Category: Obstacles

Compliance

Compliance: His wife called and said that he has been very depressed. So we scheduled him for an appointment. He has failed to show for almost all appointments. A spouse may be more aware of a change in mood than the authorized treating physician. Because a wife feels her husband is depressed is not sufficient to …

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Damages

Damages: It would be a ideal if psychological recovery coincided with physical recovery. Quite often, it does not. The depressive symptoms begin over time as the patient begins to cope with pain, limitations and the impact upon career and family. The surgeon will ultimately have completed his/her work on the patient and will release the …

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Fear of Re-injury

Re-Injury: A person who cannot tolerate a return to the environment in which a injury/trauam occurred can be suffering from PTSD. However, there are a variety of valid reasons why an injured worker cannot, and perhaps should not, return to the environment in which he./she was injured. Re-injury: Here are several valid concerns related to …

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Goal Gradient

The Goal Gradient: Importantly, those who determine functional capacity, maximum medical improvement and/or permanent and partial disability, quite often have no understanding of the patient’s life either before or after settlement. The “goal gradient” is a concept from psychological learning theory in which our behavior increases the closer we get to a goal (settlement). An …

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Going Both Ways

“Going Both Ways” I have often discussed the impact of delayed care and procedure approval on injured workers. They believe that there is no clinical basis for those delays and that the denied or postponed authorization is solely for cost containment. Sometimes they are correct. There are times, however, where the delays arise because a …

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satisfaction

Satisfaction

Satisfaction for patient and provider: A survey in 2013 reported that: “An alarming 70% of those surveyed in a recent …
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checkers

Checkers

Checkers vs. Chess: “It may be difficult to trace the origins of healthcare becoming a competitive sport where doctors …
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partial

Partial Malingering

A patient can have a valid disorder yet still be malingering (falsifying complaints for purposes of tangible gain). Malingering …
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