I have always enjoyed hard work. I began working in heavy construction at age fourteen during the remodeling of our house. I fell in love with it and kept working at it for another 18 years. I poured concrete slabs, framed, did some finish work, plumbing, and spent three summers … Read More
Chronic pain is dangerous Chronic pain is dangerous. When you are trapped by anything in life, especially pain, you’ll become angry. When you’re angry, everything is completely about you and your efforts to escape. You can no longer see the needs of those around you, much less respond to them. … Read More
Few physicians have sufficient training in the nuances of occupational medicine, yet all of us have the capacity to completely remove a patient from the work force. It has been my observation that when a person is sitting at home, his or her pain usually worsens. Without the distractions of … Read More
Our medical and political system has failed. Employers have abused workers as long as there have been employers and workers. The intent of worker’s comp’s no-fault system was to both provide excellent medical care as well as improve worker safety. Although workplace safety has dramatically improved since the early 1900’s, … Read More
A letter from a case manager Dear Dr. Hanscom: You may not receive these kinds of letters from nurse case managers very often. I thought I would advise you of the above captioned patient that you performed a redo L5-S1 microdiscectomy about a year ago. Ron got quite discouraged when … Read More
Mental Health Every injured worker should have access to some level of mental health support. I work with a veteran pain psychologist who is wonderful. 90% of her practice is caring for my patients. If she feels it is necessary, she will refer a patient to one of several psychiatrists … Read More
From my perspective, life in the worker’s comp system for my patients has never been more difficult. The improvement in overall numbers belies the daily struggles of my patients who are admittedly an unusual group. Many of them have been referred to me after “failed surgery” or have been in … Read More
Fixing the problems with the worker’s comp system is critical. However, the system is unwieldy and we are not going to change it anytime soon. We know extremely well what needs to happen to enable a worker to move smoothly through the system. One of my physiatrist colleagues felt so … Read More
I have a patient who is a muscular 43 y/o welder. He injured his back on the job about four years ago. After undergoing a laminectomy for low back pain, his pain actually increased. When I first saw him a couple of years ago, his complaint was unrelenting low back … Read More
Without an obvious source of pain, patients eventually feel that no one believes that they have pain. It is an endless source of frustration and you are a legitimate victim. But, inadvertently, you are placed in a powerful victim role. The Cry of Chronic Pain Not only did I believe … Read More