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Workers’ Compensation in a Medically Overtreated Society

November 12, 2011 (2 min read)
Workers’ compensation is no stranger to controversy. In 2009 the well-respected physician Nortin M. Hadler, MD, attacked workers’ compensation as an “evil, wrong-minded, illness-inducing maze that masquerades as social insurance”. You can read all about it in his book Stabbed in the Back: Confronting Back Pain in an Overtreated Society (see Judge Torrey’s book review). 
In his latest book, Rethinking Aging: Growing Old and Living Well in an Overtreated Society, published Sept. 2011, Dr. Hadler continues his no-holds-barred approach, warning that the Baby Boomer Generation and Generations X and Y hold unrealistic notions about defying the aging process with medical technology, thereby making them more susceptible for “medicalization and overtreatment”. And it doesn’t help that marketing has become more sophisticated and pervasive in playing off people’s fears about health and longevity, and that the media promotes the “scare of the week” and “the miracle of the month”, as Hadler puts it. (See related article: Phamaceutical industry has a $58B marketing budget, but many drug ads skirt FDA regulations.)
It’s no secret that Dr. Hadler has had it with insurance companies and even the AMA Guides for that matter. He once argued that attempts to adhere to the AMA Guides to quantify impairment were, in his opinion, “an unappealing, if not Orwellian, exercise, and not just for musculoskeletal diseases but for all diseases”, that the “AMA Guides offer little, if any, insight into disability”, and that “this tedious, often expensive, stultifying examination is a sophism” (see Journal of Risk and Insurance article). Yet, as we know, the AMA, the insurance industry, and lawmakers have been successful in mandating the use of the latest or prior editions of the AMA Guides for rating disability in workers’ compensation cases in 31 states (see Occupational Injuries and Illnesses, Vol. 3 (LexisNexis)).
But I digress.
Dr. Hadler is the Godfather of evidence-based medicine and the über whistleblower when it comes to unnecessary medical treatments, medications, and surgeries that have no real tangible proof that they work. He quips about what he calls “Type 2 Medical Malpractice”, where doctors perform the unnecessary “even if it is done well, efficiently, and paper-free” (see Op-Ed piece).
Here, in our world of workers’ compensation, we can’t deny the fact that workers’ compensation medical costs are soaring. Whether you’re an injured worker, attorney, judge, or claims adjuster, we need to make the right choices about medical care, to educate ourselves, and to stop being conditioned into believing that medical treatment can always help/save us.
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