Sports medicine model cuts time away from work
Don’t wait, diagnose and treat quickly
How do you get employees back to work faster? Try treating them like star athletes! This creative approach has worked extremely well for Fort Worth, TX-based Occupational Health Solutions, a subsidiary of Osteopathic Health Systems of Texas that includes one hospital and two occupational health clinics.
"We call it the occupational athlete model," explains Jerry W. Morris, D.O., director of medical services. "What I saw was that we were spending a lot unnecessary time dragging out diagnosis and treatment. If you have a Michael Jordan, you don’t let him sit on the bench for very long. We wanted to provide our workers with the same type of immediate treatment."
Employees served by Occupational Health Solutions have no waiting time for appointments. If they are injured, they can be seen on the same day. If they are injured on the weekend they can go to the hospital emergency room (ER), which is an integrated part of the treatment model.
Learning from others
Morris’ approach was derived from results achieved by other organizations using a similar model. He consulted with organizations like the San Antonio-based Cochrane Collaboration, which reviews the body of literature in this area. "What you really want to know is how this makes sense," he explains. "We wanted clinical evidence that showed it was effective. Some of the studies showed it probably was."
He found a willing listener in executive director Bo Brannon. "While I’m in administration, my background is athletic," Brannon says. "Last September, Jerry noted that the economy was on the way down, our business was not growing, and it was time to break the traditional model. I said, Let’s roll it out, try it in your clinic, and if it’s successful we’ll roll it out in our other clinics.’" Morris’ motives were not entirely economic. "My economic incentive is primarily to do a good job," he says. "Our feeling was, let’s take care of our customers and they will take care of us."
The new program, launched in September 2001, differs dramatically from a more traditional model.
"Say you have a low-back injury — a worker on the late night shift in a warehouse bends over and hurts his back," Morris offers. "Under our previous model, he may or may not get first aid at work. Somebody would call his doctor the next morning, and hopefully he would get to see him in two or three days. So he’d see his family doctor, who would take him off work, put him on muscle relaxers and pain medication, and tell him to call in three days if he’s not better. Then, he may have two or three X-rays over the next six weeks. If he’s no better, it’s MRIs and CAT scans. All this time he’s away from work and not getting much attention — especially in the first 72 hours, when he needs it the most."
Which brings Morris back to the Michael Jordan model. "If Michael comes off the floor hurt he gets with the trainer and is treated as soon as possible," he says. "If you provide treatment right away you dramatically reduce disability or impairment time."
Under the new model at Occupational Health Solutions, that same injured worker would be seen within a few hours of injury if the injury occurs during business hours. If not, he would go directly from the plant to the ER. "In either case, he gets immediate evaluation and treatment," says Morris. "We’ve trained our ER physicians about our approach, and they get back to us the next day for follow-up."
This initial visit includes a physical exam and meds — and physical therapy. "We start therapy on that visit — he goes right back to the physical therapy department," Morris explains. "If he goes to the ER, he doesn’t get therapy but he gets the evaluation and meds started, and we begin therapy the next morning. In either case, he’s re-evaluated within 48 hours so we have a chance to focus even more carefully on the injury if it’s required, but 75% of the patients are getting better by the third day so they can return to 80% of normal job function."
Referrals way up
Brannon concedes that on a per-patient basis, the new model will likely generate less income than the traditional model: "Our income will probably be somewhat less, but in return we are getting more business," he says. "More people are recognizing that our results are better."
It helps that in Texas, employers can send injured workers wherever they choose. "We now get more referrals of injury treatment because people see the difference," says Morris. "At one company, the CEO found out we do such a good job that when he had a personal problem with his back he came to us because his doctor used the old model. If you can get people faster relief and back to work sooner everyone will be happier."
Morris has tracked program results since September. "The results are so overwhelmingly positive we have abandoned the other model altogether," he says.
"We have implemented the model in both our clinics," adds Brannon. "Some clients have said they have cut their loss time by two-thirds."
Brannon notes that some unethical occupational health operations intentionally set up their systems to stretch out treatment time. "We decided we would rather compete on quality and let the results speak for themselves," he concludes.
[For more information, contact: Occupational Health Solutions, 1916 N. Beach St., Fort Worth, TX 76111-6703. Telephone: (817) 921-6284.]
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