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Sep
30

ProPublica’s at it again.

ProPublica’s unethical “reporting” is being used in a PR effort to distort and demonize the workers’ comp industry.

An ethical journalistic organization would have sent a reporter to this week’s IAIABC conference, where they would have found 300 people all focused on improving a system that works quite well for the vast majority of patients and employers.

Instead PP’s “research” has been put into an “infographic“‘ that, by some unfathomable logic, attempts to link states’ occupational fatalities to a contrived, wholly inaccurate, and totally misleading “cut in benefits.”  (more on that here) What one has to do with the other escapes me.

PP defines “cut in benefits” as including, among other things:

  • adoption of utilization review and/or evidence-based clinical guidelines (can you IMAGINE!)
  • employer direction of care (to avoid patients going to pill mills and purveyors of fake surgical implants)
  • using outside medical reviewers to assess medical care
  • considering a patient’s pre-existing conditions in determining if an injury should be allocated to a specific employer

The mis-infographic is here, hosted on a law firm’s website.

Allow me to describe what a PP reporter would have seen if they’d bothered to attend IAIABC, the conference that, more than any other, digs into the issues PP seems most concerned about – how injured workers are treated by the work comp system.

They would have heard a terrific presentation by three physicians on improving the quality of medical care delivered to workers comp patients, followed by much discussion among regulators on how to increase the quality of care in their states and provinces.

They would have watched over a hundred regulators and other stakeholders work for four hours to develop an agenda for continued improvements in worker outcomes, safety, medical care, and satisfaction.

They would have heard countless hallway conversations about what this state or that state is doing to speed delivery of benefits, facilitate return to work, reduce friction in the system, and what other states might be able to learn from those efforts.

They would have heard a lengthy and detailed discussion about medical treatment guidelines, and a passionate debate about how evidence-based guidelines can improve the medical care delivered to patients.

They would have heard about an industry that is working every day to reduce the volume and potency of opioids prescribed and dispensed to patients – and having a LOT of success. (cue the totally false, dishonest, and self-serving BS from self-described “injured worker advocates” about how this is adding to suffering).

They would have heard a claims exec talking about his company’s policy on paying workers; NOT waiting to make absolutely sure a claim’s been accepted, but cutting checks to pay workers’ lost wages as soon as they think the worker will be out of work for more than a couple of days.

Nope.

Why try to get the facts when it’s easier to gain pageviews by vilifying individuals who are doing their damndest to make things better?

It’s long past time each and every one of us stood up to this BS.  You – yes, YOU – need to promote, emphasize, publicize your successes.

The patient you helped find a new job.

The house you built to accommodate the paraplegic with a family.

The calls you made to that doctor to get them to change the script from Fentanyl to ibuprofen and physical therapy.

The visit to the plant to figure out why there’s been several recent shoulder injuries.

The time spent talking with state legislators about the importance of prescribers checking Prescription Drug Databases.

The multiple calls with the injured worker’s spouse, helping them understand and navigate the work comp system while listening to their fears and assuring them the check’s been cut.

What does this mean for you?

Sure, you can follow the usual insurance company playbook – don’t say ANYTHING because someone could misconstrue it.

THAT’s worked really well, hasn’t it?

 

 


9 thoughts on “ProPublica’s at it again.”

  1. Agree Joe, it is time for all professionals to let their voices be heard and share their work.

    As an Editor in Chief for a national case management publication, I resisted having the staff writers write all our articles. I felt it was important to have the voice of the reader, the nurse, the doctor, the case manager etc., share their work, their best practices in their voice.

    If you don’t work in the system, you can’t see all of the details and you write a story that does not meet the needs of the audience.

  2. Setting the facts straight for your readers:

    1. ProPublica had no involvement in the creation of this infographic.

    2. I’ve attended 5 workers’ comp conferences, more than any other non-industry journalist, including the Worker’s Comp Institute conference 4 weeks ago, which Joe did not attend.

    3. My job is not to attend workers’ comp conferences. It’s to get on the ground talking to people to find out what’s really happening, whether that’s in doctor’s offices, executive suites, or mobile homes that injured workers are desperately trying to hang on to. Our reporting with NPR took us to a dozen states over a year and a half. Most news does not happen in hotel ballrooms.

    4. The vast majority of employers and others in the workers’ comp world do not attend conferences to listen to the choir.

    5. If Joe had attended the panel Richard Victor, Becky Shafer, Melissa Dunn and I had done at WCI he would have heard a similar discussion of the ideas he gives about the image of workers’ comp.

    1. Michael – welcome to MCM!

      Allow me to address your points in order.

      Readers, please forgive my blunt tone and strong language. Mr Grabell holds himself out to be a journalist; as such he can be held to journalistic standards.

