Dr David Deitz moderated a panel of physicians tasked with describing the role of primary care in workers’ comp. Ed Bernacki, Jill Rosenthal of Zenith, and Will Gaines of Baylor Scott&White Health participated.
The takeaways –
- Primary care for occupational injuries which will evolve significantly over the next few years due to retirement of physicians, telemedicine and physician extenders.
- Most physicians never get any training in occupational medicine (I know, shocker) – therefore it’s no surprise communications with treaters can be frustrating and care management contentious at times.
- Hospital consolidation is affecting patient care, and direction of patients to the best provider can be hampered/interfered with if treating docs are required by their health system to refer to other providers in that system.
- Measurement of “performance” and “quality” is different for occ docs; we care about long-term outcomes and functional ability. Not enough payers are actually sharing scorecards/outcome reports with treating providers, and those who are aren’t doing much in the way of follow-thru to discuss results and ways to improve.
- Electronic Medical Record technology tends to be menu-driven, click-thru, or voice recognition – all of which are inadequate at best. Dr Gaines estimated EMR adds 90-105 minutes EVERY DAY to his workload. Not reimburseable, too.
- Oh, and the doc is often looking at the computer or screen – not at the patient.
- The EMR yet one more factor making primary care a less and less attractive specialty for new physicians. They just don’t want to deal with all that friction.
One thought on “Work comp – the physicians’ view”
Bottom line: multifactorial financial disincentives for physicians to take the time and to gain the skill to achieve the good outcomes. WC is analogous to the “break down maintenance” of capital equipment- short term savings but long term highest cost strategy. Only fix when broken. Preventive maintenance is the wise choice, but not provided for by the fundamental structure of WC. Hence, the worst value system in the worst healthcare value nation.
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