Tag Archives: Physical Therapy

Say Goodbye to Comp

Fellow blogger, Joe Paduda, today wrote a very prescient article about the impact the jobless economy will have on workers’ comp in the coming decades.

While the idea of driverless trucks may be something in the works, there are many factors working against it from becoming reality in the near term, and perhaps for many years to come. Laws and insurance requirements and what to do if the truck breaks down on a stretch of highway not easily accessible by repair trucks or miles from the nearest truck stop, will have to considered before driverless trucks put drivers out of work.

Yet, as Joe points out, manufacturing is already seeing a loss of jobs due to automation and higher productivity, which will lead to lower consumer costs, but will exact an even higher cost on the nation’s stability and will force politicians to come to grips with what to do with a permanently unemployed population, especially those in the service sector, who are being replaced, and will be replaced by automated cashiers, as well as those occupations tied to the workers’ comp industry.

If, as I reported yesterday, that 50% of all jobs will be gone by 2025, what do you do with those individuals who lose their jobs to machines and software?

It is a question that few have asked, and one that fewer have provided answers for. Also, what happens, as I also asked yesterday, if the 50% goes to 75% or higher?

The UBI is one idea floating around, but short of that, what else can we do to put permanently unemployed back into the workforce once technology makes them, in the words of that “Twilight Zone” episode, “Obsolete!”

It makes no sense, Joe states, to reform a system that won’t be around much longer. So, say goodbye to workers’ comp, say goodbye to claims adjusters, occupational therapists and physicians and nurses in same, pharmacy benefit managers, rehabilitation personnel, return to work specialists, case managers, utilization reviewers and bill reviewers, as well as underwriters and lawyers.

More Questions, Questions: A Call for Answers from the Medical Tourism Industry

Over the past two and a half years that I have been writing this blog, I have had contact with many individuals in the medical tourism industry. Some I have met online, and others I have met at the three medical tourism conferences I have attended since October 2012.

Most of you are in parts of the world that are too far for many Americans to travel to, especially those who might benefit from going abroad for surgery as a workers’ compensation patient. So I have focused my attention on the Latin American and Caribbean market, since there is a growing Latino population in the US generally, and within the workforce in particular.

So my purpose in this article is to elicit answers to questions that I raised earlier, and that have been raised recently by individuals I have been in contact with who are not sure my idea is viable. Therefore, this call for answers from the medical tourism industry.

Here are some of the questions being raised by these individuals:

How will they achieve post-op follow up sometimes for weeks or months? Will the time and effort of repeated travel discourage people? Will those added costs offset any savings on basic cost of surgery? If a serious post-op complication develops (surgical site infection, pneumonia, cardiac issues, etc.), will there be doctors in the US who are prepared to accept the patient of another doctor’s complication? If malpractice occurs (and it will), why would an American doctor even want to become a participant in such as case and risk being eventually named as a co-defendant? I wouldn’t, and lawyers go after the doctor most vulnerable and easily sued (foreign doctors are safe from American malpractice suits). Where is PT done post-op? What assurances do the employers have that a foreign doctor understands the concept of return to suitable work or even cares about the effects the loss of the worker has on their business? What recourse does the injured worker have if the foreign doctor screws up anything related to the work comp claim?

In order for you to be able to answer these and other questions, I am refreshing your memories of past articles I wrote that covered some of these questions.

Back in January 2014, I wrote an article called, “Questions, Questions — How Medical Tourism Can Become a Real Alternative in Health Care and What it Means for Workers’ Compensation”.

The article discussed several questions that the medical tourism industry had not sufficiently answered, such as legal liability and medical malpractice. I asked these questions so that the implementation of medical tourism into workers’ comp, like its implementation in general health care can be achieved to the satisfaction of all the stakeholders involved in workers’ comp claims.

These stakeholders range from the injured worker him/herself, to their employer, the insurance carrier (if insured through commercial insurance), the risk manager for the company, human resources managers, their broker (again, if insured commercially), and any other entity involved with the placement or administration of the workers’ compensation program. It also involves any third party administrators and physicians.

I also discussed the issue of impairment ratings in the article, and outlined the types of impairment ratings physicians must be certified to assign to patients. An understanding of these ratings is necessary for physicians dealing with injured workers, but not for those who are covered under group health plans or private pay insurance.

In February 2013, I wrote another article entitled, “What Role Can Medical Tourism Play in Physical Therapy and Rehabilitation for Workers’ Compensation?”.

In that article, I discussed the significant differences in the type and duration of physical therapy provided to workers’ comp claimants. I mentioned a study that found three key findings:

  • Corporate physical therapy centers billed for more visits and more units per episode than other practice settings.
  • There was a “large difference in treatment utilization between geographic regions regardless of practice setting, diagnosis, body-part treated or surgical intervention”
  • These corporate centers billed for “a lower proportion of physical agents indicating a greater use of those interventions supported by evidence-based guidelines (exercise and manual therapy) compared to other practice settings.”

I then concluded the article by saying that physical therapy and rehabilitation services could be packaged along with the surgery, and would provide the patient with a better outcome.

Finally, so that people in the medical tourism industry can understand what workers’ comp is all about, I wrote an article called, “A Workers’ Compensation Primer for the Medical Tourism Industry” where I gave you definitions for common concepts and terms in workers’ compensation.

So what I am asking all of you to do now is this: provide me with answers to the questions I raised earlier, and that are being raised now by those in the brokerage and medical fields who have critiqued my idea for implementing medical tourism into workers’ comp.

You might say I am asking you to put up, or shut up about how much better medical tourism is and can be, because these individuals need to be sold on this, and you are the only ones who can do the selling.

Here are the main areas of concern to address:

Legal Liability and Medical Malpractice

HIPAA (mentioned in my white paper)

Physical Therapy and Rehabilitation

After-care and follow-up

If you want the workers’ comp business, it is you, not me, who needs to answer these questions first. Then I can convey the answers to those in the workers’ comp and insurance industry who are doing the asking.