One of the very first lessons I learned in my clinical career was a quote from Dr. William Osler dating back to 1895. Dr. Osler was at the Johns Hopkins medical school and his quote is “Listen to your patient, he is telling you the diagnosis.” Another is “The good physician treats the disease; the great physician treats the patient who has the disease.”
Medicine as Art and Science: The Value of Thorough History
Clearly, medicine is as much art as it is science. In past missives, I have discussed how it is as important for each participant to obtain as detailed a clinical history as possible. Additionally, when applying the standards incumbent upon everyone relative to treating that injured employee, asking the same questions on multiple occasions can be quite informative.
Therefore, when you start your conversation and relationship with an injured individual, have a list of questions specific to the suggested diagnosis. A cursory review of the literature notes that approximately 75% of compensable injuries will include sprains & strains, cuts and punctures, contusions, inflammation such as bursitis and tendinitis, and fractures. To be clear, this is not everything that will cross your desk, but if you have a bit of a cheat sheet for these common injuries, you will have a leg up on handling and providing all appropriate care for the actual compensable injury sustained.
Strategic Questioning: Tailoring Inquiries to Potential Diagnoses
With the first encounter, and later encounters, ask that injured employee to explain the accident in detail. A colleague once told me “You never have to remember the truth.” As such, if the story changes that is a bit of a red flag and perhaps there needs to be actions taken to ensure the veracity of the story. Asking the injured individual to provide specific information to include time, location, type of task being completed, and what equipment, if any or personal protective equipment was used at the time of the event.
Unpacking the Incident: The Importance of a Detailed Account
Asked about location details, and local environmental issues such as the weather, was this a cluttered work environment, a wet work environment, or other issues that could impact the injury sustained.
Ask the injured individual their job title, the routine job activities, and ensure this is consistent with what was originally reported by the injured individual and the employer.
The Need for Unquestionable Facts: Navigating Economic Uncertainties
The point is injuries happen, and the facts applicable to this event should be consistent. Understanding the economic changes happening in our country today and what may happen in the future, there needs to be objective information whose veracity is unquestioned. Taking a few moments with your later phone calls to the injured individual shows the employee you are interested in their case, that you want to provide all appropriate care, and you have time for them. The ultimate goal will be a more rapid resolution of the claim file.