Importance of Precise Communication

Shane Mangrum, M.D.

Physicians have become “providers” in modern systems of healthcare. They order tests, prescribe medications, and offer interventions. Physicians are good at these kinds of things. They can be, however, neglectful in recognizing the importance of clear, timely communication with third parties. This component of delivering workers’ compensation care is outside of the typical purview of a physician’s day-to-day.

It is for this reason that all too often medical providers often do not see themselves as part of the return-to-work process. The friction built into the process of facilitating return to work can make physicians imagine this should be someone else’s job (or at least wish it so).

The truth is physicians are a critical part of the process of facilitating a successful return to work for an injured worker. Studies conducted by the U. S. Department of Labor have shown those employees who have been treated by physicians who more frequently used the recommended best practices experienced a quicker return to work than those not employing best practices.

Communication is critical to successful outcomes. Many studies from researchers cite poor communication from medical providers as the number one issue causing delays in returning to work. All communication does not have to be poor. Reports from the American Medical Association (AMA) have shown when communication is effective, timely, and in line with best practices, the result for the injured employee is fewer disability days and for the company is lower disability costs per employee.

Here is a list of three (3) items physicians can do to improve communication and be better facilitators of a successful return to work:

1. Clarify the use of terms and definitions shaping the process of return to work. Terms like restriction, limitation, and tolerance have very specific meanings to adjusters and employers. However, physicians may have a looser sense of the definitions of these terms. These differences have real meaning in the workplace and the area of workers’ compensation. To do our jobs well, physicians need to use them deliberately. The restriction is defined by the AMA as “what the patient should not do based on risk or harm.” Limitation is defined as “something the patient cannot physically do.” Tolerance, on the other hand, is related more to how comfortable a person is doing a given task.

2. Provide streamlined, clear forms to communicate restrictions, limitations, and expectations. A return to work/work status form should be supplied for every office visit. Remember, it’s not your job as a clinician to decide IF the patient returns to work, only to help safely navigate the necessary restrictions to avoid additional injury or exacerbation of the employee’s existing injury.

3. Be available to communicate in order to navigate potential hurdles to positive outcomes. Sometimes, a single phone call is all it takes to clarify matters and smooth the path back to optimal function.

Shane Mangrum, M.D., is an experienced, board-certified physiatrist at Axion Spine & Neurosurgery in the Atlanta metropolitan area. He is double-boarded in physical medicine and rehabilitation, as well as sports medicine. Dr. Mangrum earned his undergraduate degree in organismic and evolutionary biology from Harvard College in Cambridge, Massachusetts. He completed medical school at the University of Utah in Salt Lake City and finished medical training with residencies in physical medicine and rehabilitation at Mayo Clinic and the University of Utah. Drawn to the climate and culture of Atlanta, Dr. Mangrum now resides in Milton with his wife and four children.