Communication and Personalized Care Key to Returning to Work

Todays’ healthcare practitioners face the ongoing challenge of balancing quality care and “managed” care. We must constantly strive to integrate the two in order to remain an effective provider in a highly competitive healthcare market. Even worker’s compensation claims have entered the “managed” care arena and rely on outside services to expedite a speedy recovery for injured employees.

Traditionally, these types of claims were covered in the medical hierarchy where the treating physician was viewed as the medical manager. Now, the patient care management role has expanded to include primary care physicians, case managers, insurance representatives, employers, independent medical examinations and review boards.

Obviously, there are an increasing number of players participating in the management of patient care which has resulted in increased bureaucracy and paperwork. Never before has the need for effective teamwork been as critical to quality health care.

The creation of an Institute setting, such as exists at Fox Valley Orthopedic Institute, is a natural progression toward comprehensive healthcare and the teamwork mentioned above. The Institute offers care in a single environment that includes orthopaedic specialists, state-of-the-art diagnostic tools, surgical suites, rehabilitation and other support systems under one roof.

This team approach provides important benefits to everyone involved in the healthcare process. Patients enjoy convenience and time savings. Coordination and follow-up between patients, orthopaedists, referring physicians and employers is greatly enhanced. Third party insurance carriers realize cost containment through effective management, streamlined billing and the opportunity for global surgery fees.

Obviously, most work-related injuries are not planned. Most employers go to great lengths to survey their job sites and have instituted measures to educate and prevent common injuries, such as carpal tunnel syndrome, tennis elbow or tendonitis. They may even ask for physicians, nurses and therapists to tour their facility and offer opinions on risk factors and solutions for solving potential injuries.

The majority of worker’s compensation injuries that are trauma-related often could not have been anticipated by even the most astute employer. The nature of trauma injuries are such that they do not fit well into the managed care system as trauma does not follow guidelines, is never planned or convenient and rarely occurs during traditional office hours. Comprehensive and personalized treatments of the patient by all members of the health care team are essential to a successful outcome.

Patients often perceive themselves as the forgotten player in the managed care/worker’s compensation system of today. In fact, they are the most important team player! Quality physicians and employers have realized for years that excellent patient outcomes are only as good as the rehabilitation and education effort that follows the surgery or treatment.

This is best typified through rehabilitation departments that are staffed with therapists who provide customized treatment programs that are designed to maximize the individual’s rehabilitation potential. Often, a visit or phone call by the therapist to the injured patient’s place of employment for clarification of job demands and work environment changes can clarify the patient’s status and provide an avenue of communication that allows the worker to return to work quickly.

Communicating with the team members allows physicians, therapists, nurses and employers to work together to decide on appropriate work restrictions or modifications. The recovering patient’s work schedule may be part-time initially. Regular work duties can then be gradually reintroduced as the patient regains work tolerance. This minimizes lost days from work for the employer and allows the patient to incorporate “return to work” strategies into the strengthening and recovering process of their injury. This also provides the employer with a useful and productive worker and the patient with a positive mind set for regaining full function to the injured body part.

Research supports the theory that early “return to work” (even with modifications) provides the best opportunity for patients to return to their particular job and helps to prevent a minor injury from turning into a major long-term problem for the patient and the employer.

It is also critical for the health care team to have knowledgeable and committed support staff who can work with the team to assure that all required paperwork and insurance matters are addressed, enabling the patient to enjoy the maximum benefits of their plan. Once again, communication is key.

As you can see, patients who have these types of sudden trauma injuries deserve the health care system’s best efforts as quality outcomes greatly determine the ability of the patient to resume a healthy and productive lifestyle that includes a rapid return to some sort of positive work environment. For these reasons, it is imperative that specialized health care teams led by a physician be the standard for all patients, but especially for those patients coming from the worker’s compensation population. At all times, communication and teamwork are the keys to quality care.