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Occupational Medicine
- Thread starter rrreagan
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You can do whatever you want. No one is forcing a gun to your head and saying "see these patients." Many physiatrists see WC patients because they are actually interested in getting patients back to work and back into society and physiatrists are the *preferred* provider in the eyes of many case managers and WC firms because we understand disability and know how to differentiate real impairments from motivational ones. Once you see a paraplegic successfully rehabilitate themselves and retrain and find gainful employment its hard to accept that a healthy 45 y.o. woman with fibromyalgia is "totally disabled" from her pain as some primary care physicians will certify.
Insurance case managers' perception of quality in back pain programs: a focus study group.
Haig AJ, Rich DM, Hadwin K, Davis LP, Theissen M.
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor 48108, USA.
OBJECTIVES: Insurance case managers commonly interact with physiatrists and rehabilitation programs. They influence referrals and patients' decision making. This study was designed to determine which factors affect case managers' perception of back pain program quality. DESIGN: Repeated focus group interview in a neutral facility in an urban Midwestern United States community. Subjects were two groups (n = 12 and 11) of insurance case managers employed by case management firms (large and small), insurers, and self-insured employers. Outcome measures included group and individual responses to a pre-scripted interview and were collected on tape, transcribed, and interpreted by two different persons: the independent expert interviewer and a pain psychologist. RESULTS: There was substantial agreement between the two interpreters. Both groups overwhelmingly chose physiatrists over other specialists. They emphasized timeliness, communication, functionally oriented programs, concrete program goals and time frames, physician knowledge of the legal aspects of disability, and rapid communication of patient noncompliance. CONCLUSIONS: Rehabilitation programs may strive to meet many of these qualities but, in doing so, should be aware that the legal and ethical roles of case managers differ from that of clinicians.
Insurance case managers' perception of quality in back pain programs: a focus study group.
Haig AJ, Rich DM, Hadwin K, Davis LP, Theissen M.
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor 48108, USA.
OBJECTIVES: Insurance case managers commonly interact with physiatrists and rehabilitation programs. They influence referrals and patients' decision making. This study was designed to determine which factors affect case managers' perception of back pain program quality. DESIGN: Repeated focus group interview in a neutral facility in an urban Midwestern United States community. Subjects were two groups (n = 12 and 11) of insurance case managers employed by case management firms (large and small), insurers, and self-insured employers. Outcome measures included group and individual responses to a pre-scripted interview and were collected on tape, transcribed, and interpreted by two different persons: the independent expert interviewer and a pain psychologist. RESULTS: There was substantial agreement between the two interpreters. Both groups overwhelmingly chose physiatrists over other specialists. They emphasized timeliness, communication, functionally oriented programs, concrete program goals and time frames, physician knowledge of the legal aspects of disability, and rapid communication of patient noncompliance. CONCLUSIONS: Rehabilitation programs may strive to meet many of these qualities but, in doing so, should be aware that the legal and ethical roles of case managers differ from that of clinicians.
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Occupational Med docs also don't get trained to do EMG/NCS, spine injections, botox, prostetics, orthotics, etc. They probably understand the work environment better and know OSHA standards cold. They are the experts on workplace safety. They probably get equal exposure to outpatient PT but I doubt they get the exposure to the OT and speech side of rehab or rigorous inpatient rehab. I don't know if they actually get to work with PT directly. I'm guessing their practice is more geared towards prevention and injuries that occured AT work rather than injuries like stroke, head trauma, cord injuries, multiple fractures, degenerative processes etc...stuff that could happen anywhere, or just happens, and impairs their ability to work. They probably see more eye injures, electrical burns, chemical exposures etc. and they probably do a lot of pre-employment evals to see if people are capable of doing the specific task they're going to get paid to do. I'm not drawing from any particular Occ Med experience...just my perceptions.
Salary.com had Occ Med's median salary at 150 or 160K, I don't remember which. The procedures I listed above probably account for the difference.
Salary.com had Occ Med's median salary at 150 or 160K, I don't remember which. The procedures I listed above probably account for the difference.
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