When an employee is injured on the job, unique and difficult questions often arise: is emergency care necessary? If not, where do they go for treatment? How does the injury affect their ability to work? At what point have they fully recovered, or when is it safe for them to return to work? What can be done to prevent future injuries from occurring when performing this same task?
In order to better address these concerns, healthcare providers and employers are forming partnerships, which allow for more direct and efficient communication, reduced costs, as well as better care and a safer work environment for employees. JTECH Medical had the opportunity to talk with both sides of this partnership to gain insight into the process and learn about some of the benefits each side gains.
Bradley Kenny, D.C., founder and Clinic Director of Bellevue Total Health, began working with Carol Jamrosz, VP of Risk Management for RGL Logistics, in 2004. Initially, Dr. Kenny provided RGL with post-incident drug screens, but RGL quickly began to use Dr. Kenny and Bellevue Total Health for more and more of the services they offered.
"We've been working with Dr. Kenny for roughly 10 years, and each year it seems we add a new service," says Jamrosz.
This sentiment tends to be the norm. Many employers are not aware of the services that clinics are able to offer, but they may find them through services like drug screenings, and DOT physicals. These services can become avenues to open up communication with an employer, allowing a clinic to see what types of services the employer needs, and, in turn, the employer can see the solutions the clinic is able to provide.
One impactful service that allows clinics to set themselves apart from the traditional large hospital system is the objective post-offer screening from a musculoskeletal expert. These screenings allow an employer to ensure that potential hires are able to perform the necessary job functions, plan for possible accommodations, and establish a baseline of employee ability in the event of an injury.
"In the case of larger systems providing post-offer screenings, it is often a nurse who performs the service, and he or she may not be as qualified to perform this evaluation as a musculoskeletal expert," says Kenny. "Our post-offer screenings are performed by evaluators with a musculoskeletal background, using objective functional evaluation equipment and software. This approach allows us to assess potential new hires in order to characterize their capability and identify any potential risks they might pose to themselves or others on the job. And we are able to give a detailed report to both the employee and the employer."
In the event that an employee is injured, the treatment provided at Dr. Kenny's clinic is accompanied by a similar level of communication with both the employee and employer. This communication is key for Jamrosz, who says that the ER simply cannot offer this service.
"When we send employees to the ER, everything we hear back comes to us through the employee, and it's all subjective," says Jamrosz. "With Dr. Kenny, we get immediate, objective communication about our employees' health, and can begin to plan for any accommodations before they even return from the clinic."
Objective assessments form the foundation of these screenings, as they provide universal and comparable statistics, which can be standardized for an employee or for a specific job function.
"The objective functional data provide a baseline for an employee or job function right from the start," says Kenny. "This ability to offer an objective report to employers, detailing employee ability, recovery, and any limitations is how we stand out in the marketplace."
Jamrosz agrees that subjective evaluations simply do not cut it: "Not only does the objective evaluation show whether a potential employee may have difficulties performing a specific task, but if they do get injured, we can see exactly what needs to be done to get them back to their original ability because we have that original ability recorded. With subjective evaluations, we have no frame of reference that would allow us to create these sorts of standards."
The ability to set workplace standards and objectively measure an employee's ability against these norms is crucial when you consider the employer's responsibility for both creating a safe workplace environment, and for treatment of workplace injuries.
"In Wisconsin, if an employee with a pre-existing condition is hired and the job aggravates this condition, the employer is responsible to pay Workers' Compensation to this employee until they are able to return to work," says Kenny. "With a post-offer screening, an employer is able to see potential risks and make accommodations to mitigate potential injuries. And should an injury occur, an objective baseline allows you to know exactly what the employee's pre-employment ability was, and further objective evaluations can show when they have returned to this benchmark."
Objective post-offer screenings are strengthened by the partnership between employers and healthcare providers due to the healthcare provider's ability to tailor evaluations to the employer's particular needs. Additionally, employees receive more uniform treatment from the same provider, increasing their comfort and confidence in the process, as well as the healthcare providers.
"It is important for an employer to have a go-to medical provider," says Jamrosz. "Not only are we able to standardize our response to injuries, we are able to send our employees to a clinic that understands our business, the jobs we have here, and the unique situations we encounter. Our employees get immediate care and are treated well from the initial visit to the point of release. There is no waiting or uncertainty about where to go, which makes the employee feel valued, and shows that their well-being is important. This sense of wellbeing sometimes even translates into employees choosing to visit the clinic for other treatment not associated with work."
Without establishing a relationship with a dedicated clinic, employers are forced to send most work-related injuries to be treated at the local ER—and yet roughly 80% of all work-related incidents are not emergencies, according to Dr. Kenny. And at the ER, employees will be treated by a doctor who has limited or no understanding of the job to which they need to return.
"Clinics are able to offer an alternative to the ER," says Kenny. "If we have already evaluated the employee, and we understand the work environment and job function, we are able to reduce treatment times, and even avoid unnecessary treatment. These steps can dramatically reduce costs for the employer."
Indeed, Jamrosz says that the #1 benefit gained from partnering with a healthcare provider has been the reduction in healthcare related costs that comes with standardization and preventative measures.
"After establishing a relationship with a single clinic, who offered post-offer screenings, job site analysis, and treatment, we were able to reduce the frequency and severity of workplace incidents," says Jamrosz. "Not only does this create a safer environment for our employees, it also greatly reduces our Workers' Compensation costs."
The flexibility and convenience that these partnerships offer is another way in which clinics are able to stand out from the traditional hospital system. And while a clinic may not be able to offer every service an employer needs right from the start, this should not prevent a clinic from reaching out to industry and forming these partnerships.
"Many clinics are reluctant to begin this process because there is a lot to it, or they do not know how to talk to industry," says Kenny. "But taking small steps can lead to a partnership that allows the clinic to grow and add services as they work with employers to meet their needs."
DOT Physicals and Drug and Alcohol testing are important portals through which clinics can make contact with employers, and Dr. Kenny recommends this training and certification to any doctor who is interested in offering employer services. Dr. Kenny also offers a 12-hour program through the Texas Chiropractic College, which teaches the fundamentals of employer services, and how to incorporate it into a practice.
"The most important things a doctor or clinic can do are to become familiar with the industry and their terminology, and become well-versed in safety and wellness programs," says Kenny. "Then, make contact with the HR or safety person at a company and find a service you can provide that meets their needs. A partnership that starts with you only providing Drug and Alcohol testing can very easily transition into one in which you are doing their post-offer evaluations and job site analysis."
"When we were looking for ways to reduce our injuries and treatment times, I began interviewing clinics and doctors," says Jamrosz. "I had a list of services I knew I wanted, and asked them 'can you provide this?' Dr. Kenny offered services that met our needs, but he was also flexible and worked with me to change our approach based upon results."
"Once you have established a relationship with someone in industry and begin to build a reputation, new business opportunities start to come through referrals," says Kenny.
In an increasingly expensive and uncertain healthcare climate, these partnerships between employers and healthcare providers offer a great solution to employee health and wellbeing that benefits everyone involved.
For more information about Dr. Kenny and Bellevue Total Health, please visit their website at bellevuetotalhealth.com.