduced a new format and process for submitting entries...May 31, 2006
Deep Vein Thrombosis: Immobility in the Age of Travel
One of the ironies of modern life is that we can go anywhere in the world, but we often find ourselves immobilized in the process. There are a number of circumstances that render us immobile: long haul air travel - 4 plus hours (on a bad day, that might be just runway time!). Sitting in a traffic jam or driving...May 24, 2006
Preconceived notions and Mental Disablility: The Tale within a Tale
The way we react to a news item often depends upon our pre-conceived notions. We all have an innate sense of what is good and just, tasteless and outrageous (although your "outrageous" might be my "humorous"). Our fellow bloggers at "Overlawyered" scan the news for indications that our over-litigious society is out of control, with greedy lawyers in eternal pursuit...May 23, 2006
Are you feeling wonky this morning?
If so, you're in luck. Hank Stern at InsureBlog is hosting Health Wonk Review #7. Drop by for your biweekly ration of the best-in-class blogging on health policy, infrastructure, insurance, technology, and managed care....May 8, 2006
United we Fall: Preparing for the Next Pandemic
The Insider is determined to do its part in preparing the nation for a flu pandemic. Although the President did not specifically mention bloggers in his mobilization plans, we think that blogs offer a unique tool for getting out the word and for maintaining communications under adverse circumstances. Best of all, you don't have to come within three feet of...April 20, 2006
Docs on Disability
The Insider has long puzzled over the decision-making process of doctors treating injured workers. Why do they rely so heavily on expensive pain killers when over-the-counter medicine might do the job just as well? Why do they choose one knee replacement part over another? Why are so many doctors quick to certify a disability, when the injured worker retains much...Health Wonk Review #5
Fard Johnmar of Envisioning 2.0 gets some help from an illustrious wonk in hosting the latest carnival of the creme de la creme of recent health policy-related blogging - Health Wonk Review #5. Plan to stay awhile - lots of good reading!...April 11, 2006
The long tail of WTC toxic exposures
Health experts predict that the health implications for the workers involved in the World Trade Center cleanup will take more than 20 years to be fully evident. A recent article in the PhillyBurbs discusses the frustrations that sick workers and health authorities alike are having in trying to come to grips with the health ramifications of post 9-11 cleanups. The...April 6, 2006
The day of the wonks
For those of you who have been waiting with bated breath to get your next heaping helping of health wonkishness, David Williams of Health Business Blog does a fine job of hosting the fourth and latest edition of Health Wonk Review. Some good reading!...March 30, 2006
The odds of health care quality
DB's Medical Rants discusses an L.A. Times article that reports on a recent study in the New England Journal of Medicine about quality of health care. The study shows that, rich or poor, most people only get the right medical care about 50% of the time. This study didn't deal with access of care; rather, it looked at the care...March 23, 2006
Health wonks rule
Grab a cup of coffee and drop by Kate Steadman's place over at Healthy Policy blog to read the third edition of Health Wonk Review. Kate does a stellar job explaining why health wonks often don't get the recognition they are due. There's a great collection of wonky posts from the brightest in the blogosphere. If you care about health...March 3, 2006
A Note to Fellow Immigrants
Franklin Roosevelt may or may not have begun an address to the Daughters of the American Revolution with the memorable line, "Fellow Immigrants." (A curmudgeonly blogger says a reporter made up the quote.) If Roosevelt didn't say it, he should have. It's a great line and perhaps more compelling than ever. The current debate over illegal immigrants - as fractious...February 23, 2006
Preparing for Avian Flu
While risk managers might be tempted to ignore the potential disruption associated with a world-wide avian flu pandemic, they are paid to think about the unthinkable. So today as a public service, the Insider hopes to stimulate some disaster planning among our readers. Even with the prospect of millions dying in a few days or weeks, businesses need contingency plans,...February 21, 2006
To War and Back Again
The good news from Iraq (OK, there isn't much) involves the dramatic improvement in battle-related trauma treatment. Soldiers are surviving injuries that in prior wars would have resulted in certain death. So far, over 15,000 soldiers have been injured since the fighting began in March 2003. By the time major military operations have been completed, more than two million soliders...February 7, 2006
Avian Bird Flu: When Second Class Workers Meet a First Class Hazard
[Warning: This is not appropriate reading for bedtime.] I'm not sure where the complacency about undocumented workers comes from, but I suspect that it's a combination of racism and economics. We tolerate the presence of these second class workers because it results in cheaper products and services for us, and because we don't really have to look at these struggling...February 1, 2006
Wired for Trouble: Blackberry Thumb, Cell Phone Elbow, IPod Ear
The Insider has warned tech-savvy readers that many of our indespensable gadgets can be the source of injuries. A year ago we wrote about Blackberry Thumb, to which we now return. Perhaps this is risk management on a small and highly personal level, but it's risk management nonetheless. Despite the fact that few people seem concerned, in the interests of...January 25, 2006
The Doctor's Brain Revisited: Wallets and Body Parts
As part of the Insider's relentless effort to understand what goes on inside a doctor's brain, today we examine the choice of hardware for spinal implants. When a doctor does an implant, which product does he or she use? Is the decision based upon the merits of the product, or are there extraneous factors such as financial incentives (i.e., bribes)?...January 18, 2006
Quit smoking! Lose weight! Boss or Big Brother?
