Convenience Can be Costly

by Adam Haight , IWIRC Corp.

Prompt care, quality care or both? What is most important for employment-related healthcare? Ambulatory care is sufficient and designed for anyone looking to get treatment for minor injuries, illnesses or physical examinations. However, these centers can be big downfalls in occupational health because they treat everyone—work-related or not—without fully considering all aspects of the necessary care.

For example, when sending a potential or current employee to ambulatory care for examination, they may be exposed to hazards outside of your control (i.e. others seeking medical attention for contagious illness). While the nearest medical center might only be a five-minute drive, the triage of care-seekers could put your employee behind Johnny with a cough. In many cases, ambulatory cares do not utilize providers with experience and expertise in occupational health, not fully understanding the subtle nuances of OSHA, the ADA or the Illinois Workers’ Compensation Act. Ultimately, an employer can gain control over medical and indemnity costs by choosing a specialist who fully understands these nuances and save their company more than 50 percent in total costs.

Another issue in ambulatory care is the dual roles providers may have to play. A physician may serve as an employee’s family doctor while also providing work-related care for employers. What happens if an injured employee goes to his provider at ambulatory care for treatment of a work-related injury? If the “family” doctor also serves as “company” physician, the physician may keep the patient contented (while continuing to provide quality care) to maintain his family-care relationship with the worker.

Family practice physicians’ livelihoods are dependent on visit volume, sometimes clouding the issues of work-related care. Keeping the patient happy might include taking them off work for a few days and giving prescription medication to ease his discomfort, when neither may be necessary. While this treatment plan works well for the physician and patient, the employer has to manage OSHA recordables for the prescription drug and the patient’s time off work (including lost-time coverage).

Another facility utilized by employers for employees’ care is the traditional hospital-based program. Hospitals are able to provide a full range of services, but rarely in the same location. These services are typically spread out across a hospital campus or among numerous locations.

Consider this scenario: your employee is injured with a back strain and sees an emergency-room physician. The physician refers the worker to physical therapy for a couple of days, in a completely different facility. The patient gets lost going to his therapy appointment and reschedules for the next day. The therapist’s treatment plan recommends return to work with restrictions, and the patient makes another appointment to see the physician a day or two later. That whole process takes about a week to establish this outcome, when the same conclusion could have been identified at the onset.

Just because the nearest ambulatory care or hospital-based program is nearby or has been the “status quo” for your company, it does not mean they are the best option for occupational healthcare. Utilizing an occupational health specialist can save more than 50 percent in total claim costs. Those savings may keep your company working during these difficult economic times. iBi 


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