The Role of the Physician in the Return-to-Work Process Following Disability Onset

Physicians play an integral role in treating workers who have sustained an injury or illness, typically doing one or more of the following: (1) assess impairment, (2) provide treatment and care, and (3) communicate with third parties. Many physicians do not see themselves or their work as part of the return to work (RTW) process, however (American College of Occupational and Environmental Medicine [ACOEM] 2006). They therefore may not assess employees in terms of their ability to return to work and may not effectively communicate with employers. Physicians could take a more proactive role in the RTW process, but they face many challenges to doing so.

Implementing RTW practices is often difficult because physicians are not trained in them or educated about their benefits during medical school. This issue is exacerbated by the failure of continuing education programs to include RTW practices, an omission that may lead physicians to believe that RTW is not part of their job description. Confusion surrounding privacy issues—what information can and cannot be divulged to employers and others regarding an employee’s medical condition—is another challenge physicians face. The mindset of sick or injured employees can also be challenging: if workers view illness or injury as exempting them from their usual social roles or as protecting them from the demands and stress of their life, or if they have a poor relationship with their employer, they may be less motivated to pursue recovery, including RTW. A final challenge physicians confront is inconsistencies among RTW programs—including widely varying terminology and the absence of standardized paperwork— which can make filling out forms more time-consuming and add to physicians’ administrative burden.