In the face of rising health care costs, employers are getting more and more aggressive about targeting employee lifestyle issues. Last week we linked to an item about Weyco, a company that is fast becoming the poster child for companies that are implementing behavior modification programs to reduce health risks. Last year, Michigan-based Weyco raised a hue and cry by...December 22, 2005
Thinking about Pain
About a year ago the Insider cautioned people to view snow shoveling as a risk-laden form of heavy lifting. Recently New England experienced a storm of surprising ferocity. I shoveled once, I shoveled twice, and then, all dressed and showered and heading out for a Christmas party, I found that municipal plows had once again closed up the end of...November 29, 2005
Pom Poms for Drug Sales
The Insider has long puzzled over the way controversial drugs become industry favorites in the workers comp system. In a previous blog, we described the fancy dinners sponsored by drug companies, where doctors listened to a colleague describe symptoms and the presumed prescription cure. At that point, it appeared that the path to the doctor's brain (where prescriptions are determined)...November 8, 2005
Grand rounds: a smorgasbord of the medical blogs
Want to sample some interesting new blogs and find out what the hot news and trends are in the medical arena? This week, Rita Schwab at MSSP Nexus is hosting Grand Rounds, a rotating weekly roundup of eclectic posts from medical bloggers. Even though none of us at Lynch Ryan are medical providers, Rita was kind enough to ask us...October 12, 2005
Genetic Testing, Part Two: The Heart of an Athlete
Yesterday's blog concerning genetic testing has prompted some thoughtful responses from our readers. It has also led to further research into the current and rather compelling story of Eddie Curry, a highly touted young center for the Chicago Bulls. Curry missed the last 13 games of the season and the playoffs due to a heart problem. The Bulls wanted him...September 22, 2005
Where Workers Comp and Health Care Rationing Converge
While the Insider tends to focus on trends relating to workers comp, our esteemed colleague Joe Paduda tracks health care at his Managed Care Matters blog. You don't have to follow health care for very long before it converges on comp. We've been here before and we will be here again. Rationing Health care in this country is already rationed,...August 31, 2005
Bedside Manners
Let's paraphrase an old joke: a woman walks into the doctor's office for an examination. "You're too fat." the doctor says. "I want a second opinion," says the woman. "You're ugly, too," says the doc. An interesting firestorm is brewing in New Hampshire over the comments of Dr. Terry Bennett, a Harvard trained physician who prides himself in "telling it...August 26, 2005
NH doc under scrutiny for trying to save woman's life
Earlier this week, the Trust for American's Health issued a new report on obesity in Anmerica with the disturbing news that about 25% of American adults are obese. Health Daily News Central has more information on the details of this report. We've also previously blogged about obesity and workers comp. About the same time this report was released, the news...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...July 20, 2005
Vioxx: The Trials Begin
The first of what promises to be thousands of lawsuits pertaining to Vioxx is currently underway in Angleton TX, a town of 18,000 people. According to an article in the New York Times (registration required), famed plaintiff attorney W. Mark Lanier has zeroed in on a letter sent by Merck to physicians in 2001 which significantly understates the heart risks...July 15, 2005
Inside the Doctor's Brain
The Insider is intrigued by the decision-making process that leads a doctor to prescribe a particular drug -- say, oxycontin, a potent and addictive pain killer -- as opposed to some other medication for a work-related injury. Oxycontin was orignally developed for the extreme pain of cancer but quickly migrated to an almost routine use among workers with strains and...July 8, 2005
Workers Comp Drugs: Paying too much...For the Wrong Medicines!
