The medical world is constantly developing to find new treatment options, leverage emerging technologies, and ultimately, improve patient care. Soon, the medical care landscape may look vastly different. In this blog, I’ll discuss how embracing the changes within workers’ compensation can help ensure we care for injured workers in the most effective ways possible.
Highlights of the current landscape
An increasing number of injured workers are living with chronic health conditions — diseases that are ongoing and generally not curable. Today, nearly half of the U.S. the population suffer from at least one chronic illness such as heart disease, hypertension and arthritis, according to the American Heart Association.
As the U.S. population ages, the adult population with chronic diseases is expected to increase. Rising levels of chronic diseases contribute to the rapid growth in health care spending and other societal costs, including sick time and disability. In fact, three of every four health care dollars are spent caring for individuals with chronic conditions.
Meanwhile, record numbers of physicians, nurse practitioners, physician assistants and other clinicians have recently left the workforce due to retirement, burnout and pandemic-related stressors. In all, 334,000 healthcare professionals across every specialty of medicine left the workforce in 2021, according to a report.
Early data shows the staffing shortage will have near-term and long-term effects on patient care — including injured workers — as well as hospital and physician performance. It’s not just affecting the bottom line: organizations are being forced to scale back operations, reduce hours or close doors altogether. It’s also straining facility capacity and supply chain issues, and notably, worsening patients’ experience and quality of care.
As the shortfall continues, however, artificial intelligence (AI) adoption in the medical field is working to balance that pressure. For medical insurance claims, AI aids in strengthening fraud detection efforts, prioritizing claim reviews and streamlining overall processes. It could also play a critical role in transforming modern medicine by helping with image analysis and identifying disease outbreaks and diagnosis.
The value of orthopedic surgeries
We now have more advanced knowledge on certain orthopedic surgeries and their value on a patient’s long-term recovery. This can be hugely beneficial in determining each injured worker’s recovery path, as it could minimize patients electing to have surgeries that will bring little to no substantial outcomes.
Carpal tunnel release and total knee replacement surgeries have both proven through clinical evidence to largely be superior to non-surgical management. Total hip surgery and arthroscopic meniscal repair also show high levels of promise, although there aren’t enough non-surgical randomized studies to sufficiently test against.
Conversely, there is clinical evidence to support no difference in outcome after undergoing several types of common orthopedic surgeries, including arthroscopic partial meniscectomy, rotator cuff repair, subacromial decompression, reconstruction of the anterior cruciate ligament, lumbar spine decompression and lumbar spine fusion surgeries.
The power of TMS
There are exciting new discoveries uncovering the potential of magnetic pulse technology. Transcranial magnetic stimulation (TMS), for example, a noninvasive form of brain stimulation, has shown to alleviate severe depression by stimulating specific portions of the brain through electromagnetic induction. Studies show TMS is also effective at treating post traumatic stress disorder (PTSD) at higher frequencies, as well as physiological indicators and specific behavioral symptoms of Autism.
TMS is also useful for the screening and early treatment of diabetic neuropathy, which involves nerve damage to the peripheral nervous system caused by high glucose concentration. Although studies are in beginning stages, existing studies show that TMS has therapeutical potential for the treatment of pain and pain-related depressive symptoms in patients with disease.
Additionally, thanks to concerted efforts in recent years that’ve focused on investigating the neurophysiological changes that occur in the brain after a stroke — the leading cause of long-term disability — TMS has aided in understanding the mechanisms underlying recovery of motor function after stroke.
Psychedelic therapy
With the increasing rate of mental disorders globally, several psychedelic-assisted psychotherapies may alleviate some challenges that face conventional psychiatric medicine.
Psilocybin, a hallucinogenic compound in ‘magic mushrooms,’ has demonstrated potential to treat mood and anxiety disorders, in addition to analgesic effects on the treatment of cluster headaches, intractable phantom-limb pain and chronic pain. Treatment may be feasible, efficacious, toxicologically safe and physiologically well-tolerated, as evidenced by decades of clinical studies.
MDMA — commonly referred to as “ecstasy” or “Molly” — a synthetic drug that acts as a stimulant and hallucinogen, and lysergic acid diethylamide (LSD), a classical hallucinogen, have both garnered widespread public interest for their treatment potential.
Trials are investigating MDMA’s efficacy for social anxiety disorder in adults with autism spectrum disorder and for anxiety associated with a life-threatening illness. Meanwhile, studies have noted the experiential effects of LSD-induced behavioral changes in individuals with substance-abuse disorders.
While research on LSD is observational, the most significant evidence exists for MDMA and psilocybin, which have been designated by the U.S. Food and Drug Administration as “breakthrough therapies” for post traumatic stress disorder (PTSD) and treatment-resistant depression, respectively.
Finally, marijuana, or cannabis, contains several active compounds. The best known are delta-9 tetrahydrocannabinol (THC) — the primary ingredient that causes the “high” — and cannabidiol (CBD). Studies on the medicinal use of cannabis are a mixed bag. Research has shown that adults experiencing chronic pain who were treated with cannabis are more likely to report that they experience a reduction in pain symptoms. It is also being explored as a treatment option for conditions such as epilepsy and schizophrenia. Given the potential for harmful effects, especially when cannabis is smoked, much more research is needed in this area.
These ideas were presented during the 77th Annual Workers’ Compensation Educational Conference and 34th Safety & Health Conference, organized by Workers’ Compensation Institute (WCI).
Dr. Teresa Bartlett, Managing Director, Senior Medical Officer, Sedgwick