Connecting Skilled Doctors with Injured Workers: The Certified Physician Program
The Tennessee Bureau of Workers’ Compensation’s REWARD Program offers tools and resources to help Tennessee employers return their injured workers to gainful employment. First and foremost, it offers the REWARD Toolkit, which provides in-depth guidance for employers wanting to start their return-to-work program. Secondly, it offers synchronous online training for a company’s Return-to-work Coordinator, the hub of any employer’s return-to-work efforts. Third, it helps connect and recognize like-minded employers through the REWARD Support Network, Honor Roll, and bi-monthly Report. Finally, it provides access to a network of highly trained physicians who not only accept workers’ compensation patients but also apply the Bureau’s best practices for treating and evaluating injured workers. This network of physicians and the rules that apply to it is the REWARD Certified Physician Program (CPP).
Research and Findings
When creating the REWARD program, the Bureau’s task force quickly realized that physician education would be an integral part of our efforts to Return Employees to Work And Reduce Disabilities. Our research consistently showed us that a quicker return to work led to improved medical outcomes and reduced disability claims (Carlier et al, 2013; Jurisic et al., 2017; Kroll et al., 2009; Morris et al., 1994; Reuda et al., 2012; Roelfs et al, 2011; Shiri et al., 2013; Waddell et al., 2007). It also showed us that there was strong correlation between an injured worker’s expectations of returning to work and the actuality of doing so (Heymans, 2006; Iles, 2008; Iles, 2009; Sandström & Esbjörnsson, 1986; Kapoor et al., 2006). We found that treating physicians were in an excellent position to help shape an injured worker’s expectation of returning to work, especially when they provided “consistent, accurate information” based on published outcome data for the injury in question (Lewkonia et al, 2012; Schouten et al, 2015).
Key Questions
But some important questions remained for the Bureau’s task force. For one, how do we emphasize to physicians that one of the best treatments that they can offer an injured workers is, well, work itself? And even if physicians recognize work as “good medicine,” how do we further incentivize them to help set high return-to-work expectations for their patients? On a more fundamental level, how do we encourage physicians to accept workers’ compensation patients and learn all that is required of them under the workers’ compensation law? Physicians who treat Tennessee workers’ compensation patients are routinely required to make determinations regarding causation, work restrictions, maximum medical improvement, and permanent impairment. This is problematic because these same physicians seldom receive formal training on these issues in medical school.
An Online Course
The culmination of the task force’s effort to address these questions is the Certified Physician Program, which trains and certifies physicians in the Tennessee workers’ compensation system. The heart of the CPP is an online self-paced training course entitled “Best Practices for Treating and Evaluating Injured Workers.” Comprised of thirteen training modules, the Best Practices course teaches physicians the fundamentals of workers’ compensation, including returning patients back to work; setting RTW expectations, determining causation, MMI, permanent impairment, and work restrictions; navigating utilization review, treatment guidelines, and billing processes; and understanding the administrative court system. Physicians who take this course, pass a comprehensive test, and agree to treat workers’ compensation patients are eligible to receive enhanced fees.
To be eligible, a physician must be a licensed Doctor of Medicine, Osteopathy, or Chiropractic, must be board-certified or board-eligible, and must be certified in the AMA Guides®, 6th Edition, through a Bureau-approved vendor. CPP Physicians must also agree to have their names published on the Bureau’s website so that employers and their insurance carriers can easily find them when they need to provide a medical panel. The Certified Physician Program essentially plays matchmaker, connecting employers and their injured workers with physicians who want to treat workers’ compensation patients.
Visit the CPP Website Today
So, the next time you’re having trouble finding a doctor for your Employee’s Choice of Physician Medical Panel, try visiting the CPP Registry. Here you will not only find trained physicians who accept workers’ compensation patients, but you will also find physicians who understand the value of a quicker return to work and have the know-how to make it happen. You can search for physicians by name, medical specialty, board certification, or location. The physician’s contact information, website, and NPI number are also readily available, making the process as user-friendly as possible.
We at the Bureau recognize that finding trained physicians who accept workers’ compensation patients and know how to get them back to work is often a difficult task. With time, though, as more physicians are added to the CPP Registry every month, we think the process will become easier. If you know of physicians who might want to be on the CPP Registry, please send them a link to the program. We’ll help them in any way we can.
