Lectures, Seminars and Workshops available to the business and professional community.
- Psychological Aspects of Work-Related Injury
- Mood Disorders Affecting Physical Pain
- Personality Types in Medical Management
- Overcoming Fear of Re-Injury
- Catastrophic InjuriesSomatoform Disorders - Somatoform Pain and Conversion
- Factitious disorders
- Depression and Anxiety Complicating Recovery from Work Injury
- Factors in Lumbar, Cervical & Carpal Tunnel Injuries
- Posttraumatic and Acute Stress Disorders
- Pre- and Post Surgical Cases: Psychological Complications and Solutions
- The Aging Injured Worker
- Personal Injury: Exacerbated, Exaggerated or Fabricated
Seminars are typically scheduled on Friday mornings, although alternate accommodations can be made for regional, annual, lunch and learn, or other special presentation needs.
To arrange a seminar, call Atlanta Medical Psychology at 404-252-6454 to determine date availability and coordinate media needs. Past audiences include:
- The Georgia Board of Workers' Compensation
- Institute of Continuing Legal Education
- Georgia Association of Occupational Medicine
- Georgia Nursing Association
- Risk management associations
- Nurse case management companies
- Employers and insurers
Case Management Update
This Weeks Topic: “Higher Authority"
Question: "Sorry, but this is not injury-related, and we have no responsibility for this."
Dr. Adams replies: There are far too many times that when treating an injured worker, I come upon serious health problems that are being ignored.
The most obvious are obesity, hypertension and diabetes. Due to a variety of factors including health habits, lack of family concern and financial limitations, early signs of disease are not addressed, and did not arise from injury.
However, these are not the only, or anywhere near the most, alarming situations.
Allow me to provide some very real cases from my own practice:
- A 48 year old married woman sustained a severe back injury. Authorization for surgery, a fusion in this case, was delayed for greater than a year. The day after the surgery, she telephoned me to tell me of her pain status. I noted that her speech was slurred. I inquired as to whether she was taking too much medication. She stated that she was not on any medication, and she told me that she had increasing muscle weakness of her arms and legs, and problems with speech, swallowing and breathing.
This was deemed unrelated to her injury or surgery. She had no funds for private health care. Within months, she had died, and her cause of death was said to be from Amyotrophic Lateral Sclerosis (ALS),"Lou Gehrig's Disease," a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. When muscles no longer receive the messages from the motor neurons, progressive degeneration occurs.
Was there a relationship between her injury/surgery and her neurological disease? Such a relationship was denied. Could her disease have emerged suddenly the day of surgery?
This is a progressive disease that, for her, began suddenly and led rapidly to her death. Neither she nor her family had means or authority to understand relatedness or resources to seek other care.
- The patient was 43 years of age when she sustained a neck injury at work. There were numerouse delays. Her employer fired her. Her husband had health problems that precluded his working. They had no children. They had no health insurance. She told me that she was concerned about her husband, that he complained of increasingly severe abdominal pain, so severe that he would sob in pain. Without insurance, no one would examine/diagnose/treat him. She then called one morning to tell me that he had awakened her to tell her that he needed something in their barn. She found him several hours later, having hung himself.
- The patient, at 34, had a truck driving career. He was thrown from his truck with severe facial, lumbar and shoulder injuries. Almost all care had been denied/controverted or delayed. He was often denigrated by his treating physicians because he was uneducated and told that it was not their problem that he failed to understand the nature of his problems. He told them of a small lump at the base of his neck. That lump grew to the size of a softball. Rural living, they went to a small hospital that attempted to drain the mass. The hospital discharged him without closing the hole that they had opened and instructed his sister-in-law to drain the mass for him. He had no insurance, private funds or providers that could direct him for what was becoming an emergency situation. The mass was malignant and ended his life.
- The patient was a 53 year old production worker. She sustained a rotator tear, and she had become almost immediately abrasive and suspicious about her providers and the quality of care. Her husband had elected not to work. He had married her after injury and was continually collecting documentation to assist in bolstering their settlement under workers' compensation. She complained of severe and concerning lower GI symptoms. This was not related to her shoulder injury, and she insisted that workers' compensation address the complaint, more out of anger than out of acceptance of boundaries under the workers' comp system. Prior to her shoulder completely healing, she died of colon cancer.
The workers' compensation system sets specific limits on what can be explored and treated. The most common thing told to the patient by the provider is that "this is not my area", "I am not authorized to address this," and/or "this is not something I can discuss with you." What is not done is to explain to the patient that "while I cannot address these complaints, I am nonetheless very concerned, and I want you and your family to seek help. Here are some people (or facilities) you could consider."
We have an obligation to help the patient find appropriate care even if we are not authorized to provide that care.
Online Referral: http://psychological.com/consultation-form/
Linkedin: Dr. David B. Adams
Google Places: https://plus.google.com/+PsychologicalDoctorAdams/posts
Dr. David B. Adams is Board Certified in Clinical Psychology (ABPP) and specializes in the treatment of mood, anxiety and pain disorders in adults.
In addition to his private practice, Dr. Adams consults to physicians, attorneys, employers and insurers in the diagnosis and treatment of chronic pain, posttraumatic stress disorder, disability determination and psychological complications in work-related injuries. He performs stimulator-implant-candidacy evaluations.
Dr. Adams is a Distinguished Practitioner in the National Academy of Practice in Psychology, a member of the American Psychosomatic Society, the Association of Medicine and Psychiatry, and a platinum member of the National Register of Health Service Providers in Psychology.
He is Fellow of the Academy of Clinical Psychology and a Fellow of the American Psychological Association and it's Division of Psychologists in Independent Practice, the Division of Psychotherapy; the Society of Clinical Psychology, the American Academy of Pain Management and the Academy of Psychosomatic Medicine.
Dr. Adams is a graduate of the University of Cincinnati, Xavier University, and the University of Alabama with a postdoctoral fellowship from the Institute of Clinical Training of the Devereux Foundation (Philadelphia).
Dr. Adams is the author of greater than sixty articles on the impact of psychological functioning upon claims of disability. He is a well-known presenter of seminars and regional workshops, addressing the psychological aspects of physical disease and injury.
His practice is located in The Medical Quarters, adjacent to Northside, Scottish Rite and Emory Saint Joseph's Hospitals in north Atlanta.
Atlanta Medical Psychology
5555 Peachtree-Dunwoody Road, N.E.
The Medical Quarters - Suite 251
Atlanta, GA 30342-1703.
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