Handbook of Complex Occupational Disability Claims: Early Risk Identification, Intervention, and Prevention
http://www.100md.com
《新英格兰医药杂志》
It should come as no surprise that some of the most poorly understood medical conditions are also the most difficult to treat successfully. The causes of low back pain, whiplash, chronic headache, post-traumatic stress disorder, mild closed head injury, fibromyalgia, repetitive strain injury, depression, and anxiety remain quite obscure in many cases. These complex "biopsychosocial" injuries and illnesses tend to defy the classic biomedical management model. Effective treatment, identification of the risk of disability, and early intervention and prevention have remained elusive, despite extensive research developments in the field. As in many disciplines, there is a considerable time lag from theory to research and from research to practice. The Handbook of Complex Occupational Disability Claims attempts to bridge the divide between the latest, most promising research advancements in the treatment of biologic, psychological, and social disabilities and the implementation of these treatments in clinical and case management practices.
Editors Izabela Schultz and Robert Gatchel present 29 well-written, well-researched, and well-annotated essays that are organized into five cohesive sections. The book begins with discussions of the conceptual and methodologic issues involved in predicting disability. Included in this first section are thorough discussions of impairment and disability and their epidemiologic and societal costs. Traditional models of disability — including the biomedical model, the psychiatric model, the insurance model, and the labor relations model (with their attendant tenets; implications for diagnosis, treatment, and compensation; limitations; and scope of applicability) — are discussed as they relate to this class of disability. The authors of these essays point out that much of the difficulty of treating these disabilities stems from the fact that the ailments themselves are ill-defined. The biopsychosocial model is presented as the most comprehensive approach to these complex, multidimensional afflictions because it takes into account the biologic, psychological, and social aspects of disability. Return to work is thoroughly discussed, and the role of each stakeholder (the patient, the employer, the health care provider, and the insurer) is reviewed.
A series of insightful chapters that include original research and critical reviews of the literature guide the reader through recent scientific discoveries into some of the more common pain-related and psychological conditions resulting from occupational disabilities. These include low back injury, fibromyalgia, repetitive strain injury, mild traumatic brain injury, and post-traumatic stress disorder. The authors of these chapters emphasize the early detection of potential disability and present a number of programmatic steps designed to facilitate appropriate, early treatment for the benefit of the patient, the employer, the insurer, and society as a whole.
The application of research findings to the fields of rehabilitation, disability management, and compensation systems is also discussed, with emphasis on overcoming the obstacles to recovery. The biopsychosocial factors encountered, the management of secondary gains within the medico-legal setting, and other potential impediments to appropriate rehabilitation and lasting return to work are all discussed, with an emphasis on how to avoid them. An outstanding chapter presents evidence-based best practices for early identification and intervention, emphasizing a multidisciplinary and multimodal approach that includes effective coordination between stakeholders. Additional specific models of early workplace screening and intervention for employees at risk are showcased. Emphasis is placed on tailoring programs to the needs of the individual and community being served, and it is reported that recent research suggests shifting the rehabilitation process to the workplace for greater efficacy. In an outstanding closing chapter, Schultz and Gatchel review the common themes presented by their diverse group of authors and provide some guidance for widespread implementation. They encourage the rapid transfer of new knowledge into clinical practice and suggest areas for future research.
The book is highly technical and not for the lay reader. Physicians who are directly involved in the treatment of occupational disabilities and want to improve the outcomes for their patients will benefit from the information provided. Case managers, insurers, and lawyers who handle occupational disability claims will appreciate suggestions on how to optimize their clients' social and clinical recovery. Finally, corporate officers responsible for occupational safety, worker compensation programs, or return-to-work programs will become informed about prevention, prediction, and early intervention programs that have been proved to increase worker satisfaction and diminish financial losses.