We have long been intrigued by a number of conundrums relative to drug prescriptions in the workers comp system. Why are exotic brand name drugs prescribed so frequently, when effective generics are readily available? Why are doctors so quick to adopt "off line" uses for exotic drugs, endorsing unconventional applications for very expensive medications? What accounts for the remarkable success...June 27, 2005
Morbid Obesity: One Man's Tale
David Montgomery, a staff writer for the Washington Post, has written a moving and intimate article (registration required) about John Keitz, who weighs 625 pounds (down from his maximum weight of 781 pounds). The article is accompanied by a remarkable set of photographs, which you should be able to link to at the article. Keitz is so heavy his legs...June 21, 2005
The Aging Workforce - Iceberg, Dead Ahead
The aging of the American workforce is a dynamic that we have been tracking closely. I can personally swear that as one ages the body begins to wear down. Oh, that this truth were not so. In my father's day, it was common for people (mostly men) to work until age 65 and then retire on the proverbial company pension...June 10, 2005
We're Number 1...in Mental Illness?!
The National Institute of Mental Health recently issued the findings of its $20 million study of mental health in the United States. Parallel studies are taking place in 27 other countries, but even though these studies have not yet been completed, the National Institute of Mental Health is ready to declare us the winners. "We lead the world in a...May 24, 2005
Pre-existing conditions and second injuries
Over the weekend, one of our regular readers left a comment in another post asking for information about work injuries that are aggravated by a pre-existing condition. At one time, most state laws had Second or Subsequent Injury Funds (SIFs) that offered some measure of recovery to employers/insurers for injuries that were exacerbated by a pre-existing condition, whether that condition...May 16, 2005
Drug Prescription Hit Parade: Ka-Ching go the Strings...
Lately we've been thinking a lot about drugs. According to a study released by NCCI last year, prescriptions are taking an increasing portion of medical care in workers compensation: rising from about 6.7% of total costs in 1997 to 12.1% in 2002. The precentage today is probably higher than that. So what? Is this really news? The LynchRyan focus is...May 11, 2005
Recognizing and preventing occupational disease
The Canadian Centre for Occupational Health and Safety (CCOHS) recently held a national forum on Recognizing and Preventing Occupational Disease. and as a part of that forum, delegates participated in workshops where they developed new strategies for dealing with occupational disease. The preliminary results of these forums are posted as survey recommendations under the following categories: Infectious DiseasesOccupational CancerRespiratory DiseasesStressWorkplace...April 13, 2005
Docs and Jocks: Exclusive Remedy for a Pro Football Player
I set out this morning to blog the general status of "exclusive remedy" in the workers comp system, but I've been distracted by a specific case which involves an injury to a professional athlete. I will return to the more general ramifications of "exclusive remedy" in a few days. Greg Lotysz was a lineman for the New York Jets. In...April 4, 2005
Workers without Health Insurance
As the costs of health insurance rise, the number of people who cannot afford it rise, too. An article in the Los Angeles Times (registration required) addresses the issue of people spending more of their income on health insurance, to the point where they can no longer afford coverage. Working families are devoting as much as 25% of their income...March 29, 2005
Post Traumatic Stress: How do people heal?
