June 18, 2015

Nancy’s super-simple guide to pain

Nancy Grover’s June 15 column on Work Comp Central is a super simple guide to pain for anyone who isn’t really interested in the latest science of neurophysiology — but who wants a basic understanding of how the science of pain is changing our view about how to treat it.

Nancy interviewed me and wrote her column after reading a white paper entitled Red Herrings and Medical Over-Diagnosis Drive Large Loss Workers’ Compensation Claims released by Lockton Companies.  I am one of the co-authors, along with Keith Rosenblum, senior risk consultant at Lockton Companies and Dr. David Ross, a Florida neurologist who is CEO of NeuroPAS Global,

Our goal was to draw attention to an issue that is driving UP costs for payers and driving DOWN quality and outcomes for patients.  In short, all of us (physicians and patients, claims payers, employers, lawyers, judges, etc.) have been getting seduced by the false certainty created by “objective findings” of diagnostic imaging, especially by MRIs.

Before proceeding with invasive procedures and expensive/risky surgeries (that often fail to relieve the pain or create worse problems), we really should be making a good faith effort to identify (and treat) other things that are either causing or worsening the patient’s distress.  Before that first cut is made — are we sure all soft tissue problems have been identified, and then treated by skilled professionals using evidence-based methods?   Have all emotional, psychological, and other human issues known to manifest as bodily distress been identified, and then treated by skilled professionals using evidence-based methods?

If you’re a WorkCompCentral subscriber, read Nancy’s excellent column Low Back Ache: A Pain in the Brain.  If you’re coming to the SIIA conference which is October 18-20 in Washington DC, plan to attend our session on Medical Red Herrings — I’ll see you there!   (SIIA = Self Insurance Institute of America)

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