Iowa Workers Compensation: The Ames Chamber of Commerce is wrong about doctor choice bill.

The Ames Chamber of Commerce argues that workers getting to choose the treating physician will result in a higher cost for workers compensation and for that reason alone Senate Study Bill 1119 should be rejected. They Chamber is as wrong as wrong can be. I don’t believe that can be true and if it does prove to be true there is an easy solution.

First of all workers need to work or else their jobs will leave and head overseas to China; I think by now they all know this to be true. Second, employers and their insurance carriers spend an inordinate amount of money with case managers and other ancillary semi-professionals attempting to manage the care. End the tug-of-war and let the employees decide who gets to cut on them. It’s the dignified thing to do.  If the employee is choosing the doctor the employer will no longer have to spend the time and money doing this so there should be savings overall.

Lastly, if the costs do for some reasons increase then the employers and insurance carriers have another sensible option; they ca start managing the costs of medical services. There is no one in this business who is managing the medical service providers and what they charge.  Blue Cross and Blue Shield does manage cost for its insured’s so why isn’t someone doing it for the employers. It’s that simple. Stop whining and move on to more important issues.

Iowa Workers Compensation: Which way will the full House vote?

Iowa’s Governor Chet Culver is in favor of the bill before the legislature that would allow injured workers the right to choose their own treating physician. Join us today on The Verdict as we discuss which way the full House will vote on the bill that would allow injured workers the right to choose who treats their injuries.

Disease Transmission From the Transplantation of Organs

According to the United States Department of Health and Human Services, in the year 2006 there were a total of 98,263 patients listed on the organ donation waitlist within the United States, but only 14,756 organ donors. To make the situation even bleaker, there are a small number of organ recipients who receive more than just their desperately needed organ; they also receive life-threatening disease.

Within the United States, there are significantly more patients waiting for organ donation than there are organ donors. High demand causes organ procurement groups, such as the Indiana Organ Procurement Organization, to race against time in order to determine which organs are safe. However, due to increased demand, the desperate need for organs, and time restraints corner-cutting has also increased, which leads to increased instances of failure within the organ-sharing network.

Dr. Michael Nalesnik, Vice Chairman of the Disease Transmission Advisory Committee of the United Network for Organ Sharing and a professor of pathology at the University of Pittsburgh Medical Center, claims that transmission of disease from donor to recipient occurs less than one percent of the time. This means that with the more than 28,000 transplants nationwide per year, there are fewer than 280 instances where disease is transferred from donor to recipient.

There are minimum procurement standards that outline the appropriate medical tests and examinations before an organ is accepted for transplantation. However, the nature of the standards leave wide discretion to over 50 organ procurement groups that assess organs used for transplantation. Another problem is that these assessments are made with the clock ticking, in order to ensure that they reach the recipient in as little time as possible and to prevent the organs from perishing. This could result in organs being rushed through tests and examinations, or organs skipping tests and examinations, which could result in further injury to patients that are already in dire straits. Transplant surgeons also have the discretion to reject and organ, which is a decision that is sometimes made when there is limited information about a donor.

The United Network for Organ Sharing reports that malignant cancer was the cause in 14.5 percent of kidney recipients five to ten years after the transplant operation.

CAT Scans Lead To Radiation Exposure

A computed tomography scan ("CT scan" or "CAT scan"), which is a procedure that takes no more than a few minutes, is a medical imaging method that is used to create three-dimensional x-ray images. CT scanning has a number of benefits over traditional medical radiography. For example, CT scanning eliminates superimposed structures outside the area of interest and tissues that differ in physical density can be more easily identified. The most crucial part of the scan is usually completed in under a minute, but prolonged scanning could result in a number of severe health risks due to high radiation exposure.

A typical dose of radiation for a CT scan that includes the head and chest would result in exposure to 7.3 mSv (millisievert) of radiation. For comparison, the average survivor of the Hiroshima and Nagasaki bombings were exposed to 40 mSv of radiation, and the average radiation exposure from natural sources to an individual within the United States is about 3 mSv. Additionally, the effects of low doses of radiation-less than 100 mSv-are observed on a cellular level and may not be detected for up to twenty years after exposure.

