Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Psychological Overlay

When a patient begins to exhibit increased signs of entitlement and resentment, there is the concern that a variety of people are likely telling the patient that your goals for care are exclusively cost containment.

This includes being told that he/she is being sent to the worst doctors, trying to settle the case so that you can money is saved and/or wanting the patient to return to work long before truly capable.

The patient may have little in life to offset what is being told to him/her. The patient has all day to sit and ponder whether these accusations about are correct.

The patient may have no other activities other than sitting in doctors’ offices listening to the complaints of others and hearing their interpretation of their own care. People are very free with advice without regard to its impact upon others.

I refer to this as the “poor man’s paranoia.” It is what truly paranoid individuals will do although they do it on a much grander scale. But the one commonality between the frankly paranoid schizophrenic and the distrustful injured worker is that there are two tasks.

1. Is there any reality to their beliefs? Are inadequate providers being selected?

2. If these suspicious are not accurate, then everything must be maintained very simple and direct.
[*]Explain why a particular doctor is selected.
[*]Describe the process that will be followed to see determine maximum improvement.
[*]Be certain that that the patient goals are understood and may be very different and explain how the patient’s goals are at odds.
[*]Do not fall prey to accounting for good behavior and all that has beeb done.
[*]Simply outline the steps of injury management and answer the patient questions.

Even though fair and honest, one can never compensate for the distortions being fed and fueled by others.

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