In this country, when traumatic events occur, we send in the counselors. Whether it’s a school shooting, a tragic fire or violence in the workplace, counselors are routinely sent in to help survivors deal with the trauma. Is that the best way to help people heal? Is it a universally accepted response? After a recent conference in Rome called "Project...March 22, 2005
Obesity and Workers Compensation
A little while back we blogged the conundrum of smokers, whose habit, while not illegal, does impact their over-all health and their ability to recover from injuries (whether work related or not). Today we’ll look at obesity: another physical condition that can severely impact the recovery time of injured workers. Obesity and Discrimination As with smoking, obese individuals are generally...March 14, 2005
Where There's Smoke, You're Fired
On a bitter cold day in the dead of winter a few years back, I drove into the underground parking garage of a major insurance company. There were dozens of people huddled outside the elevators. I first assumed that there was a fire drill and the building had been evacuated. On second look, I discovered that these were employees...January 28, 2005
The Smallpox Conundrum
Remember smallpox? At the height of concerns about terrorism following 9/11, the federal government proposed that health care providers and first responders get vaccinated against the disease. The lack of response, as they say, was deafening. Recently there was a privately-funded simulation of a smallpox incident in the news. Headed up by former Secretary of State Madeline Albright, the exercise...January 13, 2005
Sleepy Docs Revisited
Back on November 15 and 16, we blogged the problem of sleep deprivation for interning doctors and the potential negative impact on the treatment of injured workers. Interns are routinely on call for over 30 consecutive hours. Once beyond about 16 hours, they are more prone to making mistakes. Given that these sleep deprived doctors staff our emergency rooms, which...January 12, 2005
Technophiles take note: medical gadgets galore
OK, all you early-adapter occupational docs, case managers, and healthcare professionals - or anyone else with a penchant for technology - here's a fun site to add to your bookmarks: Medgadget is a weblog featuring the latest medical gadgets and technologies. A sampling of recent posts include an AutoPulse resuscitation system, a pill sized thermometer that monitors body temperature and...January 11, 2005
Poppy Seeds and Drug Testing: False Positives?
Many employers are aggressively testing job applicants and employees for drug use. According to a brief article in today's New York Times (registration required), it is now scientifically proven that poppy seeds can cause false positives for opiate abuse. Poppy seeds come from the same plant that produces heroin. Arnahad O'Connor points out that "eating a couple of bagels heavily...December 17, 2004
Study reports black workers compensated less for back injuries
A Saint Louis University study that appears in the December issue of Pain reports that black Americans who suffer work-related back injuries are compensated less for their injuries than white people in similar situations. "The implications of these differences are sobering. Even though patients have equal access to health care through the worker's compensation system, there are substantial differences in...December 16, 2004
Top 10 backbreaking jobs
According to the American Chiropractic Association (ACA), back pain is one the most common work-related injuries in the United States, accounting annually for approximately one-quarter of all lost or unproductive workdays. What do ACA members consider to be the most backbreaking jobs? Heavy truck and tractor-trailer drivers top the list, followed by construction workers, landscapers, police officers, farmers, shingle roofers,...November 18, 2004
Prolonged PC use may cause glaucoma
Does heavy computer use increase the risk for glaucoma? Yes, according to a study by the University of Japan at Toho. The study was conducted with 10,000 office workers who are heavy computer users: “… the researchers found that those who were short-sighted and sat in front of computer screens for long hours were at significantly higher risk of developing/having...October 22, 2004
15 medical conditions driving cost increases - many can be managed
The August issue of Health Affairs carried a recent study issued by Emory University revealing that more than half the overall growth in cost of health-care spending could be attributed to the 15 most costly medical conditions. The study notes that many of these conditions are preventable or manageable conditions through interventions. The 15 costly medical conditions (chart) accounted for...October 15, 2004
Preparing for Flu Season
With the dramatic shortage of flu vaccine, employers are facing some daunting problems this coming flu season. The limited available shots will go to high priority populations: very young children, the elderly and the chronically ill. For relatively healthy people, flu shots are unlikely to be available. This means, in turn, that the average workplace is much more likely to...October 10, 2004
Oxycontin and Workers Compensation: Prescription for Trouble