According to the United States Nuclear Regulatory Commission, the exposure to radiation can have three effects: 1) cells are injured or damaged and then later repair themselves, resulting in no enduring damage; 2) cells could be killed, which happens on a large scale every day; or 3) cells incorrectly repair themselves, which results in a biophysical change.

Genetic effects and the development of cancer are the primary adverse effects attributed to radiation exposure. Cancer is five times more likely to occur after radiation exposure than a genetic effect.

With CT scanning technology on the rise, the likelihood for public exposure to harmful levels of radiation increases. Traditionally, it was a physician's decision whether or not to scan a patient; but today, an individual may undergo a scan of their entire body without consulting a primary care physician.

There exists a lack of awareness of the risks of radiation exposure. Patients who undergo CT scanning, as opposed to other imaging techniques, are exposed to higher levels of radiation. For example, MRI is safer, but more expensive and has limited availability. As CT technology increases, the necessary dose of radiation also increases. Therefore, there is an increase in radiation exposure to the public, as well as its adverse health effects.

Due to the increased public exposure to radiation, there is an increase in controversy regarding a more conservative use of CT scanning. For example, asking the question "Is there a reasonable need for a CT scan in this situation?" might help decrease the detrimental effects of radiation on the public.

Iowa Workers Compensation: What is a company doctor?

In Iowa the employer, or in most cases, the employer's insurance company has the right to select the treating physician. The injured worker has limited rights to select the treating physician. There are times the insurance adjuster will ask the worker who he wants as the treating physician, but that's unusual.

Many employees don't like the doctors chosen by the insurance company. That's not unusual because many of those doctor decisions about treatment seem to require input from the patient. Company doctors as they are called, seem to have little concern for what the patient wishes to do. You could say the company doctors don't seem to care about what the patient may want. That's not far from the truth.

Think about it for a minute. Doctors know that they are being chosen by an insurance company. Insurance company's select conservative doctors who start off thinking all workers are liars and would love nothing better than to be on workers' compensation for the rest of their lives. That's an unjustified and stupid assumption but one not entirely without a historic basis. To stay within the insurance company's favor doctors must maintain a certain distance from the patient/injured employee. Thus they remain aloof from the injured employee who is the patient.

The company doctor will almost always espouse conservative opinions towards issues like going back to work, maximum medical improvement and permanent impairment. Conservative means the less the better and get the injured back to work. The company doctor resolves any doubts in favor of the insurance company. They will endear themselves to the insurance company executives to remain within their favor. That way they keep getting referrals from the insurance company.

So if as the injured worker you're frustrated with the way the company doctor is treating you, join the rest. So is everyone else.

The limited rights you have depends on what the Industrial Commission considers "reasonable". If the doctor and the adjuster get too far off the reservation, then your lawyer can file for alternate medical care and ask for a different doctor. That's as good as it gets under Iowa's workers' compensation law.

Who chooses the Medical Care? 

The employer provides medical care reasonably suited to treat the employee’s injury, and has the right to choose the medical care. If the employee is dissatisfied with the care offered, the employee should discuss the problem with the employer or insurance carrier. In certain situations the employee may wish to request alternate care. If the employer, or insurance carrier, does not allow alternate care, the employee (through appropriate proceedings) may apply to the workers' compensation commissioner for alternate medical care. (85.27)

If the employer-retained physician gives a rating of permanent impairment, which the employee feels is too low, the employee does have a right to another examination by a doctor of the employee’s choice at the employer’s expense. (85.39)

 

British Doctor Volunteering in Republic of Congo performs surgery through text-message instruction

Doctor David Nott, doing charity medical work in the Republic of Congo performed surgery by text message instructions sent from a colleague in the United Kingdom. The boy, sixteen-years-old had injured his arm in an accident. By the time Dr. Nott arrived for his one month per year stint with the charity Medecins sans Frontieres, the boy’s arm was badly infected and the boy was dying. To save the boy’s life the doctor determine the arm needed to be amputated. An arm amputation isn’t a procedure the doctor had previously performed. Aside from having very few resources he would be required to also remove the collar bone and shoulder blade.

Sending a text-message to a colleague in the U.K. Dr. Nott received step by step instructions on how to perform the operation.  If you would like to hear Dr. Nott click on the video link.

Today at the Des Moines InjuryBoard we salute Dr. Nott for his creative abilities, quick thinking and gutsy move.