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References for Worker's Comp reviews


#1

Hello, fellow practitioners!

I was recently invited to complete Worker's Comp reviews for a URO service (an attorney who is hired to do such work, who in turn subcontracts health care practitioners who determine to medical necessity of the reviewed treatments). The difficult part for me (other than saying that another acupuncturist's treatment is worth being paid upon) is siting credible source material that states, for example, what a reasonable treatment plan would be six months after commencing treatment. I feel that the reasonableness of treatment is taught to us in school as a felt plan, not as hard-and-fast rules. If you are treating a pain patient twice a week for 2 months and that patient is only getting a few hours of relief after each treatment, there is a point where, I believe, you must be honest with the patient and discontinue treatment. But is there a book that states that? What do you think? Thanks!


#2

I really don&#39t think you can generalize at all within Chinese Medicine - even with such generally straightforward conditions like pain. While there are probably some reasonable time frames within which to expect results for various conditions, there is no way to account for the true clinical realities of us as people. There are just as many pain related conditions that could easily warrant weekly treatments for years as there are those that should be completely resolved within a few treatments. The relative severity of the presenting symptoms for better or worse quite often has no relation whatsoever to the timeframe to resolve such symptoms which adds a further level of complexity to a question like yours. Each case would have to be deeply analyzed to decide what is appropriate and only experienced practitioners with access to the patient themselves could probably even come close to answering those types of questions.

There are numerous clinical studies (pubmed.gov) for various conditions that could give a ballpark if you were trying to prove some sort of necessity. Those could be useful if they matched appropriately. But as far as using clinical studies as tools for measuring treatment outcomes and durations, most are not designed to explore this.


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