Disagree with orthopedic surgeon's work restrictions

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chinojosa
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Joined: Thu Jun 07, 2012 12:14 pm
Location: Williamsport, PA

Disagree with orthopedic surgeon's work restrictions

Post by chinojosa » Mon Nov 07, 2016 9:51 am

Does anyone have thoughts on your approach to handling cases when you as a treating physician disagrees with the orthopedic surgeon on work restrictions? Usually we as treating occupational doctors keep our patients on the job with restrictions. Often the orthopedic surgeon to whom we referred a patient takes the person off of work (before or after surgery) when it is not necessary per published guidelines. Would you go along with the surgeon, get off the case, try to negotiate with the surgeon, or just put your restrictions on the patient anyway? If we conflict with the surgeon's recommendations that could be confusing to the employer.



Robert Swotinsky MD
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Re: Disagree with orthopedic surgeon's work restrictions

Post by Robert Swotinsky MD » Mon Nov 07, 2016 11:27 am

Reach out to the orthopedist to discuss the case and define the patient's activity limitations/restrictions. While the orthopedist may have filled out an OOW note, that doctor may also think the patient has some work capacity and would be willing to commit to that. I've found that most orthopedists are optimistic about their patients' recoveries. It can be hard to get other doctors on the phone. But, if you do, and if you reach consensus, write up a brief summary of the conversation, fax it to the other doctor, and ask that doctor to please review it and if needed correct it, and then fax it back to you.

If the orthopedist won't talk to you, that's unfortunate, especially where you are the referral physician.

If the orthopedist and you DO talk but there is a difference of opinion, the orthopedist's opinion probably carries more weight since that doctor is the specialist. But, if the orthopedist's opinion is off-the-wall, you could document this, speak with the employer, and the employer then has to decide which opinion it thinks is more reasonable.

chinojosa
Posts: 26
Joined: Thu Jun 07, 2012 12:14 pm
Location: Williamsport, PA

Re: Disagree with orthopedic surgeon's work restrictions

Post by chinojosa » Mon Nov 07, 2016 4:15 pm

Thank you. I'll take your approach. That would probably improve the immediate outcome for the patient and perhaps improve the approach in the future as they get familiar with hearing our perspective.

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