ANNUAL REPORT 2007: Thoughts on Health Care Reform
By Tim Gilmore, MD, Occupational Health Services
Let's say you have an injured employee who is having difficulty returning to work. At Group Health, case managers from Occupational Health facilitate will bring together physicians, physical therapists, nurses, behavioral health specialists, and sometimes employer reps to troubleshoot problems and refine treatment plans to ensure a successful recovery.
Sometimes it seems like an employee injured on the job might never make it back to work. Occasionally, when injuries are severe enough, this occurs. However, many injured workers linger in a kind of "workers' comp limbo" for reasons ultimately harmful to themselves, their employers, and the economy. Some fear re-injury. Others find physicians who coddle them. A few get addicted to painkillers and end up choosing Oxycontin or Percocet over the time clock.
At Group Health, we've created specially trained occupational health teams that look comprehensively at every on-the-job injury. We treat not only the injury, but also the person. We school our doctors in the most common work-related injuries — such as those to the knee, back, neck, and arm — and also mentor them on not-so-common skills, such as recognizing narcotics abuse. Because paperwork for Labor & Industries and other insurers is crucial, we train our staff to handle these forms expertly. We also can tailor services to unique company needs.
Last fall, for example, in response to a request from a major employer, we created a continuing medical education seminar for primary care physicians in the community. The focus helped these doctors address work challenges for employees with non-job-related injury and illness.
We use Group Health's clinical information system to automatically keep all providers abreast of developments with each employee's care and prognosis. As soon as we begin to treat a patient, we generate a comprehensive plan that goes to the patient, to Labor & Industries, and to the employer, so everyone involved knows the extent of the injury and a timeline for return to work.
Finally, our entire Occupational Health team — about 60 of us — meets quarterly to continuously improve delivery of care to injured workers, as well as provide a greater sense of predictability and transparency to employers. I believe our broad expertise, combined with our integrated system of coordinated care, gives us capabilities that others marketing occupational medicine in Washington state simply cannot match.
"Ernst & Young has shown that injured workers who go through an integrated care model similar to ours experience a drop in costs with no loss in quality," says Dr. Abid Haq, shown to the right of colleague Dr. Tim Gilmore.
With Group Health since 1982 and board certified in occupational medicine and family medicine, Tim Gilmore, MD, PE, is also a licensed professional engineer (chemical engineering). He helped Group Health develop the first case manager collaborative program in Washington state.
