Patient Management I:  Doctors, Work & Cultural Beliefs

• Research on benefits of work avoidance / risks of worklessness
• Preventing needless work disability in hispanic, native american, and other cultures
• Being culturally competent while avoiding stereotyping

Investigate and Address Social and Workplace Realities

Acknowledge and Deal with Normal Human Reactions

Difficult Situations I:  Patient Advocate or Patsy?

• Responding to patient requests for excessive time off / disability certification / other benefits
• Responding to employer / insurer requests / information
• When you think the patient is not telling the truth

Support Appropriate Patient Advocacy by Getting Treating Physicians Out of a Loyalties Bind

Reduce Distortion of the Medical Treatment Process by Hidden Financial Agendas

Be Rigorous, Yet Fair in Order to Reduce Minor Abuses and Cynicism

Patient Management II:  How to Set  Early Expectations That Improve Outcomes

• Techniques to pre-emptively set expectations
• Screening tools that identify patients at risk for poor outcomes and thus need extra support

Acknowledge and Deal with Normal Human Reactions

Therapeutic Approaches That Produce  Better Treatment Results & Less Work Disability

• Functional recovery focus in treatment planning
• Disability duration guidelines
• Referrals for testing and rehab services (OT/PT)

Adopt a Disability Prevention Model

[Instill a Sense of Urgency] Urgency is Required Because Prolonged Time Away from Work is Harmful

Simplify/Standardize Information Exchange Methods between Employers/Payers and Medical Offices

Your Role as Designated Guesser: What Can This Patient Do at Work Now?

• Matching current work capacity with job demands.
• Methods to use in your office.
• When to refer and to whom.
• Which tests to request.
• How to interpret test results.
• How to interpret job descriptions.
• Resources

Improve/Standardize Methods and Tools that Provide Data for SAW-RTW Decision-Making

Patient Management III:   Dealing with psychiatric overlay

• Dealing with mental health consequences of work disability
• How to recognize and deal with psychiatric co-morbidities
• Simple techniques to help patients with low resilience and poor coping skills
• Simple techniques to help patients with depression
• Resources: Local people & web resources

Find a Way to Deal Effectively with Psychiatric Conditions

When More is Needed:  Referral Resources and Reimbursement for Services That Prevent Needless Work Disability and Help People Get Benefits and Keep or Get a Job.

• Role of case manager
• Billing for SAW/RTW services
• Authorizations & documentation
• Reducing hassles and effort

Pay [or Otherwise Reward*] Physicians for Disability Prevention Work to Increase Their Professional Commitment to It

Difficult Situations II:  When You Are Told the Employer Has No Light Duty or Reasonable Accommodations.

Investigate and Address Social and Workplace Realities

Increase "Real-Time" Availability of Transitional Work Programs, and Permanent Job Modifications

Difficult Situations III:  The Rescuer Doctor:  Power Imbalance and Social Justice Issues

• Patients who have bad employers or insurers
• Unjust treatment; unjust laws
• When a patient is afraid or angry at their employer or Insurer
• When the patient is ignorant, naive and passive

Acknowledge and Deal with Normal Human Reactions

Investigate and Address Social and Workplace Realities

Devise Better Strategies to Deal with Bad-Faith Behavior

Make Your Job Easier:  Get Everyone On the Same Page From the Start

• Dealing with ignorant patients, employers, insurers.
• Practice philosophy
• Communications policy & tips
• Specific ways to simplify SAW/RTW communications: office workflow; better forms;
• Educational materials/resources

Disseminate Medical Evidence Regarding Recovery Benefits of Staying at Work and Being Active

Increase Awareness of How Rarely [Work] Disability is Medically-Required