Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Motivating the Patient

There are complaints that unmotivated patients and divisive attorneys make workers’ compensation unpleasant. However, Insurers passively approach each case in a similarly, and often ineffective. Often there is a failure to authorize care and to simply await resolution.

There is a psychological reason why a patient chooses not to recover.

The surgeon may not be able to state what that is and how to handle it.

This is not a surgical determination, and the surgeon expects others to find someone else to determine the reason the patient is not mobilizing.

Both the insurer and the surgeon are asking for the same information, and both expect the other to provide it.

These issues are psychological (the science of behavior) and not surgical.

A psychological exam is postponed because the simple question is not asked: _I am referring this patient because I need to know why he/she is not recovering as expected._

And, if the psychological referral is made, there is an expactancy that the surgeon will make it.

The way I see it, the surgeon should provide the clinical care and note that the patient is not appropriately/predictably responding.

A one-time psychological evaluation to determine which the patient is not responding is needed.

The surgeon then has the psychological data before authorizing more therapies, pain management, and invasive procedures are considered.

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