Two costly medical actions to avoid: physician dispensing and emergency rooms

Physician dispensing

While many states have enacted laws governing physician dispensing, it is still common in post-reform states, with California, Florida, Illinois, Maryland, and Pennsylvania still seeing a large portion – 54% to 64% – of pharmaceutical costs coming from doctors who dispense drugs. According to a study by the Workers’ Compensation Research Institute (WCRI) drug companies have introduced newer versions outside of those addressed in the reforms to circumvent the laws. The WCRI study found that “when dispensing these new drug products, some physician-dispensers were paid much higher prices than they were paid when dispensing existing-strength drug products.”


Emergency room treatment

Treatment at an emergency room is not only one of the most expensive places to get medical care, but also likely to derail a rapid return to work. While often used for convenience, it should be a last resort and used for critical, emergency situations only.

According to a recent study published in JAMA Internal Medicine, there are exorbitant markups in emergency medical care and emergency departments charged an average markup of 340 percent on Medicare allowable amounts. Further, facing physician shortages, some hospitals have been outsourcing the staffing and operation of emergency rooms. According to a recent article in the New York Times, this has led to higher charges for more costly procedures, out-or-network rates, and surprise bills.

If the costs alone are not a sufficient deterrent, understanding the process should be convincing. An emergency physician is trained to triage and stabilize an injury. There isn’t time or expertise to focus on short-term work restrictions or long-term recovery. In most cases, the injured worker will be told to rest and take days or even weeks off from work. It’s also usual to refer the injured worker to a specialist, which could mean further delays in treatment. And a disability mindset begins to build in the worker.

On the other hand, if treatment begins with an occupational medicine provider or clinic, they will prescribe treatment plans that are going to return your employee to work as soon as possible. They can also help manage the workers’ compensation process so that employees understand the value of recovery at work.

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