      Before discussing your points, I must note that you failed to address the key issue PP’s inaccurate characterization of many regulatory changes as “cuts in benefits.” Your methodology and unfounded assumptions, as I pointed out to you – in detail – in our phone conversation 18 months ago and in subsequent blog posts, and as others pointed out as well, was seriously flawed.

      1. You state PP had “no involvement” in the creation of the infographic. Not true. PP’s “reporting” was the basis for the infographic developer’s work.

      2. Two points.

      a) Just how do you know you’ve attended more industry conferences than “any other non-industry journalist”?

      b) I don’t attend WCI for multiple reasons; August in Orlando, other commitments (speaking at the Montana WC Conference, noted elsewhere in this blog), and the sparse attendance at most sessions.

      3. “News” does indeed happen in hotel ballrooms; IF you are interested in “news”. “Stories” and “anecdotes” occur in many places, but a few anecdotes do not accurate reporting make. And your failure to accurately report on what really happens in workers’ comp, the many great things work comp people do for patients, and an unwillingness to correct your misstatements and misattributions reflects not journalism, but advocacy journalism.

      4. Interesting that you claim to know why the “vast majority of employers and others in the workers’ comp world” attend conferences. As to “listening to the choir”, I have no idea what you mean.

      5. If I had attended the panel discussion, it would have been enlightening indeed. And you would have heard a discussion about fairness in reporting, and the damage you’ve done to people who work hard every day to help workers’ comp patients. There are many great people you’ve deeply offended through your gross over-generalizations and unfounded attacks.

      The image of workers’ comp has been damaged by your reporting, and that is troubling indeed.

    2. I’d like to point out a few things regarding improving the workers comp system, something which I’ve attempted to do, not always successfully, for the past 15 years.
      First, I think there is a legitimate concern regarding the variability of disability benefits from state to state, and the essential fairness of some wage replacement calculations, and I’m no fan of opt out. However, this is not the same thing as suggesting that most of the legislative and regulatory changes over the last decade are intended to disenfranchise injured workers. What I am most disappointed by in the ProPublica articles and Mr. Grabell’s response is the willful ignorance of data. Yes, the stories that injured workers have to tell are important, and there are regulators and others who need to hear them. As someone who practiced medicine for 20 years, I hated to read some of those stories of bad outcomes. But good public policy is based on data as well. How often do injured workers not get needed care, versus how often are they well-served by the WC system? How often are utilization review requests approved? A balanced account would marry these data with the anecdotes; the ProPublica account uses data selectively and incorrectly. As Joe correctly points out, 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 – its divergence from the clinical evidence that commercial health systems (and Medicare) have embraced as necessary for improving quality and outcomes. Hundreds of physicians have worked across multiple states to develop workers compensation treatment guidelines and other clinical recommendations for care. I could give you plenty of anecdotes of bad care driven by attorney-direction to bad physicians, but that isn’t the point.
      The argument about who attended which conferences is silly. I was in Orlando this year (and attended the aforementioned panel), but didn’t attend last year. So what? Conferences don’t provide data either, and I certainly wouldn’t make policy based on conference presentations, what happens in hotels, anecdotes, or journalist’s articles.

      I do think there are important discussions to be held regarding benefits, access to care, and quality in workers compensation. I intend to keep having them, and I’m sure this weeks DOL report will stimulate more.

      And, I’m sorry, but the notion that ProPublica bears no responsibility for an infographic based on the series is like saying your microphone didn’t work properly after a debate.

  3. Joe,

    As you well know, I have tried for nearly four years to get this industry to change. But sadly, it is inhabited by people who ridicule new ideas, refuse to listen to anyone not holding a current position in the industry or even an executive title, and is so heavily regulated, that some really bad folks tried to drag it back to the 19th century through a con job called “opt-out”.

    So, if PP is not telling the truth, they have a lot of company from within the industry and without. The system is too adversarial from the point of view of the employer against the employee, the carriers against both, and the service providers to all the rest. To put it simply, there are too many cooks (or is that crooks?) spoiling the broth of workers’ comp.

    Too many stakeholders for real change, too many stakeholders who game the system for their own greed and profit, and too many stakeholders who do more harm than good to the injured parties.

    To quote and paraphrase an ancient saying, “Physician (and everyone else), heal thyself!”

  4. Joe, When is the last time you went down to the the WCAB?

    When is the last time you went to an applicant attorneys conference?

    Are outcomes in WC the same as group health?

    1. Jeff – thanks for the comment.

      As I don’t live in California and don’t practice law, haven’t been to a WCAB.

      I’ve been to WCI in the past; there are plaintiff attorney sessions there that I have attended.

      Re outcomes, I’m not sure how you define same. We care about functionality, and group health does not. Therefore the metrics used are often different. That said, if you look at patterns of care, e.g. for back injuries, there are far more surgeries in work comp than in the real world, and far more opioids.

      That’s what we need to fix.

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Joe Paduda is the principal of Health Strategy Associates

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