Treaters are at the front line for helping the injured worker to recover.

Who is the ideal treater?

The ideal practitioner listens carefully, treats, certifies appropriately, communicates with the workplace and supports RTW.

What are the challenges for treaters in RTW?

There is often a reluctance by doctors to take on return to work cases. There is often additional administrative work needed, and doctors are rarely adequately compensated for the additional workload. Although they care about their patients, they are busy people.

As the ratio of return to work patients compared to standard patients is relatively low, there may also be a lack of awareness about some of the factors involved in RTW.

Medical practitioners have been trained in medicine, and failure to return to work is often about non-medical factors. They lie outside the doctors’ awareness and ability to manage so they are left dissatisfied about managing work injury cases.  

Additionally, there may be a reluctance as claims agents may have previously overruled their advice, or employers disregarded the advice regarding the employees’ abilities on their return to work.

Treaters often feel that by removing someone from the workplace they are helping them, however this may have detrimental effects on a worker’s health and wellbeing.

A further challenge is that the treaters often have little knowledge of the employee’s workplace. It can therefore be challenging for them to determine the patient’s return to work ability. In complex, long term cases, it can be useful to arrange a site visit for the treater so they can see the environment for themselves. For this, they should of course be adequately compensated.

Working with Treaters in RTW

A recent poll indicated that 75% of RTW coordinators found treaters to be difficult to deal with. It is worth remembering however that treaters are patient-focused. Communication becomes easier if the approach is lined up with what’s best for the employee rather than what’s best for the workplace.

In determining diagnoses, doctors are frequently reliant on reports of symptoms, however within the compensable sphere, patients rarely make up their symptoms. The main challenge is in determining the severity of symptoms rather than whether the symptoms exist, and from this, the degree to which the patient is disabled or incapacitated. Within this context, it is vital that the treater be given as much information as possible. They’re ‘designated guessers’, and the more clues they’re give, the better the guess.

Research has also shown that a poor diagnosis and being certified unfit for work often leads to poorer return to work results, with advice becoming a self-fulfilling prophecy.

Treaters opinions also become vital in determining whether the injury was work related. At times, claims agents may request second opinions or Independent Medical Assessments to determine the validity of their opinion. This can be a further challenge for doctors within the RTW system, as they feel that their medical opinion is being ignored.

You can get an injured worker back to work sooner if you build a great relationship with their treating practitioner. According to Occupational Physician Dr Robyn Horsley, it’s all about getting your communication style right:

• Ring at the right time – speak to the receptionist to find out when this would be. In most cases, avoid Mondays and Fridays.
• Call the location where the injured worker is being treated – many practitioners work from different locations. This ensures that the patient file is available.
• Ensure that the doctor has the correct file – tell the receptionist the patient’s name.
• Be clear and succinct – introduce yourself including your role and the reason for your call. You could also email the details you would like to discuss prior to the call, such as alternate duties.
• Be precise about what you want to know – for example, what the worker can or can’t do, or when RTW can begin. Don’t be intrusive and don’t push for medical details.
• Don’t ask too many questions in one call – find out the most vital things. Other aspects can wait until later.
• Avoid opinions about whether the worker’s condition is legitimate.
• Be aware of the treater’s mood – if they sound tense, keep the conversation brief and suggest speaking to them at a better time.
• Dealing with psychiatrists – employers are best dealing with psychiatrists in writing, or to communicate through a rehabilitation provider or doctor – always with the patient’s consent.
• Record all conversations – make notes about what has been said so you can relay it to the injured employee, although ideally they would be present.