A decade ago, I outlined the need for additional education and training for orthopaedic surgeons in the area of workers’ compensation. Workers’ compensation makes up 20 percent of the general orthopaedist’s practice, 65 percent of a hand surgeon’s practice, and 90 percent of the independent medical examiner’s practice.

Although orthopaedists have unique training in diagnosing and treating musculoskeletal conditions, their formal training in the sciences of epidemiology, biomechanics, ergonomics, impairment evaluation, disability management, workplace prevention, and medical-legal testimony has been limited. For this reason, the AAOS annually sponsors “Occupational Orthopaedics and Workers’ Compensation: A Multidisciplinary Perspective,” and combines it every other year with “Expert Witness: Solving the Legal Quagmire.” This year, the two courses will be held in early November in Phoenix.

What do you know?
State and federal laws governing workers’ compensation and determining compensability (legislative criteria), how and which treatments are allowed (treatment guidelines), and employer requirements are rapidly changing. Because more than 50 percent of workers will have an occupational injury during their careers, orthopaedists who treat work-related injuries must understand how these programs work and how these programs will impact their patients and their practice. With the advent of federal healthcare reform, new attention will be on legislated health care and prevention in the workplace—topics that were not taught during residency training.

Outcomes based on successful return to work have been supported by the AAOS, the American Medical Association, the American College of Occupational and Environmental Medicine, the California Medical Association, and others. To increase successful return to work rates, however, physicians need to develop additional communication and negotiation skills.

Filling the knowledge gap with continuing education courses remains the key to improving occupational orthopaedics and the associated benefits to the injured worker and society.

J. Mark Melhorn, MD, is co-director of the 12th Annual AAOS Occupational Orthopaedic & Workers’ Compensation Course, Nov. 5-7, 2010. For more information, visit www.aaos.org/courses