Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Improprieties and Their Impact

Many involved in a case obstruct psychological examination much less psychological care.

Several years ago, I was part of a panel presenting to a group of doctors and nurses. One member of the audience asked the surgeon on the panel what he does with the psychological aspects of a case.

He basically said “pffft, it is all hocum…unimportant…you fix it surgically and send them packing.”

About three months later, he began referring patients. He found that they did not go back to work regardless of how successful surgery had been. And he also found that many injured workers had great demand for disability ratings, low compliance with physical therapy and increasing demand for narcotics.

Contrast that with attorneys and adjustors who eschew psychological examination because they are fearful as to what will be revealed. Adjustors and defense attorneys are just certain that an exam will reveal a very expensive-to-treat psychological problem. This is almost never the case. Indeed, to date, I have not seen an expensive psychological problem.

Patients and claimants attorneys obstruct psychological examination for fear of what will be revealed: other injuries, pre-existing pathology, criminal history, and/or outright deception.

So…yes, psychological examination is quite often obstructed, but chiefly the justification for the obstruction is based upon urban myth and legend that it will make it more difficult for the patient to find resolution.

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