Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Patient Who Do Not Mobilize

The patient is released by the authorized treating physician_benefits cease_they still do not mobilize.

To better understand the situation, answer these questions:

1. Was the patient released because he/she is fully recovered?

2. Or was the patient released because he/she has a PPD for which nothing more can be done?

3. Or was the patient released because you are suspicious about his/her symptoms?

4. Or was the patient released because this particular doctor had no more to offer?

Then answer these:

A. Does the patient or someone close to him/her truly understand what is wrong and why nothing more can be done?

B. Does the patient understand that further change is very unlikely?

C. Does the patient know it is his/her responsibility to find a life for himself (accepting pain and limitations and finding work or surviving on social security disability_or living off family and friends?

D. Does the patient trust and believe this doctor?

a. Do they have a functional relationship?

b. Does the patient feel that he/she received compromised care?

E. Is the patient disappointed_or fearful_or depressed_or enraged?

Contact your consulting psychologist and forward complete medical records. Have the psychologist meet with the patient for one visit. Ask the psychologist to answer any of the above questions which you are unable to answer.

Finally, have the psychologist summarize the current status, determine what the patient needs for closure, explain that closure must occur but that reasonable attempts will be made (or have long ago been made) to answer these questions.

Most often the patient does not like the message (chronic problems) and is angry at the messenger (authorized treating physician) and has confused disappointment with distrust. The patient needs a neutral party to understand his/her fears, uncertainty and help them accept their options.

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