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(c) 2010-2024 Jon L Gelman, All Rights Reserved.
Showing posts with label Medical Care. Show all posts
Showing posts with label Medical Care. Show all posts

Friday, February 3, 2017

AMA Urges Trump Administration to Clarify Immigration Executive Order

A major element of workers' compensation benefits is medical treatment and that will be impacted the Donald Trump's recent ban on immigration. An adequate number of physicians must be available to provide medical care to cure and relieve  a work related medical condition. The American Medical Association (AMA) sent the following letter today to the U.S. Department of Homeland Security regarding the Administration’s executive order issued last week,“Protecting the Nation from Foreign Terrorist Entry into the United States:”

Tuesday, January 6, 2015

Selecting the right surgeon is a big deal

Workers' Compensation was designed to provide the best available medical treatment possible. A good surgical results benefits all stakeholders. The patient has a better outcome, the employer gains an employee who is productive in the workplace, and the insurance company ultimately pays less indemnification by way of permanent disability and a reduced cost for medical follow up care.

Over the decades since its original enactment 1911, the issue of cost of medical care has come to the forefront. Some states, such as New Jersey, prohibit an employee's free selection of a medical provider. Additionally, some employers and their insurance companies have contractually negotiated a best price fee with medical providers and have an established medical care networks, consequently restricting the employee's free selection.

A recent article authored by Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK) focuses on the need to select the best surgeon in order to obtain the best outcome.


“You can think of surgery as not really that different than golf.” Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK). He has performed more than 4,000 open radical prostatectomies. “Very good athletes and intelligent people can be wildly different in their ability to drive or chip or putt. I think the same thing’s true in the operating room.”

The difference is that golfers keep score. Andrew Vickers, a biostatistician at MSK, would hear cancer surgeons at the hospital having heated debates about, say, how often they took out a patient’s whole kidney versus just a part of it. “Wait a minute,” he remembers thinking. “Don’t you know this?”

“How come they didn’t know this already?”

In the summer of 2009, he and Scardino teamed up to begin work on a software project, called Amplio (from the Latin for “to improve”), to give surgeons detailed feedback about their performance. The program—still in its early stages but already starting to be shared with other hospitals — started with a simple premise: the only way a surgeon is going to get better is if he knows where he stands.

Vickers likes to put it this way. His brother-in-law is a bond salesman, and you can ask him, How’d you do last week?, and he’ll tell you not just his own numbers, but the numbers for his whole group.

Why should it be any different when lives are in the balance?


Thursday, July 10, 2014

Patient Access To Physicians Notes: An Experiment of Psychological Importance

Today's post is shared from the NYTimes.com  What would happen if all workers' compensation patients had access to all their treating physician's records including pschiatric care? Would such access assist in limiting and increasing litigation for continued medical care and the need for medical treatment?
David Baldwin wasn’t sure how he had come across the other day in group therapy at the hospital, near the co-op apartment where he lives with his rescue cat, Zoey. He struggles with bipolar disorder, severe anxiety and depression. Like so many patients, he secretly wondered what his therapist thought of him.
But unlike those patients, Mr. Baldwin, 64, was able to find out, swiftly and privately. Pulling his black leather swivel chair to his desk, he logged onto a hospital website and eagerly perused his therapist’s session notes.
The clinical social worker, Stephen O’Neill, wrote that Mr. Baldwin’s self-consciousness about his disorder kept him isolated. Because he longed to connect with others, this was particularly self-defeating, Mr. O’Neill observed. But during the session, he had also discussed how he had helped out neighbors in his co-op.
“This seems greatly appreciated, and he noted his clear enjoyment in helping others,” Mr. O’Neill wrote. “This greatly assists his self-esteem.”
A smile animated Mr. Baldwin’s broad, amiable features. “I have a tough time recognizing that...
[Click here to see the rest of this post]

Related articles

Monday, August 26, 2013

CA DWC Posts Proposed Changes to the Medical Treatment Utilization Schedule Regulations Online for Public Comment

Medical treatment guidelines are being proposed to providence evidential standards for the workers' compensation medical benefits. Today's post was shared by votersinjuredatwork and comes from www.workerscompensation.com


The Division of Workers’ Compensation (DWC) has posted proposed changes to the existing Medical Treatment Utilization Schedule (MTUS) regulations to the online forum where members of the public may review and comment on the proposals.

“These changes to DWC’s evidence-based medical treatment guidelines provide a critically needed framework describing best practices for providing medical care for work-related illnesses and injuries,” said DWC Executive Medical Director Dr. Rupali Das. The proposed updates to the MTUS were developed in cooperation with the multidisciplinary Medical Evidence Evaluation Advisory Committee (MEEAC).

The proposed amendments to the MTUS regulations modify regulatory definitions, which includes a definition for Evidenced Based Medicine, and adds new definitions for terms used in the strength of evidence methodologies. The regulations clarify the role of the MTUS in accordance with Labor Code section 4600 and set forth the process to determine if medical care is reasonable and necessary when the MTUS is inapplicable.

Tuesday, May 21, 2013

Just Go to The Emergency Room

Emergency room medicine is becoming an easy avenue for work-related medical care as employers and insurance carriers keep restricting traditional medical care access. Over the past decades it is becoming increasingly difficult for workers who have suffered occupational accidents or diseases to obtain quick, efficient and authorized diagnostic services and medical treatment.

