Putting the welcome mat out for doctors

Physicians can play a crucial role in preventing workplace injuries and getting injured employees back to work, but managing employer-doctor interactions can be a delicate balancing act that requires constant attention.

Employers can and should be inviting medical professionals treating injured workers to workplaces before injuries actually occur, experts say.

“It’s a really good practice, probably a best practice, for these companies to have a relationship with the treating physicians,” said Don Martin, senior vice president with consultancy DEKRA North America Inc. in Marietta, Georgia. “They’re certainly not directing the physician on how to care for the worker. But what they’re doing in this relationship is making sure the doctor understands the operations where the employee works, what kind of equipment they work with, what the work environment is like. If the doctor understands the work situation and the exposure situation that the worker faces, then they’re in a better position to treat the employee for a full and complete recovery.”

Having medical professionals tour an employer’s facilities can be helpful because the professionals can examine a site, see safety hazards that may not be visible to staffers who regularly work in the facilities, and suggest ergonomically friendly changes that can reduce injuries and prevent claims from materializing, experts say.

“You bring them into your environment,” said Perry Hawkins, corporate director of environmental, health and safety and risk management with Circor International Inc. in Spartanburg, South Carolina. “I wholeheartedly support that. Until you actually bring them into the facility and walk them through the process and let them see it, they don’t really get a good understanding.”

Physicians who have seen the worksite or are familiar with the employee’s job duties can work with the employer to craft a return-to-work plan that does not aggravate the injury but gets the injured employee back to work more quickly, experts say.

“If they have to come back to work in a restricted duty capacity, the doctor knows what types of other work are available at the facility that would be safe for that worker to go back to and would be productive for that worker,” Mr. Martin said.

This type of engagement can be particularly helpful in unique workplaces,

said Coleman Brown, Baltimore-based vice president of loss control with CBIZ Insurance Services Inc. For example, the company has worked with the Baltimore Aquarium, which houses poisonous animals that could bite employees, with the local hospital reviewing the aquarium’s risks and storing anti-venom treatments.

“If it’s unique, share the information,” Mr. Brown said. “Bring that doctor in and work with them.”

But it is also useful in more typical worksites if employers are noticing trends such as multiple employees complaining about back pain. The physician may notice that the back pain is being caused by the arrangement of the equipment and “may be able to solve it before it becomes a big problem,” he said.

The level of engagement between employers and physicians “really depends on the aggressiveness of the company,” Mr. Brown said. “In very active safety programs, you’re going to find the employers or their safety person or claims management person will engage with the physicians.”

But it is critical for employers not to become complacent in establishing and maintaining these relationships. “It’s no different than dating,” he said.

And the engagement should not just be with the physicians, but with nurses and triage professionals treating injured patients, experts say.

Many employers may have not engaged directly with treating physicians partly due to concern about violating employees’ privacy, but they have the right to do so in the workers compensation context and should be more proactive in forming relationships with medical professionals, experts say.

“My experience has been that one of the reasons why (employers) don’t engage that way is that they don’t know that they can,” Mr. Martin said.

Medical providers are covered entities under the Health Insurance Portability and Accountability Act and generally subject to its requirements to safeguard patients’ personal health information. But HIPAA regulation on uses and disclosures allows physicians to share this information without authorization in certain circumstances, and workers comp falls into that category, said Krisa Benskin, a Houston-based senior associate with law firm Baker Botts L.L.P.

But the ability to engage medical professionals “all depends on the physician … and their willingness to be open,” Mr. Hawkins said.

“Getting them engaged and comfortable enough to want to have these conversations with us is great. Getting them comfortable enough to understand what the requirements are when it comes to work-related injuries versus HIPAA and … that we all understand any condition of an employee that has to do with their personal medical history which is not directly related to the injury cannot be discussed,” he said.