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February/March 2018  Volume 16, Number 1        

evidence-based treatment

Three Important Rehab Trends to Watch

New techniques and technologies are providing alternatives for rehabilitation.

  1. Pain Therapy Alternatives The problem of opioid addiction has prompted the workers’ comp industry to focus on alternative pain therapies, including physical therapy, chiropractic, exercise, yoga and even “mindfulness” therapies, such as meditation and cognitive behavioral therapy. Since these therapies are typically outside mainstream medicine, they don’t fit the preconceptions of most patients, who expect the immediate relief they would get from a drug. It’s easier to persuade new claimants and younger people to accept these approaches.

    But there are other challenges. An injured worker may have an attorney supporting his or her resistance to follow a less traditional path to recovery. And too often medical providers themselves don’t buy into alternatives either.

    Taking an advocacy approach can help employers overcome employee resistance to alternative therapies. This means the injured employee, the employer and the physician need to understand the long-term harmful consequences of automatically turning to opioids for pain relief, according to Beth Wood, a Kansas City senior claims costs control consultant. “You have to develop trust and have conversations,” Ms. Wood told Business Insurance magazine. “When it comes to alternative therapies and motivating the worker, the relationship between the employee and the employer is paramount. [You need to build] rapport with the employee, and when you have that going on, the employee is motivated for recovery and discussing alternative treatments.”

  2. Your Words Matter
    The physician’s choice of words for dealing with patients and their medical condition — sometimes referred to as bedside manner — can shape a patient’s perceptions of pain. Attendees at a workers’ comp conference in California were advised not to say “getting you back to work,” but rather “getting your life back to normal.” Instead of referring to “your injury,” the audience was told to call it “your recovery process.” It’s not “How’s your pain?” but “How’s your progress?” Putting a positive spin on medical matters can really make a difference, according to Dr. Jennifer Christian, president and chief medical officer at Wayland, Massachusetts-based Webility Corp. “[There are] people who have relatively moderate conditions who end up creeping toward catastrophe. A lot of it has to do with words,” Dr. Christian told Business Insurance.

    For example, an MRI may reveal an issue that is mild and really doesn’t warrant surgery. However, when the doctor delivers the results, it’s often presented as the “bad news” and soon the remedy becomes way out of proportion to the problem.

    “[Their] perception of pain is not accurate,” Michael Rosenthal, an assistant professor in the Doctor of Physical Therapy Program with San Diego State University, told Business Insurance. “When patients start having pain outside of the proportion that we expect, [they] may need a little more than reassurance and simple education … others may need more advanced psychological informed rehabilitation.”

    “What we say [and] how we say it … words can reassure or frighten. [Words] can build trust or confidence. … They can empower or undermine. Your words are either going to establish yourself as someone helpful, or create distance,” according to Dr. Christian.

  3. Tele-Rehab
    You’ve heard of telemedicine. Now there’s tele-rehab. Instead of visiting a rehabilitation facility, the patient goes online to view exercise demos, get instruction sheets, provide feedback and obtain direct consultation with specialists.

    Convenience is a big factor. People can access their therapy session with a desktop or mobile device from anywhere, usually at any time of day. Live videoconferencing is also a possibility.

    A recent white paper by MedRisk touts the benefits of the concept for offering “greater patient compliance, smoother care coordination among clinicians, a more flexible rehabilitation timeline, and cost and time savings for key stakeholders.” https://tinyurl.com/yc6dj6fx

    Again, like the other alternate therapy approaches discussed in this article, adoption has been spotty because it’s new. However, Michelle Despres, vice president and national product leader at workers’ compensation firm One Call, thinks leveraging technology like this is inevitable.

    “This will be a no brainer for the younger group, but I do think we can’t discount the older population either. Anyone who embraces technology and possibly leads a busy life [will appreciate tele-rehab],” Despres told Insurance Journal.

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In this issue:

This Just In...

Three Important Rehab Trends to Watch

Workers’ Compensation and the Teleworker

The Six Types of OSHA Violations and Their Penalties

Simple Steps to Reduce Telecommuting-Related Risks



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