It All Depends On Where You Start


Why is it that different treatment protocols and prescribing patterns are implemented for similar patients/diagnoses? According to a The New England Journal of Medicine study as highlighted in The New York Times, sometimes it all depends on the first physician contact.


This research tracked Medicare patients, seen in emergency rooms, who presented similar complaints and concentrated on opioid usage.


The study identified what they described as “high-intensity” prescribers whose patients were 30% more likely to become long-term opioid users with substandard outcomes.


Once these patients left the ER, problems continued with their follow-up physicians due to what the authors describe as “clinical inertia.” Technically this is inaction by a prescriber when guidelines or optimal care would recommend a more aggressive course. Or in layman’s terms, “if the opioids were good enough for the ER doc, they’re good enough for me.”


In addition, most ER and treating doctors realize that opioid alternatives such as acupuncture, massage therapy and physical therapy may improve outcomes, but there is a “structural disincentive” to offer these options due to poor insurance reimbursement.


So…it really does all depend on where you start.


Doing better depends on the right network, early intervention and aggressive utilization/pharmacy reviews.


Call us. You can depend on us to do better.

William Faris, JD
Chief Executive Officer

Posted in Bill's Favorite Files, OMCA, Workers’ Compensation