Wednesday, November 16, 2011

New Mexico Effort Demonstrates Cultural Challenges

This morning's WorkCompCentral news features an interesting story about New Mexico, a coalition of stakeholders trying to do injured workers right, and the reticence of physicians in that state to accept that work is good.

This is a story that I wasn't prepared to read!

In 2009 a group of insurers, lawyers and employers formed the New Mexico at Work Partnership to extol the virtues of programs that make light duty or modified positions available to injured workers. The coalition grew out of Dr. Jennifer Christian's 60 Summits projectan effort to teach employers how to minimize the disruptive impact of illnesses and injuries on workers and employers.

60 Summits seeks to change how people view workers' compensation and disability systems by focusing not on efficient claims processing but rather looking at the prevention of needless disability.

I know Dr. Christian well and have seen 60 Summits grow from her introduction of it to me at its infancy several years ago into a very positive tide of influence throughout America and beyond.

Dr. Christian notes that there are five basic underlying presumptions making up the claim processing model that are fundamentally flawed because of the focus on disability:

1. Work absence or disability is necessary after illness and injury.
2. Work avoidance assists in recovery from illness or injury, so it is good.
3. Duration of work absence reflects the severity of the illness or injury.
4. Most people don't need any help because they will receive appropriate medical care and support in managing their health-related employment disruption.
5. Tragic situations and "bad people" cause most loss costs.

Instead of this traditional paradigm, 60 Summits says instead that 5 presumptions should be:

1. Much of today's work disability could be foreshortened or averted entirely because work absence is not medically required for more than a few days after illness and injury.
2. Being active during convalescence speeds recovery, while extensive work avoidance and "rest" tend to delay it.
3. Prolonged absence or permanent withdrawal from work is bad for people's well-being -- mental, physical, social and economic.
4. Prolonged withdrawal from work is usually being driven by non-medical factors instead of medical ones.
5. In today's complex world, many people need pro-active instruction, advice, or even one-on-one assistance in:
     - how to navigate the healthcare system;
     - how to select doctors who will provide the most effective treatments;
     - how to cope best with a health-related employment situation.

New Mexico employers and other stakeholders are embracing this model, but the fight they are now facing is getting the state's physicians on board.

Kathy Diaz, executive director of the Food Industry Self Insurance Fund and chairwoman of the partnership, told WorkCompCentral that largely due to New Mexico's rural population, physician training has been on the old paradigm, and that they are unwilling to test a new model:

"The most recalcitrant audience is doctors, especially in our rural state where their training is if the injured worker doesn't feel good, they should have time off work for recovery," she said. "We've found employers are more amenable to working on it than the doctors."

Cultural change is a difficult process, and takes time. Constant and pervasive education and marketing is key to making a shift successful.

Diaz said the partnership will work in the New Year on setting up an educational website either through the state agency or the New Mexico Workers' Compensation Association. The online information the partnership hopes to provide will outline how to create a successful return-to-work program, Diaz said. The partnership also plans to hold several informal education workshops next year as well.

"We're trying to get the work out and give employers talking points to use with employees and doctors," she said. "We're urging everyone to consider stay at work during the healing process, and if not that, early return to work because modified duty is much better than physical therapy or being at home isolated from the employer." 

I applaud Diaz and her coalitions efforts, and the efforts of Dr. Christian, in trying to change the focus of conversation in the work injury dialogue. These are root efforts that ultimately will be the basis for changing our laws to match our modern understanding of disability science and the economy.

And on a topic that is completely different, see my Advertising Director's blog for this month. Christina every month puts together helpful information specifically on marketing to the work comp industry featuring a guest article this month from Byron Kerns on 7 rules to grow your business.workers compensation, work comp, injured worker 

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