Can a treating physician also be the MRO?

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Can a treating physician also be the MRO?

Post by geoff_md » Tue May 25, 2010 10:38 pm

Is this legal or ethical? The patient comes to the urgent care and is seen by the regular doctor on duty that night. The patient is then sent for a follow-up exam the next day to the workers' comp doctor. This particular workers' comp doctor is also the company's MRO. In other words , he treats the patient for a strained back and then looks at the patient's drug screen and interprets it as positive or negative. Are there any regulations on this? Is it legal or ethical? This is about non-DOT testing.


Re: Can a treating physician also be the MRO?

Post by gwoccmed » Tue May 25, 2010 11:04 pm

I see no legal issue and no ethical issue with the scenario you present.

I am curious as to where you see the potential for one . . .

"Work-comp" doctors are usually more careful to advocate facts, honesty, and health first. I have found the "personal docs" more inclined as "patient advocates" to fudge the facts (lie) on behalf of a patient. The AMA published a study a few years back that half of physicians admitted they had or would do just that . . . one reason that "doctors notes" have become almost worthless.

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Re: Can a treating physician also be the MRO?

Post by Robert Swotinsky MD » Wed May 26, 2010 8:24 am

I agree with gwoccmed that there seems no ethical or legal conflict.

I am both MRO and "workers' comp" doctor for many employers. On a handful (or less) of occasions, I've been treating someone who I've also had to interview (by phone call - this is how I and other MROs reach donors) about their drug-positive test results. This can be a little awkward, probably more so for the patient than me. The treating physician stays professional and sticks to the clinical issues at hand, which should not include the positive drug test result. It is commonplace -- indeed, a standard practice -- for occ docs to serve as MROs and treat injured workers from the same employers.

Some in-house corporate occ docs have declined to serve as MROs because (among other reasons) they feel it would taint their reputation among employees. There are many other reasons, too, why in-house corporate occ docs may want to avoid MRO work, including lack of experience and availability of inexpensive contractors to handle this.

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