Recovery Environment and Medical Care for Injured Patients

Dr. Teresa Bartlett, the SVP and Medical Director at Sedgwick, a global third-party claims administrator, discusses the importance of the recovery environment and medical care administered to injured workers, medical literacy as it pertains to management and surgical cases, and the approaches to best manage mental and emotional well-being.

Dr. Teresa Bartlett, M.D. has been Senior Vice President and Medical Officer of Sedgwick Claims Management Services Inc. since February 2009. As Medical Director for Sedgwick CMS, Dr. Bartlett is its Senior Advisor in matters affecting the design and delivery of medical management services for Sedgwick’s claims clients. She provides strategic counsel and operational support in all areas of medical management including managed care, return-to-work, bill review, medical outcomes protocols, and health and safety matters. Dr. Bartlett advises and represents Sedgwick CMS in efforts to integrate the delivery of occupational and non-occupational medical services and in public policy matters affecting healthcare as part of the claims services process. Dr. Bartlett served as Senior Manager of Chrysler LLC, responsible for integrated health care and disability medical programs. During her twenty-year career with Chrysler, she managed their multi-state workers’ compensation and disability programs, as well as Workplace Safety and Insurance Board (WSIB) programs for Chrysler’s Canadian operations. Dr. Bartlett served as Member of the steering committee of the Michigan Primary Care Consortium. The American College of Occupational and Environmental Medicine awarded a team directed by Dr. Bartlett its 2005 Corporate Health Achievement Award for the development and implementation of a best practice clinical model. In 2008, She received the Health Care Hero Award from Crain’s Detroit Business for workplace back pain mitigation initiatives. A graduate of the School of Medicine of the Technological University of Santiago, DR, she completed clinical internships in the Yale Affiliated Hospitals Program of the Yale School of Medicine.

Transcript

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, glad that you could join us again. Our guest is Dr. Teresa Bartlett, she’s senior vice president and medical director at Sedgwick. Now Sedgwick is a global third party claims administrator and she’s joining us on the program this morning to talk about the importance of the recovery environment and medical care administer to injured workers, medical literacy as it pertains to management and a little bit about surgical cases and the approaches to best managed mental and emotional well-being. It’s a lot to cover in a very short period of time. Thanks for joining us today on the program Dr. Bartlett.

Dr. Teresa Bartlett: Thank you Neal, I appreciate the invitation. My background is in family medicine but I’ve spent a lot of my career in the occupational health space and helping employers come up with creative solutions. And so the medical care perspective is something that I’m very passionate about and it’s a philosophy at Sedgwick that we want to get the injured worker to the very best care as soon as possible. We know that that’s very, very important in the outcome of the case and we use what I like to call the ‘family case’ when do you want your parents or your child or your loved one treating with that physician. And we also take an approach of scoring every provider that we use so that we know what their outcomes are like, we know if they’re good communicators and how well they do in terms of using evidence based guidelines. So these are very important and we’d like them to expedite the care and in general work as fast as possible to help us get this person back to work which is best for everyone. We all know that. We also know that recovery starts on Day One and that we have to set the stage for that so internally at Sedgwick we wrap around the injured worker all of these different services such as telephonic case management, field case management, behavioral case management, pharmacies, complex and catastrophic case managers in addition to specially trained nurses, or surgery or orthopedic and catastrophic care so all of that, super important in terms of. Getting off on the right foot and setting the stage to recovery.

Neal: Would you say that there’s an equal balance of importance placed on the patient’s care as well as educating and steering some of these physicians that you say you’re rating? Now those ratings are obviously going to be used in some shape, form or fashion – either to better the care that the provider gives or to steer patients toward or away from certain practices or physicians, is that correct?

Dr Bartlett: That’s correct, it is a fair assumption. And in many states because of the nature of worker’s compensation, the employer or us as the third party administrator redirect the care so the patient is oftentimes bound to treat where we asked them to go. And that’s why we don’t want to take advantage of that, we want to get them the highest quality care. And by scoring the physicians, we know who those doctors are and where that care will best be rendered, if that  makes sense. And I was going to say that it also is incredible to me that you asked about medical literacy because that is and has been for a long time one of my big passions. I don’t think that we in the medical community speak in a language that patients clearly understand. For example, if surgery is needed, we focus with a surgery nurse and assign a special nurse to that case and the very first thing that that nurse does is break down the entire process through a medical literacy lens. Meaning, explaining in clear everyday language as I always tell my team, “Explain this to me like I’m a kindergartener. You might think I understand but please I want it to be very simple.” And help them understand where the incision will be, how big it will bem how bad it will hurt, how long they’ll be in the hospital, what kind of equipment they will need. And we really focus on five key pillars at that point which are super important but are often overlooked. One being the understanding, that’s the basic premise, but second is mindfulness, relaxation guided imagery. We have to help that person deal with the pain that we know they’re going to experience and to have tools other than the quick fix of an opioid. So giving them those tools to rely on after the surgery is very important and we’ve found to be very, very helpful. And if you think about all the years of childbirth and all of the deep breathing techniques that have been taught, but we forget about that when it’s a knee surgery or a shoulder or a hernia repair. And so we’re kind of taking it back to basics with those mindfulness and guided imagery and deep breathing. Then the next thing that is so overlooked especially in the United States is nutrition. We have got to get them eating healing food, things that provide the macro nutrients to the body that allow the body to heal. And oftentimes, we find that when people are stressed during pain, they turn to their comfort foods which are highly processed and not very beneficial to help the healing process so we really focus on the importance of that. The fourth pillar would be pretty pre-habilitation, meaning prepare the body with pre-surgery exercises such as you just simple three to five minute exercises that get that part of the body ready. Teach them how to get in and out of bed after surgery, in and out of the car, in and out of the bath. All those things are super important and we do that through the use of an app. If the person chooses to download it, we’ve partnered with PeerWell and this app has proven to be very very helpful for patients in the long term. And it even has an aspect of augmented reality which allows us to look at the safety of the home which is the fifth pillar. What do we know about the home environment? How can we help them make it safer post-operatively and get the tools in place so that they don’t trip and fall or that they have the adequate tools to recover safely?

Neal:  So it seems that in order to create I guess the best recovery environment, we all need to learn two languages of medical literacy. I guess physicians need to remember when they were not physicians and we as patients need to understand that you all have been through some training, you have some conventions that you’re used to where you understand each other but you need to learn the language that we speak so that we can understand you. Is that what we need to have to create that recovery environment?

Dr Bartlett: Exactly right, yes.

Neal: Well where can our listeners go online and get some more information about Sedgwick and about medical literacy in general?

Dr Bartlett: Well we have information, our surgery nurse program at sedgwick.com. If you look under the Claims and Managed Care Areas, there is all of our specialty programs there that really help people connect and understand what the protocols are and what they would need to do to have a healthy outcome.

Neal: Well Dr. Bartlett, thank you so much for joining us on the program and come back as soon as you can.

Dr Bartlett: Thank you so much Neal, it’s been a pleasure.

Neal: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this program are available at hpr.fm and healthprofessionalradio.com.au. You can also subscribe to the podcast on iTunes, listen in and download at SoundCloud and be sure and visit our Affiliate Page at hpr.fm and healthprofessionalradio.com.au

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