Ethics, treatments, and Comp (Oh my!)

I closed a rehab file this week. Not because the worker, Joe* had recovered, and not because he had returned work, but because there was nothing more I could do.

Despite mine and the rehab team’s optimistic attempts to support suitable duties, and accommodate a graded recover at work program over an 18 month period, the primary medical team’s outright refusal to allow Joe to trial working for more than 3 hour per day, for 3 days per week was too large of an obstacle to overcome. Joe is now certified unfit for any work.

For two years, Joe underwent treatments by a physiotherapist, an exercise physiologist, and a chiropractor. He had cortico-steroid injections, nerve blocks, lumbar discectomy, and most recently a second bout of radiofrequency ablation (rhizotomy). These were in addition to the narcotic based medications which were mixed with over-the-counter pain relief medications.

My pleas to the medical team to also refer to pain management and psychological counselling fell on deaf ears. Some of the medical team responded to my letters, not with helpful recommendations, but with invoices requesting pre-payment of up to $325 prior to sending a response. (Side note: one medical questionnaire had asked only one question requiring a yes / no answer).

Yet still, the medical team continued to poke and prod Joe despite the lack of any objective or significant improvement to his quality of life, function, pain experience, or work capacity.

Some of my recommendations on the closure report read:

  • Joe’s medical team to consider the effectiveness of their treatments, their professional and ethical obligations as medical practitioners and treatment providers, and their obligation to assist and support Joe with improving his quality of life.
  • Joe’s medical team to consider his longer-term prospects and the benefits of returning to work.
  • Joe’s medical team to review and understand their role and responsibilities with the workplace compensation scheme.

When I asked Joe why he keeps going on with treatment, his response was:

“They’re the Doctors, I trust them, they know what’s best for me”