There is no doubt that skyrocketing disability claims are having a profound monetary and social impact on Western societies. Leading this explosion are the biopsychosocial disabilities that have proved elusive to standard modeling. Schultz and Gatchel have created a repository of new knowledge about these disabilities, with some practical suggestions on how to integrate this knowledge effectively into clinical, case-management, rehabilitation, corporate, compensation, and return-to-work practices. Albert Einstein is reported to have said that "the significant problems we face cannot be solved by the same level of thinking that created them." This book does an admirable job of presenting a new paradigm to better address this challenging problem.
Brian E. Grottkau, M.D.
Massachusetts General Hospital
Boston, MA 02114(Edited by Izabela Z. Schu)
Editors Izabela Schultz and Robert Gatchel present 29 well-written, well-researched, and well-annotated essays that are organized into five cohesive sections. The book begins with discussions of the conceptual and methodologic issues involved in predicting disability. Included in this first section are thorough discussions of impairment and disability and their epidemiologic and societal costs. Traditional models of disability — including the biomedical model, the psychiatric model, the insurance model, and the labor relations model (with their attendant tenets; implications for diagnosis, treatment, and compensation; limitations; and scope of applicability) — are discussed as they relate to this class of disability. The authors of these essays point out that much of the difficulty of treating these disabilities stems from the fact that the ailments themselves are ill-defined. The biopsychosocial model is presented as the most comprehensive approach to these complex, multidimensional afflictions because it takes into account the biologic, psychological, and social aspects of disability. Return to work is thoroughly discussed, and the role of each stakeholder (the patient, the employer, the health care provider, and the insurer) is reviewed.
A series of insightful chapters that include original research and critical reviews of the literature guide the reader through recent scientific discoveries into some of the more common pain-related and psychological conditions resulting from occupational disabilities. These include low back injury, fibromyalgia, repetitive strain injury, mild traumatic brain injury, and post-traumatic stress disorder. The authors of these chapters emphasize the early detection of potential disability and present a number of programmatic steps designed to facilitate appropriate, early treatment for the benefit of the patient, the employer, the insurer, and society as a whole.
The application of research findings to the fields of rehabilitation, disability management, and compensation systems is also discussed, with emphasis on overcoming the obstacles to recovery. The biopsychosocial factors encountered, the management of secondary gains within the medico-legal setting, and other potential impediments to appropriate rehabilitation and lasting return to work are all discussed, with an emphasis on how to avoid them. An outstanding chapter presents evidence-based best practices for early identification and intervention, emphasizing a multidisciplinary and multimodal approach that includes effective coordination between stakeholders. Additional specific models of early workplace screening and intervention for employees at risk are showcased. Emphasis is placed on tailoring programs to the needs of the individual and community being served, and it is reported that recent research suggests shifting the rehabilitation process to the workplace for greater efficacy. In an outstanding closing chapter, Schultz and Gatchel review the common themes presented by their diverse group of authors and provide some guidance for widespread implementation. They encourage the rapid transfer of new knowledge into clinical practice and suggest areas for future research.
The book is highly technical and not for the lay reader. Physicians who are directly involved in the treatment of occupational disabilities and want to improve the outcomes for their patients will benefit from the information provided. Case managers, insurers, and lawyers who handle occupational disability claims will appreciate suggestions on how to optimize their clients' social and clinical recovery. Finally, corporate officers responsible for occupational safety, worker compensation programs, or return-to-work programs will become informed about prevention, prediction, and early intervention programs that have been proved to increase worker satisfaction and diminish financial losses.
There is no doubt that skyrocketing disability claims are having a profound monetary and social impact on Western societies. Leading this explosion are the biopsychosocial disabilities that have proved elusive to standard modeling. Schultz and Gatchel have created a repository of new knowledge about these disabilities, with some practical suggestions on how to integrate this knowledge effectively into clinical, case-management, rehabilitation, corporate, compensation, and return-to-work practices. Albert Einstein is reported to have said that "the significant problems we face cannot be solved by the same level of thinking that created them." This book does an admirable job of presenting a new paradigm to better address this challenging problem.
Brian E. Grottkau, M.D.
Massachusetts General Hospital
Boston, MA 02114(Edited by Izabela Z. Schu)