When we approach a holiday season where the patient feels increased financial pressure, and concurrently often less access to their doctors, there is increased agitation.
Benefit checks mailed during this time period may arrive late. Vacation scheduled may interfere with adjustor or nurse case manager availability. Pharmacy hours may complicate receipt of medication especially in those instances wherein medication is mailed (and/or prescriptions are to be called in when practices are all-but-chaotic due to before-the-holiday demand.
I consulted on a case recently in which the injured (husband) was already deeply in debt with no means of generating income at this time. His wife, however, insists that he take out a loan, he cannot repay, in order to buy her Christmas presents. She is unable to fathom that this compounds their problem. Additionally, despite his lumbar, cervical and rotator cuff injuries, she feels he can return to laying foundation blocks.
This is the time of the year when many patients are referred to me because they are `depressed about their pain_, but I learn that the underlying problem is fear and helplessness during the most economically demanding time of the year.