Category: The Rx Professor

One of the biggest misconceptions in workers' compensation is that injured workers lose trust when something goes wrong. A claim is denied A treatment request is delayed A utilization review doesn't go their way An independent medical examination reaches an unexpected conclusion Those events certainly can damage trust. But in my experience, distrust usually begins much earlier. It often begins before the first potentially negative decision is ever made. An…

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One of my favorite sessions at the California Coalition on Workers' Compensation (CCWC) annual conference had an incredibly long title: "Best Practices Californians Can Learn from Other States to Find Solutions for Cost Containment, AI Adaptation, and More." Thankfully, the conversation itself was much more concise than the title. More importantly, it offered a perspective that extends well beyond California. The panel included Stuart Colburn, Esq. (Downs & Stanford, P.C.),…

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One of the sessions I looked forward to at the California Coalition on Workers' Compensation (CCWC) Annual Conference was presented by Dr. Tyrone Spears (City of Los Angeles) and Stephen Peacock (Safety National): "Are You Ready for a Workers' Comp Catastrophe?" The title immediately grabs your attention, which is one reason why the room was full. Most of us don't like thinking about catastrophic claims. They are, by definition, rare…

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At this year's Southern Association of Workers' Compensation Administrators (SAWCA) Annual Convention, one theme surfaced repeatedly across multiple sessions: access to care. It wasn't discussed simply as a healthcare issue or a reimbursement issue. It was presented as one of the defining challenges facing the future of workers' compensation itself, and its implications were discussed from multiple perspectives throughout the week. The theme was top of mind at the event’s…

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Imagine walking into a clothing store and being told there is only one size available. It doesn't matter whether you're tall or short, narrow or wide. Athletic or not. Male or female. Everyone gets the same shirt. Most of us would immediately recognize the flaw in that approach. Yet when it comes to professional education, we do it all the time. Organizations spend significant amounts of money on training programs…

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If you had told me fifteen years ago that opioid prescribing would eventually become one of the defining healthcare issues of a generation, I would have believed you. If you had told me that we would spend more than a decade collecting mountains of data, implementing formularies, changing prescribing guidelines, introducing prescription monitoring programs, restricting access, educating physicians, and dramatically reducing opioid utilization, I would have believed that too. I…

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There was a time when earning a professional credential meant something very specific. It meant you had invested time, demonstrated competence, and met established standards. It meant you had proven a level of mastery that distinguished you from others in your field. The credential itself wasn't valuable because of the paper it was printed on. It was valuable because people trusted what it represented, the combination of its credibility and…

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If you've spent any time in workers' compensation, you've probably attended a conference or training program that looked successful on paper. The room was full. The instructors were engaging. The PowerPoint slides had graphs and graphics. I’ve seen, from the stage, attendees nod in agreement and take notes. Everyone left feeling like they learned something, and the instructors felt like they made a difference. Then Monday arrived, and very little…

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Nobody who files a workers' compensation claim expects it to become a catastrophe. Yet every day, a strained back becomes surgery, a minor sprain becomes disability, and a routine claim becomes a six-figure reserve. Over the years, I've come to believe that many of these situations can be explained by a concept increasingly discussed in healthcare as the "medical cascade." The idea is simple. One event triggers another. One decision…

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For an industry that spends a lot of time talking about indemnity and medical benefits, RTW, litigation, and now artificial intelligence, it is remarkable how often the biggest factor influencing outcomes comes down to something much simpler. Human connection. That was the central theme of a session I attended at the Tennessee Bureau of Workers’ Compensation Annual Education Conference on June 11. The session, Working for a Brighter Day: Rewriting…

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