Work comp – the physicians’ view

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.