There is an interesting convergence of issues concerning the pain killer, Oxycontin. Originally developed to combat cancer pain, Oxycontin has been aggressively marketed over the past three years by its manufacturer Purdue, to the point where the drug is now the pain-killer of preference for work related injuries. This drug is twice as powerful as morphine and, while not technically...September 27, 2004
Out in the cold; America's cold war energy workers
For energy workers in the United States, the cold war is nowhere near over. Why? Because the Energy Department (DOE), the Department of Labor (DOL) and the National Institute of Occupational Safety and Health (NIOSH) seem to be playing "keystone cops" with the lives of thousands of these American citizens. Hang on. This is not a pretty story. During the...September 2, 2004
Mosquitoes and Workers Comp
A Brockton, Massachusetts, man recently succumbed to eastern equine encephalitis, a mosquito transmitted disease that, while rare, is fatal in 35% of cases. The Associated Press report, carried by the Boston Globe online edition, notes that the 60 year old man worked as a landscaper. Subsequent tests of standing water in the area where he was working (southeastern Massachusetts) showed...August 24, 2004
Controlling the high cost of prescription drugs
Industry trends point to a consistent decline in claims frequency, but a disturbing trend towards increased severity. In other words, the number of claims is trending down, but the cost of claims is trending up. Part of this is due to skyrocketing medical costs. Claims costs include both wage replacement and medical benefits. Historically, wage replacement has represented the larger...August 13, 2004
When the Employer Plays Doctor
The Associated Press has a fascinating story of a lawsuit being brought against UPS by a former employee who was ordered by UPS to stop taking a legally prescribed medication for anxiety. The story reveals that the employee had completed an alcohol treatment program (and thus likely qualifies as an individual with a disability under the Americans with Disabilities Act)....August 2, 2004
Boston pilot to import prescription drugs from Canada
In the continuing saga of the high cost of prescription drugs, a report in Business Insurance last week announced that Boston launched a drug reimportation program. It's a pilot program so far, but in taking this step, Boston becomes the largest municipality to defy federal law against drug imports. The pilot is currently restricted to Boston employees and retirees. Mayor...May 13, 2004
Cover the Uninsured Week
Thanks to Ross at The Bloviator for informing us that we are midway into the Cover the Uninsured Week, and that more than 20 million workers lack health insurance. Ross provides a link to a 57-page state-by-state analysis of Americans without health insurance (PDF) commissioned by The Robert Wood Johnson Foundation (RWJF) and conducted by the State Health Access Data...April 18, 2004
Reducing medically unnecessary disability
Any regular visitor to Workers Comp Insider would know that we are not ones to minimize the seriousness of workplace injuries, and we bemoan the frequency with which work injuries occur. Essentially, we believe that if American businesses can aspire to total quality management and zero defect philosophies for parts and processes, they can do at least as well for...April 16, 2004
A health literacy crisis looming?
A few weeks ago, we featured an article that discussed the need for cultural competence in healthcare - "the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients." More recently, The Health Show pointed us to a recent report by the Institute of Medicine (IOM) suggesting that 90...April 11, 2004
Trading tax cuts for health care?
How important is health care to the average American? We certainly knew it was important, but an article in bizjournals about a recent poll on health care conducted by the Commonwealth Fund drove the point home: It is apparently important enough that "62 percent of Americans would be willing to give back all of the recent federal tax cuts in...March 29, 2004
Cultural competence in healthcare and beyond
Is your workers comp provider network culturally competent? If not, you may fostering needless disability. Georgetown University's Center on an Aging Society has an excellent article on the issue of cultural competence in healthcare, and defines the concept as "the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of...March 9, 2004
Number of uninsured workers at large employers growing
Human Resource Executive's Workindex reports that the ranks of uninsured workers at large firms - companies with 500+ workers - have been growing at a rapid rate. According to a recent report - The Growing Share of Uninsured Workers Employed by Large Firms (PDF file) - issued by the Commonwealth Fund, the proportion of uninsured workers at large firms increased...February 29, 2004
IBM cancer lawsuit - exclusive remedy, workplace illnesses, and technology industry exposures
Last week a jury found in favor of IBM by denying damages in a suit filed by two retired workers. The workers alleged that exposure to chemicals and toxins at an IBM plant led to cancer. This case points to several issues that should be of interest to employers and to those of us who work in the field of...States ask drug firms to report gifts to individual physicians
