Lectures, Seminars and Workshops available to the business and professional community.
- Psychological Aspects of Work-Related Injury
- Mood Disorders Affecting Physical Pain
- Personality Types in Medical Management
- Overcoming Fear of Re-Injury
- Catastrophic InjuriesSomatoform Disorders - Somatoform Pain and Conversion
- Factitious disorders
- Depression and Anxiety Complicating Recovery from Work Injury
- Factors in Lumbar, Cervical & Carpal Tunnel Injuries
- Posttraumatic and Acute Stress Disorders
- Pre- and Post Surgical Cases: Psychological Complications and Solutions
- The Aging Injured Worker
- Personal Injury: Exacerbated, Exaggerated or Fabricated
Seminars are typically scheduled on Friday mornings, although alternate accommodations can be made for regional, annual, lunch and learn, or other special presentation needs.
To arrange a seminar, call Atlanta Medical Psychology at 404-252-6454 to determine date availability and coordinate media needs. Past audiences include:
- The Georgia Board of Workers' Compensation
- Institute of Continuing Legal Education
- Georgia Association of Occupational Medicine
- Georgia Nursing Association
- Risk management associations
- Nurse case management companies
- Employers and insurers
Case Management Update
This Week's Topic: Case Management Solution?”
Question: “…was injured in another state. Adjustor wants me to find providers here to treat her, but the patient most often fails to show. She does show for her monthly narcotic refills.“
Dr. Adams replies: “Among the many concerns that confront a nurse case manager is finding health care assistance for a patient who:
a. may be simply drug seeking
b. is not truly interested in recovery or
c. sees the injury as an opportunity to end working for a specific employer
This is especially problematic if the patient was injured years ago in another State. The patient may have been compensated for subjective complaints, had a pattern of medication misuse, and clung to an over-prescribing clinician who no longer expected recovery.
The adjustor may not be privy to the observations and concerns held by the new case manager. The case manager is, indeed, forced into an intermediary role, assuring quality of care while also trying to establish treatment boundaries. The case manager may also be in the disadvantageous position of educating patient, providers, adjustor and employer, all of whom may have quite different expectations.
This complexity of roles exists for clinicians as well, but clinicians gather their own data and draw their own conclusions. Ultimately, they reach a point where they can make the summary statement “there is no more I have to offer this patient.” And when discharged, the clinician does not concurrently state that the patient requires no additional care. The case manager or the adjustor must inform the patient who will, quite often, question the medical appropriateness of the decision to release him/her.
Here is one of the most troubling scenarios: The patient was given access to narcotics for subjective pain. The patient was known by the original prescribing physician to use medication outside of schedule whether this is through drug screening or pharmacy records. Yet knowing that relocations is imminent, it may be easier to refill these medications than to actively intervene in the misuse of narcotics. “Let the next person handle this.”
The patient then relocates. Much historical information may be lost in this process since concerns are not always forwarded or well-documented.
New providers develop their own baseline, and it may take months before the goals/intentions of the patient are known. It is often up to the nurse case manager to obtain the medical records and communicate with the past case manager when possible.
Not to be overlooked is the positive change that sometimes occurs with a new environment. This change can be the opportunity to streamline care going forward. But the patient may cling to the previous method of case (mis)management and communicating this to all involved may present a weighty challenge.
From a psychological vantage point, it may be quite clear that the patient has long been in nonproductive care which has become more habit than recovery oriented.
Online Referral: https://psychological.com/consultation-form/
Linkedin: Dr. David B. Adams
Google Places: https://plus.google.com/+PsychologicalDoctorAdams/posts
Dr. David B. Adams is Board Certified in Clinical Psychology (ABPP) and specializes in the treatment of mood, anxiety and pain disorders in adults.
In addition to his private practice, Dr. Adams consults to physicians, attorneys, employers and insurers in the diagnosis and treatment of chronic pain, posttraumatic stress disorder, disability determination and psychological complications in work-related injuries. He performs stimulator-implant-candidacy evaluations.
Dr. Adams is a Distinguished Practitioner in the National Academy of Practice in Psychology, a member of the American Psychosomatic Society, and a platinum member of the National Register of Health Service Providers in Psychology.
He is Fellow of the Academy of Clinical Psychology and a Fellow of the American Psychological Association and it's Division of Psychologists in Independent Practice, the Division of Psychotherapy; the Society of Clinical Psychology, and the Academy of Consultation Liaison Psychiatry.
Dr. Adams is a graduate of the University of Cincinnati, Xavier University, and the University of Alabama with a postdoctoral fellowship from the Institute of Clinical Training of the Devereux Foundation (Philadelphia).
Dr. Adams is the author of greater than sixty articles on the impact of psychological functioning upon claims of disability. He is a well-known presenter of seminars and regional workshops, addressing the psychological aspects of physical disease and injury.
His practice is located in The Medical Quarters, adjacent to Northside, Scottish Rite and Emory Saint Joseph's Hospitals in north Atlanta.
Atlanta Medical Psychology
5555 Peachtree-Dunwoody Road, N.E.
The Medical Quarters - Suite 251
Atlanta, GA 30342-1703.
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