Unthoughtful reforms will only hurt patients

Medical offices are small businesses. Physicians are in the unique position to see both sides of the recent debate on changing Illinois’ workers’ compensation rules. When one of our staff is injured on the job, we contend with the same workers’ compensation system as any other employer. Many of us also see injured workers as patients, so we understand their unique clinical needs and the added administrative burdens required to treat them.

An arbitrary slashing of the amount paid for injured workers’ medical care is not the right prescription for reform. The workers’ compensation fee schedule is set at its current level because it is so much more expensive and time consuming to treat patients who come into our offices as “work comp” cases. Work comp means dealing with case managers and attorneys, submitting transcribed reports, evaluating and reporting disability status, filing rating reports and participating in legal depositions.

Appealing “utilization review” decisions is another common course of business with work comp. This is a term used to describe an oversight system, which requires doctors to spend significant time on the phone defending why a course of treatment is necessary for a patient. We commonly have to wait years for payments because of disputes over the validity of work comp claims.

Unfortunately, patients will be the ones hurt the most if the proposed 30 percent slashing in the amount paid for injured workers’ medical care goes through. Given that work comp cases require so much additional effort, without reasonable reimbursement many doctors will be forced to stop seeing work comp patients.

Illinois doctors understand the need for reform and we are committed to working with lawmakers, but let’s not settle for simplistic “solutions” that will lead to more severe problems for patients down the line.

Steven M. Malkin, M.D.

President

Illinois State Medical Society

Chicago