Don’t Bring a Knife to a Gun Fight
If there is anything I have learned after 20 years of controlling runaway workers’ comp medical costs, its is that you “Don’t Bring a Knife to a Gun Fight”. On more than one occasion, I have heard regulators say, “if you want to contest medicals, don’t do it on the cheap and if you want me to overrule a treating physician, then give me something scientific that will stand up under scrutiny.”
Like it or not there is a distinct hierarchy in the medical community. A family doctor may not listen to a PBM pharmacist, an occ med doctor is not going to listen to a chiropractor, a neurosurgeon is not going to listen to an internist.
If our industry really wants to improve outcomes and reduce abusive prescription regimens, it requires involvement from the highest credentialed and most scientifically informed physicians who personally interact with treating physicians to help improve patient care and control medical costs.
Posted in OMCA