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Early Return to Work Speeds Patients’ Recovery
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Business New Haven
11/13/2000
By: BNH
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Getting back to work as quickly as possible after a work-related injury or illness helps patients recover faster. Thus, the workers-compensation system should give patients incentives for early return to work.
Such are the conclusions of J. Mark Melhorn, M.D., a specialist in occupational orthopaedics. But currently, he charges, “The system encourages disability instead of rehabilitation.”
Melhorn is clinical assistant professor in the section of orthopaedics, department of surgery, at the University of Kansas School of Medicine in Wichita, Kan. In the October issue of the Journal of Bone & Joint Surgery, published by the American Academy of Orthopaedic Surgeons, he says it's time for a change.
Patients in the workers-compensation system “often take longer to heal, have more symptoms, and require more office visits than other patients,” he says. “Those with extended disability can become depressed and less motivated.
“As a result,” says Melhorn, “their medical outcomes are usually worse than patients who do not file a workers-compensation claim.”
Each year, 6.1 million work-related illnesses and injuries occur in the U.S., at a cost of $1.25 trillion, according to the article.
“Individuals with legitimate painful injuries should be appropriately compensated for pain and suffering,” he says. “But an alternative to the current reimbursement system is needed. The Social Security disability system discourages potentially disabled workers from even attempting rehabilitation.”
Melhorn adds that physicians must be trained to “look at the whole person, not just the work injury,” when treating these patients.
And he notes similarities between sports medicine and the emerging field of occupational medicine. After an athlete recovers from a sports injury, the player is expected to return to competition and 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,” he notes. “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, an “Early Return to Work Programs” position statement was recently issued by the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons. Among the recommendations:
• Injured employees should be medically evaluated and referred to specialty care as necessary;
• Employees should be encouraged to report potentially hazardous conditions or situations for review;
• Attending physicians should understand the patient's work environment and occupational tasks (video tapes, formal job analyses or ergonomic reports might help);
• Safe early return-to-work programs are in the best interest of patients;
• Workplace guides should be written out and provided to the employer and employee.
Concludes Melhorn, “Patients who proactively participate in their recovery and go back to work sooner have better outcomes.”
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