A recent RAND study now validates that an alternate route is increasingly being used to access the medical care system, the emergency room. Few restrictions exists to enter an emergency room door. The red tape imposed by insurance carriers is eliminated, and the concept of deny and delay are non-existent in emergency room medicine.

Hospital emergency departments play a growing role in the U.S. health care system, accounting for a rising proportion of hospital admissions and serving increasingly as an advanced diagnostic center for primary care physicians, according to a new RAND Corporation study.

While often targeted as the most expensive place to get medical care, emergency rooms remain an important safety net for Americans who cannot get care elsewhere and may play a role in slowing the growth of health care costs, according to the study.

Emergency departments are now responsible for about half of all hospital admissions in the United States, accounting for nearly all of the growth in hospital admissions experienced between 2003 and 2009.

Despite evidence that people with chronic conditions such as asthma and heart failure are visiting emergency departments more frequently, the number of hospital admissions for these conditions has remained flat. Researchers say that suggests that emergency rooms may help to prevent some avoidable hospital admissions.

"Use of hospital emergency departments is growing faster than the use of other parts of the American medical system," said Dr. Art Kellermann, the study's senior author and a senior researcher at RAND, a nonprofit research organization. "While more can be done to reduce the number of unnecessary visits to emergency rooms, our research suggests emergency rooms can play a key role in limiting growth of preventable hospital admissions."

Friday, March 15, 2013

Workers' Compensation is Riding on the Road to Wellville with Obama Care

As Obama Care [The Affordable Care Act] launches, workers' compensation programs will start to undergo subtle changes   The innovation of wellness programs and new treatment protocols will eventually cause major shifts to the delivery of workplace medicine.

Workers' compensation's future, ironically, has actually been viewed primarily in a rearview mirror. The shift to break with old habits has been a major struggle. The inertia will give way to a creative future based on new technologies and socio-economic challenges.

In a recent article by The Honorable David B. Torrey, Judge of Workers' Compensation ["The Affordable Care Act and Effects on the Workers' Compensation System, (7 PAWCSNL 114 at 30, March 2013)], the significance of  Obama Care is reported.  Judge Torrey recognizes that even those with major pecuniary interests in the compensation business have been unable to halt the momentum of change.

Saturday, January 12, 2013

Medical Outcome Based Compensation - Essentially a Workers' Compensation Concept Already

Outcome Based Medicine Being Adopted by NYC
The idea of compensation medical providers for the end result, or benefits of medical care provided, is not a new concept as it is already embraced theoretically by the workers' compensation system. Employers, who usually control the delivery of medical benenfits, not only pay for medical benenfits, but also compensate the injured worker for the outcome through permanent disability awards.

In actuality the workets' compensation system rewards the employer for the most favorable outcomes by theoretically awarding lower permanent disabillity benenfits to those with the most favorable outcomes.
Adopting this concept to the nation's entire medical care system, is a wise step and one that is being advanced in the New York City Hospital system.

"In a bold experiment in performance pay, complaints from patients at New York City’s public hospitals and other measures of their care — like how long before they are discharged and how they fare afterward — will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals."

Click here to read New York Ties Doctors’ Pay to Quality of Care (NY Times)
Nov 09, 2012
On Tuesday, the American people expressed its support for a unified medical care program that will embrace all aspects of life, including industrial accidents and diseases. They validated, as did the Supreme Court, the ...
Jan 10, 2013
Soaring medical costs have afflicted the workers' compensation industry with economic distress and have severely impacted the efficient and effective delivery of medical care to injured workers. Both increased costs/profits ...
Nov 16, 2012
Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the standard of care for the treatment of injured workers with carpal tunnel syndrome;; Modify current MTGs to include new maintenance ...
Jan 01, 2013
Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare. While a trend continues to ...

Friday, November 9, 2012

Our Journey Forward on Occupational Medical Care

President Barack Obama
On Tuesday, the American people expressed its support for a unified medical care program that will embrace all aspects of life, including industrial accidents and diseases.  They validated, as did the Supreme Court, the coverage afforded those who have suffered from industrial pollution such as the deadly asbestos exposures that occurred in Libby Montana (“Libby Care”).

Going forward it is imperative that a universal medical program be established to provide medical treatment for  all work-related occupational injuries and exposures. The delay and denial of medical benefits to those who suffer from industrial illness must be cured.

“America has never been about what can be done for us. It’s about what can be done by us, together, through the hard and frustrating but necessary work of self-government. That's the principle we were founded on.”
— President Barack Obama, November 7, 2012

....
Jon L.Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson).  

Read more about Universal Medical Care – The “Libby Care” Prototype
Workers' Compensation: Libby Care Launches - Center for Asbestos ...
Apr 03, 2010
The recent health care reform legislation provided for the Libby Care which will provide universal medical care for victims of asbestos related disease. The plan is a pilot program for occupational disease medical care fully ...
http://workers-compensation.blogspot.com/
Workers' Compensation: Libby Care Program Begins Enrollment ...
May 19, 2010
The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. Potential pilot programs will now be available to ...
http://workers-compensation.blogspot.com/
Workers' Compensation: The Health Reform Act Charts a New ...
Apr 12, 2010
The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. Potential pilot programs will now be available to ...
http://workers-compensation.blogspot.com/