Industrial rehabilitation medicine. 1. Why is industrial rehabilitation medicine unique?
This self-directed learning module is part of the chapter on industrial rehabilitation medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Industrial rehabilitation medicine encompasses injuries and illnesses that occur in the workplace and are covered under workers' compensation. The central thesis of this article is that industrial rehabilitation medicine is a unique area because the workers' compensation system influences the behavior of injured workers. The article is divided into three sections. The first briefly reviews the history of workers' compensation in the United States, and describes eight key features of compensation systems. The second explores several hypotheses to explain why injured workers frequently have less favorable outcomes than noncompensation patients with similar medical conditions. Some explanations focus on dysfunctional psychologic reactions such as "compensation neurosis" and "disability syndrome." Others focus on contextual factors, including return to work policies by employers and financial incentives or disincentives for return to work. The third section outlines reasons why the physiatrist is often the "preferred provider" in industrial rehabilitation medicine. One crucial consideration is that many of the most important disabling work injuries are those with which physiatrists are familiar. Also, physiatric training and philosophy prepare the physician to focus on function, to work with a rehabilitation team, and to be sensitive to psychologic factors that might impede an injured worker's recovery. All of these skills are important in the treatment of injured workers.
Robinson
J P
JP
University of Washington, Seattle 98195, USA.
Rondinelli
R D
RD
Scheer
S J
SJ
Weinstein
S M
SM
D002908:Chronic Disease; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation; D009784:Occupational Diseases / Q000534:rehabilitation; D009787:Occupational Medicine; D010810:Physical and Rehabilitation Medicine; D010819:Physician's Role; D012046:Rehabilitation; D012803:Sick Role; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014942:Workers' Compensation / Q000331:legislation & jurisprudence; D014947:Wounds and Injuries / Q000523:psychology / Q000534:rehabilitation