(no subject)
My nephew is the most adorable little boy! He is BIG with huge hands and long limbs. He likes to yawn a lot, and eat apparently. Yesterday my brother had his first diaper changing experience when I was there. He was a bit freaked, not by the poop, he said, but that he would hurt Crue. I helped him a bit, but he did well. I can't wait until I can post a pic, but it won't be until after Beth has had a chance to do so.
I had my first IME (Independent Medical Assessment) yesterday. Car insurance companies will send clients for an IME if they don't want to approve a proposed treatment plan, in order to get an unbiased opinion on the person's condition from another health care practitioner in the same field.
I have been waiting for my "package" from the insurance company for three weeks. As of yesterday it had still not arrived. Finally, after numerous phone calls, we DID manage to get the first 14 pages of the clients file through by fax at 2pm (his assessment was at 3pm). To my horror, I noticed that the date of the MVA (motor vehicle accident) was in 2001.
When the accident has happened more than a year ago, you KNOW it will be complicated. Then I saw the appendix for his file (my god it must be huge if there is an appendix!)....including reports for disability, accident benefits, DAC's, rehab reports, psychology reports, physiatry reports, chiropractic progress reports, massage therapy progress reports, functional abilities assessments, physiotherapy reports and hospital records!!!
Now all I am supposed to do is take an extremely detailed history from the patient and physically assess him to determine if I feel that the massage therapy treatment plan submitted by his RMT should be approved. This exam takes about a hour and a half to 2 hours, with the majority of it being accident history, treatment history, social history, health history etc. I can't deny, the guy will probably benefit physically from the treatment, but I doubt he'll improve in the long run....this may help control his pain levels, but I strongly believe it will be for pain management only.
The thing is, he's a total PSYCH case!!!! The guy has gone off the deep end since the accident. His marriage fell apart, he has become borderline agoraphobic and admitted that he has suicidal thoughts all the time and the only reason he is still living is for his 8 year old daughter. He hates going out, and sometimes stays in his den for days upon days where he doesn't even eat because he can't face the world. (AT this time, I'm totally crapping my pants too, because I'm ALONE in the office with this guy, and I don't know whether he's going to start crying or what, or maybe just whip out a gun and shoot himself). He IS under the care of a psychologist though, and on meds, but apparently (according to me) they are not working that well!
I hated making him relive the accident but that is what I had to do, and as it turns out, he was basically hit head on by another car and when he got out to see if everyone was okay (several cars were involved), he found the driver of that car dead at the wheel. The image of that has haunted him since.
So now I wait for his MASSIVE file to arrive so I can review it and I've also been asked to have a conference call with his current RMT and then I must write my report. I do think he could benefit slightly from massage therapy, but it's not like massage is going to "make him better". Also, I'm concerned with compliancy as his RMT only works 2 days per week, and he is very non-committal with answers to questions and I don't feel confident that he'd be able to stick to a consistent treatment plan.
SO, are IME's worth the $$$??? I dunno, I'll let you know when I'm finished my report. I have another next Thursday but really, can it be much harder than this one was????
At least I had something to write about, aside from the usual "so and so was stinky, so and so dripped snot all over my stool etc..."
And NOW, I must actually go study (cram) for finals which are TOMORROW. Oops, the procrastinator strikes again.
I had my first IME (Independent Medical Assessment) yesterday. Car insurance companies will send clients for an IME if they don't want to approve a proposed treatment plan, in order to get an unbiased opinion on the person's condition from another health care practitioner in the same field.
I have been waiting for my "package" from the insurance company for three weeks. As of yesterday it had still not arrived. Finally, after numerous phone calls, we DID manage to get the first 14 pages of the clients file through by fax at 2pm (his assessment was at 3pm). To my horror, I noticed that the date of the MVA (motor vehicle accident) was in 2001.
When the accident has happened more than a year ago, you KNOW it will be complicated. Then I saw the appendix for his file (my god it must be huge if there is an appendix!)....including reports for disability, accident benefits, DAC's, rehab reports, psychology reports, physiatry reports, chiropractic progress reports, massage therapy progress reports, functional abilities assessments, physiotherapy reports and hospital records!!!
Now all I am supposed to do is take an extremely detailed history from the patient and physically assess him to determine if I feel that the massage therapy treatment plan submitted by his RMT should be approved. This exam takes about a hour and a half to 2 hours, with the majority of it being accident history, treatment history, social history, health history etc. I can't deny, the guy will probably benefit physically from the treatment, but I doubt he'll improve in the long run....this may help control his pain levels, but I strongly believe it will be for pain management only.
The thing is, he's a total PSYCH case!!!! The guy has gone off the deep end since the accident. His marriage fell apart, he has become borderline agoraphobic and admitted that he has suicidal thoughts all the time and the only reason he is still living is for his 8 year old daughter. He hates going out, and sometimes stays in his den for days upon days where he doesn't even eat because he can't face the world. (AT this time, I'm totally crapping my pants too, because I'm ALONE in the office with this guy, and I don't know whether he's going to start crying or what, or maybe just whip out a gun and shoot himself). He IS under the care of a psychologist though, and on meds, but apparently (according to me) they are not working that well!
I hated making him relive the accident but that is what I had to do, and as it turns out, he was basically hit head on by another car and when he got out to see if everyone was okay (several cars were involved), he found the driver of that car dead at the wheel. The image of that has haunted him since.
So now I wait for his MASSIVE file to arrive so I can review it and I've also been asked to have a conference call with his current RMT and then I must write my report. I do think he could benefit slightly from massage therapy, but it's not like massage is going to "make him better". Also, I'm concerned with compliancy as his RMT only works 2 days per week, and he is very non-committal with answers to questions and I don't feel confident that he'd be able to stick to a consistent treatment plan.
SO, are IME's worth the $$$??? I dunno, I'll let you know when I'm finished my report. I have another next Thursday but really, can it be much harder than this one was????
At least I had something to write about, aside from the usual "so and so was stinky, so and so dripped snot all over my stool etc..."
And NOW, I must actually go study (cram) for finals which are TOMORROW. Oops, the procrastinator strikes again.