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Welcome to our blog post where we delve into the important topic of injury management and injury resources in the workplace. In this post, we will be discussing the key points from a town hall discussion featuring experts in occupational health. Dr. Larry Earle, Dr. John Koehler, Dr. Marilyn Bishop, and Dr. David Fletcher shared their insights and expertise on various aspects of injury management, including confirming compensability, reaching maximal medical improvement, implementing work restrictions, training less experienced providers, managing return to work, and addressing the changing landscape of occupational medicine. Let’s dive into the details!
Confirming Compensability:
Dr. Marilyn Bishop emphasized the importance of taking a comprehensive history to determine if an injury or complaint is compensable and covered by workers’ compensation insurance. She stressed the significance of understanding state-specific workers’ compensation laws and obtaining a written authorization from the employer to confirm the work-relatedness of the injury. Dr. John Koehler highlighted the role of medical providers in identifying potential malingering and ensuring that workers’ compensation claims are legitimate.
Reaching Maximal Medical Improvement:
Dr. David Fletcher discussed the concept of maximal medical improvement (MMI) and its role in determining the endpoint of medical treatment. He emphasized the need for clear communication with patients about their treatment progress and functionality. Dr. Fletcher suggested that the term “permanent stationary” could be used for MMI, indicating that further interventions or imaging are unlikely to change the patient’s condition. He also highlighted the importance of ongoing maintenance care for patients in order to ensure continuity and effective management of chronic pain.
Implementing Work Restrictions:
The experts addressed the question of whether work restrictions make a case OSHA recordable. Dr. John Koehler stressed the importance of having broad job descriptions in order to keep workers within a “full duty” status, thereby minimizing OSHA recordables. He emphasized the need for effective collaboration with employers to establish a clear understanding of what constitutes productive work and ensuring that work restrictions allow for real productivity. Dr. David Fletcher underlined the importance of being creative and understanding nuances in recordability to avoid unnecessary OSHA recordables.
Training Less Experienced Providers:
Dr. John Koehler highlighted the need for training less experienced providers, such as physician assistants (PAs) and nurse practitioners (NPs), in handling occupational injuries. He emphasized workshops and hands-on training, providing examples such as suturing on pig’s feet, injection models, and corneal foreign body removal on hard-boiled eggs. Dr. Marilyn Bishop emphasized the significance of onboarding programs that involve shadowing and close collaboration with supervising physicians to develop effective relationships and enhance clinical knowledge.
Managing Return to Work:
When discussing the management of return-to-work programs after an injury, Dr. Marilyn Bishop emphasized the importance of understanding the work environment and ensuring that any restrictions align with a person’s ability to perform productive work. Dr. David Fletcher highlighted the value that occupational medicine physicians bring to the table in terms of their expertise in understanding work sites and managing communication with case managers, employers, and rehab facilities. He emphasized performing second evaluations, integrating physical or occupational therapy, and the ability to provide drug and alcohol testing.
Addressing the Changing Landscape of Occupational Medicine:
The experts discussed how the increasing adoption of PAs and NPs in occupational medicine has had an impact on insurance reimbursement. Dr. John Koehler mentioned the rising trend of payers posturing to minimize compensation and pushing for case rates instead of fee-for-service reimbursement. He emphasized the need for occupational medicine providers to demonstrate their unique value, especially in return to work processes, drug testing, and breath alcohol testing, which orthopedic surgeons are less equipped to handle effectively.
Injury management and injury resources play a vital role in ensuring the health and well-being of workers in the occupational setting. By confirming compensability, reaching maximal medical improvement, implementing work restrictions, training less experienced providers, and managing return-to-work effectively, occupational medicine physicians can make a significant impact on the lives of workers and the success of their employers. As the occupational medicine landscape evolves, it is crucial for providers to advocate for the value they bring to the table in maintaining a safe and productive workforce.
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