FCE conflict of interest
Thu, 01/29/2009 - 3:03pm
I currently am employed at an outpatient clinic owned by a large hospital here in town. At present, when an employee at the hospital gets injured and requires PT, they are referred to PT at my clinic. If they need an FCE they are referred to our competitor because our employee health nurse and workers comp physician are worried about a conflict of interest if we perform the FCE. I would like to retain this business if at all feasible. Am interested in any court cases that might be applicable or any information that might be pertinent. Thanks for your help.
Tue, 03/09/2010 - 10:35pm
#2
We had the same problem with
We had the same problem with one of our referral sources in the health system but addressed it through good sound marketing with the ideas that we know these patients very well, and will not do anything that will injure them. We also have a good rapport with these clients already so we will not have to spend time breaking down walls. We are safer with these people because of our familiarity with their injuries.
In regards to conflict of interest, we discuss the research and literature that backs the tests used in our FCE system that looks at effort and reliability of pain and disability reports. It's all about good marketing and gaining the trust. It really comes down to ensuring that your familiarity of your patients will ensure a safe, effective, valid FCE finding.
It took me two years (after someone else tried for 5 years) to be able to get that change but if you put sound reasoning and literature proven evidence, they will turn over. You can't argue with peer reviewed published evidence support of the tests you utilize in your FCE. Now, they go to other sources for FCE's because we have a wait list. be patient and show them the evidence. They will come around.
Mon, 02/02/2009 - 10:38am
#3
FCE conflict of interest
Hello,
Our clinical advisor said:
I agree with her concerns. Perhaps she could arrange swapping referrals with the competitor? I know of no court cases that deal with this issue. Sorry.
I apologize if this isn't much help. I am trying to see what Roy has to say and if his opinion differs and if he knows of any court cases then I will let you know.
Good luck!
Jenn
A couple of thoughts: first, and I know you may have heard this many times, always push the Practice Hierarchy. A professional evaluator who follows the hierarchy begins with Safety, followed by Reliability. To challenge Reliability one would have to show that the evaluator was consciously influencing the test process...in other words, discriminating against a certain individual or group of individuals. This goes by way of saying that the professional evaluator is presumed to be without bias.
The next issue is a recent one in the Federal courts. We all need to take a new look at the evaluation of individuals who are returning to the same job, same employer. Recent cases make it very clear that we need to base the evaluation on the job demands tied to the essential functions of the job. Not doing this cost Georgia-Pacific $250,000 in a recent case. The court in the 5th District, I think, established the right of the employer to test individuals for the ability to safely perform their incumbent job, but based the ruling on the assumption that the test protocol was valid. Coupling the Georgia-Pacific outcome with the 5th District outcome, the need for a strong JA and FCE protocol in incumbent cases is very clear.