A comment by David Deitz MD on last week’s post is well worth your read. Referring to ProPublica, Dr Deitz said:
describing the use of guidelines and other evidence-based tools as a cut in benefits is not just misleading, it gets to the root of one of the central problems with much WC care
As Dr Deitz notes, what PP doesn’t grasp is this; evidence-based guidelines promote better medical care, and when work comp patients get sub-standard care, everyone suffers. .
Not just a few patients highlighted in a couple of headline-grabbing stories, but thousands victimized by lousy medical treatment. Today, many states do not allow or support the use of evidence-based clinical guidelines (which PP describes as a “cut in benefits”), and as a result many patients get crappy medical care.
- Workers’ comp accounts for 1.25% of total US medical spend, but 13% of opioid spend. Opioid prescribing and dispensing is a major contributor to death, extended disability, ruined families, and ruined lives.
- The Drobots and their ilk – carving up workers’ comp patients to implant faulty devices to generate huge profits for a select few doctors.
- Physician dispensing of drugs extends disability, runs up medical costs, and keeps patients from returning to work.
- Physician-owned toxicology labs.
Data and the analysis thereof identifies these issues.
Outcomes data such as return to work, disability duration, functionality, sustained re-employment, re-injury rates differentiates good medical care, and providers who deliver that care, from providers who don’t.
Alerts based on potentially problematic treatment such as prescription of opioids without trauma or surgery, high incidence of surgery for patients with soft-tissue injury diagnoses, physical therapy scripts for patients without musculoskeletal injuries are based on data collection and analysis.
Dull stuff, huh?
Anecdotes are easy to grasp, get lots of attention, generate excitement, start politicians squawking. Data is, well, boring. Thinking based on data requires focus, concentration, effort, and a desire to understand. Anecdote is quick, easy, and triggers emotions that often lead to simplistic and misguided conclusions.
That’s the briefest explanation I could come up with as to why work comp reform efforts are far too often sidetracked by issues/stories that, while concerning or even troubling, do NOT represent what happens the vast majority of the time.
What does this mean for you?
Make decisions based on data, not on anecdote.