In an attempt to control rising drug costs, four states - Maine, Nevada, New Mexico, Vermont - have legislation requiring pharmaceutical representatives to report on marketing expenditures to physicians. Ten other states are currently considering such legislation, while six other states have rejected similar legislation. "The first step state lawmakers are taking is requiring companies to report how much sales...February 22, 2004
Toxic mold and workers compensation: an issue for your watch list
The Sebastian, FL police station recently dealt with 21 toxic mold claims from employees who allegedly became ill from mold at the station. Fifteen cases were dismissed or settled for small amounts; another six involved lump sum settlements. Toxic mold is an issue to watch. It's a potentially explosive issue, and some in the industry liken it to asbestos or...February 11, 2004
A new prescription for back pain
I have long suspected that the way this country treats back pain for work-related injuries is not only ineffective, it's actually destructive. I have seen countless back claims degenerate into permanent and total disability following surgery. We are now beginning to see data that bears this out. In an article with profound implications for employers, insurers and workers with lower...January 29, 2004
Study shows active recovery fosters return to work
A recent study on lower back pain and return to work was conducted by a Dutch research team, and the findings were unsurprising to those of us who espouse the idea of an active rather than a passive recovery whenever possible. In the study, workers with nonspecific low back pain who engaged in a graded activity program returned to regular...January 28, 2004
Economic downturn effects changes in health insurance coverage
Thanks to Pulse for pointing us to the study Changes In Health Insurance Coverage During The Economic Downturn: 2000 - 2002. The study reports that the uninsured population has grown by 3.8 million during that time period. Low-income Americans, particularly males and nonparents, fared the worst, as gains in public programs failed to offset lost employer-sponsored coverage. Look to the...January 12, 2004
NCCI report: frequency trending down; severity trending up
Last week, NCCI reported on a recent study on workers' compensation claim frequency and, as they reported last year, frequency continues to decline. They cite several potential reasons for this - employer safety initiatives, increased use of robotics and power assisted processes, and ergonomics, to name a few. Here is a breakdown by size of claim - note that the...January 6, 2004
More on the prescription drug saga
The story continues to unfold as the FDA says "nix" to states and cities seeking to import prescription drugs from Canada to get relief from onerous pricing here in the U.S. No states are actually importing drugs yet, but many say they will fight the FDA ruling. The cities of Springfield, MA and Montgomery, AL are both currently running programs...January 4, 2004
New year's news roundup from fellow 'blogs
PA Judge Robert Vonada of PAWC points to an article in the New York Times about two different treatment options for back pain and the methods hardware manufacturers use to market their products to doctors and hospitals. Would you be surprised to learn that the more expensive treatment is prevalent, despite lack of evidence that it is more effective? We...December 28, 2003
Business blog added to linklist
We're adding Small Business Trends to our "blogroll" over to the right. It's a weblog that tracks trends impacting small and midsize businesses. While not specific to insurance, it appears to have varied and interesting content. One recent item of note is a posting on Forrester Research's top 10 predictions for healthcare in 2004....December 16, 2003
HIPAA Blog added to sidebar
Workers' compensation, insurance, workplace health & safety and HR weblogs are far and few between so we were delighted to chance upon the HIPAA Blog. This is a weblog that bills itself as "a discussion of medical privacy issues buried in politcal arcana." Besides frequent news updates, it has an impressive list of links to HIPAA-related resources. (for the unitinitated,...November 18, 2003
Job-related hepatitis C infections are hard to prove
The likelihood of contracting hepatitis C from a single, contaminated needle stick is small, perhaps 2 percent or lower. But the number of accidental needle sticks and other skin punctures each year is high - 380,000 to 600,000, according to the Occupational Safety and Health Administration. Still, many workers have little hope of getting their treatments or doctor visits covered...October 23, 2003
Ouch! Pain drugs or drug pains?
The Bloviator points us to the fifth article in an excellent series on prescription drugs that ran in the Washington Post. This article deals with the millions of Americans who are turning to Mexico to curb rising drug costs - a practice not limited to consumers. In their quest to secure prices that are 20 to 70% cheaper, some municipalities...October 22, 2003
