In a perfect world, every injured worker would be treated by a physician trained in Occupational Medicine, one who understands how to facilitate recovery and expedite return to work.However, it's not unusual for employers and employees to be dealing with a family or urgent care practitioner who has little or no training in Occupational Medicine.
Demand for trained occupational and environmental physicians far exceeds the supply, and the need continues to grow. In fact, according to the Institute of Medicine (IOM) subcommittee on physician shortage in occupational and environmental medicine, there currently is a dearth of 3,100 to 5,500 physicians.
All too frequently, there are horror stories about physicians asking injured employees how many days they want off work or prescribing an unnecessary or improper treatment. Constrained by inadequate knowledge, declining revenues and pressures to limit visit time, many family and urgent care practitioners know little about Workers' Compensation beyond filling out the required Workers' Comp forms.
Exacerbating this problem is that the treating physician focuses 100 percent on the injury itself, giving little if any thought, to the employer or arrangements for returning the employee back to work that could actually speed recovery There is a common bias that injured employees want time off from work and the most expeditious treatment is to give them what they want.
The end result is unnecessary costs and delays in return to work with the blame being squarely placed on the treating physician. Suspicion and frustration prevail and an antagonistic attitude develops, polarizing the physician/employee/employer relationship.
At a May 2008 symposium of the Institute of WorkComp Professionals, Dr. Michael Weizman, a board certified family physician in Asheville, N.C., presented a new perspective on the employer/employee/physician relationship. Prior to being introduced to the Institute's injury management process, Dr. Weizman's assumptions were quite typical:
- He assumed the injured patient did not want to return to work
- He also assumed that injured patients in general wanted to blame the employer and take advantage of the situation
- He further assumed the injured employee's visits would be unrewarding doctor-patient encounters
- Finally, he would more than likely give the patient whatever he/she wanted to expedite his day Dr. Weizman readily admits that he did not fully understand the mentality and motivation of the injured employee or the attitude and goals of the employer. More importantly, he had little incentive to learn more or change his ways. Although he wanted to do what was right for his injured patients, he lacked knowledge and understanding of Workers' Compensation and had not been contacted by employers who may have helped him reevaluate his thinking.
However, when he learned more about the value of managing job-related injuries, he realized his approach needed to change:
- Most injured employees want to get back to work as soon as possible
- Employers want the injured worker to receive proper care.
- There are evidence-based guidelines for various injuries and time away from work predictions that he could use
- The sooner employees return to work, the more likely they are to stay in the workforce
- Returning to work can speed recovery
- He could take a more proactive role in the process
- He could increase his job satisfaction of caring for injured patients by doing the right thing
Today, Dr. Weizman works to influence patient outcomes based on his newly developed proactive approach to Workers' Comp cases. While he is committed to expanding his knowledge, he expresses frustration that some employers are surprised by his approach and few employers are proactive in returning injured employees to work.