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For more information, contact:Joanne Swanson
For Immediate Release
(847) 384-4035, [email protected]Paula Poda
(847) 384-4034, [email protected]
Early return-to-work improves Workers' Compensation patient outcomes
ROSEMONT, Ill.-The Workers' Compensation system could improve patient outcomes by providing an incentive for patients to return to work as soon as possible after a work-related injury or illness, according to an article published in the October issue of The Journal of Bone and Joint Surgery.
"Right now the system encourages disability instead of rehabilitation," said JBJS author J. Mark Melhorn, MD, clinical assistant professor, section of orthopaedics, department of surgery, University of Kansas School of Medicine, Wichita, Kan. "These patients often take longer to heal, they have more symptoms, and they require more office visits than other patients. Those with extended disability can become depressed and less motivated. As a result, their medical outcomes are usually worse than patients who do not file a Workers' Compensation claim.
"Patients who proactively participate in their recovery and go back to work sooner have better outcomes," said Dr. Melhorn. Each year, 6.1 million work-related illnesses and injuries occur in the U.S. at a cost of $1.25 trillion.
"Individuals with legitimate painful injuries should be appropriately compensated for pain and suffering," he said, "but an alternative to the current reimbursement system is needed. The Social Security disability system discourages potentially disabled workers from even attempting rehabilitation."
"Work-related injuries do not occur in a vacuum," Dr. Melhorn said. "The impact of the injury and the outcome of treatment are influenced by economic incentives, motivation, social implications and legal issues.
Physicians must look at the whole person, not just the work injury. They often are inadequately prepared to deal with the biosocial issues that influence the treatment outcomes."
Noting the similarities between sports medicine and the emerging field of occupational medicine, Dr. Melhorn said that after an athlete recovers from a sports injury, the player is expected to return to the game and to perform at his or her previous level of athletic ability.
"Similarly, the injured industrial worker is expected to return to his or her previous level of performance," said Dr. Melhorn. "On the industrial playing field, it is necessary to treat the workers as well as improve the workplace to help prevent future injuries."
To help employers and employees reduce work-related illness and injury, the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons (AAOS) have issued the "Early Return to Work Programs" Position Statement. Among the recommendations:
-An injured employee should be seen for early medical evaluation and appropriately referred for specialty care as medically necessary.
-Employees should be encouraged to report potentially hazardous conditions or situations for review.
-In all cases, the treating physician needs to understand the patient's work environment and occupational tasks. In difficult cases, a videotape of the job, formal job analysis, or an ergonomic report may be helpful to assist in establishing workplace guides.
-Safe early return to work programs are in the best interest of patients. Studies have demonstrated that prolonged time away from work makes recovery and return to work progressively less likely
-Workplace guides should be written out and provided to the employee and employer.
"Occupational orthopaedics rapidly is developing into a medical specialty," he said. "Orthopaedic surgeons are uniquely qualified to combine the science of musculoskeletal care with the art of medicine in this emerging field." Dr. Melhorn is course chair of the Academy's November 10-12 continuing medical education course in Baltimore, "Occupational Orthopaedics and Workers' Compensation: A Multidisciplinary Perspective."
The Journal of Bone and Joint Surgery is the official scientific publication of the 24,500-member American Academy of Orthopaedic Surgeons (www.aaos.org), a not-for-profit organization which provides educational programs for orthopaedic surgeons, allied health professionals and the public.
An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (www.bonejointdecade.org), the global initiative in the years 2000-2010 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life.
The peer-reviewed JBJS, located in Needham, Mass., is published monthly. Abstracts are available online at http://www.jbjs.org.
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