References
- Carlier, B. E., Schuring, M., Lötters, F. J., Bakker, B., Borgers, N., & Burdorf, A. (2013). The influence of re-employment on quality of life and self-rated health, a longitudinal study among unemployed persons in the Netherlands. BMC Public Health, 13, 503 https://doi.org/10.1186/1471-2458-13-503
- Heymans, M. W., De Vet, H. C. W., Knol, D. L., Bongers, P. M., Koes, B. W., & Van Mechelen, W. (2006). Workers’ Beliefs and Expectations Affect Return to Work Over 12 Months. Journal of Occupational Rehabilitation, 16(4), 685–695. https://link.springer.com/article/10.1007/s10926-006-9058-8
- Jurisic, M., Bean, M., Harbaugh, J., Cloeren, M., Hardy, S., Liu, H., Nelson, C., & Christian, J. (2017). The Personal Physician's Role in Helping Patients With Medical Conditions Stay at Work or Return to Work. Journal of Occupational and Environmental Medicine, 59(6), e125–e131. https://doi.org/10.1097/JOM.0000000000001055
- Kapoor, S., Shaw, W. S., Pransky, G., & Patterson, W. (2006). Initial patient and clinician expectations of return to work after acute onset of work-related low back pain. Journal of Occupational and Environmental Medicine, 48(11), 1173–1180. https://doi.org/10.1097/01.jom.0000243401.22301.5e
- Kroll, L. E., & Lampert, T. (2011). Unemployment, social support and health problems: results of the GEDA study in Germany, 2009. Deutsches Arzteblatt international, 108(4), 47–52. https://doi.org/10.3238/arztebl.2011.0047
- Lewkonia, P., Dipaola, C., Schouten, R., Noonan, V., Dvorak, M., & Fisher, C. (2012). An evidence-based medicine process to determine outcomes after cervical spine trauma: what surgeons should be telling their patients. Spine, 37(18), E1140E1147. https://doi.org/10.1097/BRS.0b013e31825b2c10
- Morris, J. K., Cook, D. G., & Shaper, A. G. (1994). Loss of employment and mortality. BMJ (Clinical research ed.), 308(6937), 1135–1139. https://doi.org/10.1136/bmj.308.6937.1135
- Rueda S., Chambers L, Wilson M., et al. (2012). Association of Returning to Work with Better Health in Working- Aged Adults: A systematic review. Am J Public Health, 102 (3): 541-556. doi: 10.2105/AJPH.2011.300401
- Sandström, J., & Esbjörnsson, E. (1986). Return to work after rehabilitation. The significance of the patient's own prediction. Scandinavian journal of rehabilitation medicine, 18(1), 29–33.
- Schouten, R., Lewkonia, P., Noonan, V. K., Dvorak, M. F., & Fisher, C. G. (2015). Expectations of recovery and functional outcomes following thoracolumbar trauma: an evidence-based medicine process to determine what surgeons should be telling their patients. Journal of Neurosurgery. Spine, 22(1), 101–111. https://doi.org/10.3171/2014.9.SPINE13849
- Shiri, R., Kausto, J., Martimo, K. P., Kaila-Kangas, L., Takala, E. P., & Viikari-Juntura, E. (2013). Health-related effects of early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial. Scandinavian journal of work, environment & health, 39(1), 37–45. https://doi.org/10.5271/sjweh.3301
- Waddell, G., Burton, K., & Aylward, M. (2007). Work and common health problems. Journal of Insurance Medicine (New York, N.Y.), 39(2), 109–120. https://pubmed.ncbi.nlm.nih.gov/17941336/
Jay Blaisdell, MPA
Jay Blaisdell, MPA, is the coordinator for the Tennessee Bureau of Workers’ Compensation’s MIR and CPP Registries. He has been the managing editor of AdMIRable Review since 2012. He is certified in public policy and medical impairment rating methodology. He earned a master’s degree in humanities from California State University, Carson, and a master’s degree in public administration from Tennessee State University in Nashville. His numerous articles for AdMIRable Review have been republished, with permission, by the AMA Guides Newsletter. A veteran of the U.S. Army, Jay has been with the Tennessee Bureau of Workers’ Compensation since 2005.
DISCLAIMER
Views expressed in the REWARD Report are solely those of the authors and may not reflect the official policy or position of the Tennessee Bureau of Workers’ Compensation, the Tennessee Court of Workers’ Compensation Claims, the Tennessee Workers’ Compensation Appeals Board, or any other public, private, or nonprofit organization. Information contained in the REWARD Report is for educational purposes only.
R.E.W.A.R.D. PROGRAM: RETURN EMPLOYEES TO WORK AND REDUCE DISABILITIES
To maximize the chances that injured workers will successfully return to work, employers must carefully choose the physicians listed on their physician panels. Did you know that employers can find information in the REWARD toolkit on developing a diverse “pool” of physicians? The toolkit also contains sample letters for employers to use including one for communication with the physician regarding transitional positions. To read more on picking the right physicians for the panel download the REWARD Program Toolkit (tn.gov).
MEET WITH LIKE-MINDED EMPLOYERS
Employers are encouraged to attend the annual in-person only REWARD Employer Group meeting that is scheduled before the Bureau’s Annual Conference begins in Murfreesboro at 1200 Conference Center Blvd, Murfreesboro, TN 37129 on Wednesday morning June 12th at 9:45AM Central Time. Brunch is included. No fee is required to attend this pre-conference employer meeting though a reservation is required.