When a patient requests extend beyond that needed to recover, it is important to must know the patient’s expectations for the future. These expectations dictate how many opinions he/she will seek, whether he/she can accept chronic (even mild) problems in the future, and the time frame in which he plans to mobilize.
Here are the most common expectations:
[*]No residual symptoms whatsoever
[*]A new job or career
[*]A cash settlement that pays for all of my pain and suffering
[*]An apology from the coworker who caused this
[*]An apology from the insurance company
[*]An apology from my doctors
[*]A fix for my marriage and family problems
These are the thoughts that run through his head during the day, every day.
While workin on an MMI release and PPD rating, he ruminates about his anger, disappointment and discomfort.
It needs to be determined what the patient expects to happen and help him understand which expectations are not going to be met…and why they are not.
Until that time, he will remain (or keep himself) within the “system” because of his underlying fear, anger and disappointment.