Shor M J, Miller J C
Healthcare First, Inc., Newton, Massachusetts, USA.
Orthop Clin North Am. 1996 Oct;27(4):711-21.
Many opportunities exist today for orthopedic surgeons in the treatment and management of work-related injuries. Physicians wishing to enter or participate in this market must realize that the role of the physician in the treatment of the injured worker has expanded from one of being solely the care giver to being a patient manager, a problem solver, and a communicator. A number of years ago, many orthopedic surgeons missed out on managed care contracting for health maintenance organizations because they thought they could survive without it. They soon learned the challenges of sitting on the sidelines. Whether we like it or not, managed care for work-related injuries is here and its likelihood for going away is about zero. If your state has not yet adopted utilization management standards or managed care for workers' compensation-enabling legislation, when you wake up tomorrow they may have done so. Because of its relative embryonic development, there are exceptional opportunities for practitioners to take active roles in shaping the models that will serve employees and employers in the year 2000. Physicians who are interested in the treatment of injured workers have a unique opportunity right now to develop relationships in the managed workers' compensation arena. Payment and patient referrals for workers' compensation may turn out to be more attractive financially than many of the contracts currently in place with health maintenance organizations and other general health plans. Physicians willing to partner with employers and other players in the workers' compensation arena currently face some challenging, rewarding, and exciting opportunities. In the immortal words of Hippocrates, "Healing is a matter of time, but it is sometimes a matter of opportunity."3 It is unclear whether Hippocrates ever imagined our current level of science, practice, and organization, but it is clear the opportunities to be an active participant in the changes occurring in workers' compensation are as real today as they were in 1973 when then President Nixon passed the Health Maintenance Organization Act.
如今，骨科医生在治疗和管理与工作相关的损伤方面有很多机会。希望进入或参与这个市场的医生必须认识到，医生在治疗受伤工人方面的角色已经从单纯的护理提供者扩展为患者管理者、问题解决者和沟通者。几年前，许多骨科医生错过了与健康维护组织签订管理式医疗合同的机会，因为他们认为没有这份合同也能生存。他们很快就体会到了置身事外的挑战。不管我们喜不喜欢，与工作相关损伤的管理式医疗已经存在，而且消失的可能性几乎为零。如果你的州尚未采用利用管理标准或针对工伤赔偿的管理式医疗授权立法，那么明天当你醒来时，它们可能已经实施了。由于其相对处于萌芽发展阶段，从业者有绝佳的机会积极参与塑造在2000年为员工和雇主服务的模式。对治疗受伤工人感兴趣的医生现在有一个独特的机会在管理式工伤赔偿领域建立关系。工伤赔偿的支付和患者转诊在经济上可能比目前与健康维护组织和其他一般健康计划签订的许多合同更具吸引力。愿意与雇主及工伤赔偿领域的其他参与者合作的医生目前面临着一些具有挑战性、回报丰厚且令人兴奋的机会。用希波克拉底不朽的话说：“治愈是时间的问题，但有时也是机会的问题。”3不清楚希波克拉底是否曾想象过我们当前的科学、实践和组织水平，但很明显，如今积极参与工伤赔偿领域变革的机会与1973年尼克松总统通过《健康维护组织法案》时一样真实。
