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Transcript of EAP with the Doctor Next Door – How to Optimize the Relationship Health and Performance Solutions...
![Page 1: EAP with the Doctor Next Door – How to Optimize the Relationship Health and Performance Solutions University within the Employer Solutions Division of.](https://reader037.fdocuments.in/reader037/viewer/2022110206/56649ced5503460f949ba6f1/html5/thumbnails/1.jpg)
EAP with the Doctor Next Door – How to Optimize the
Relationship
Health and Performance Solutions University within the Employer Solutions Division of
ValueOptions
July 12, 2007
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Vice Chair of the Division of Preventive and Occupational Medicine at Mayo Clinic, Rochester, MN
Medical Director, Mayo Clinic EmbodyHealth programs
Philip Hagen, M.D., Mayo Clinic
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Robin Molella, M.D., Mayo Clinic
Division of Preventive, Occupational and Aerospace Medicine at Mayo Clinic, Rochester, MN
Key contributor to the health management programs and health promotion campaigns
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Mark Hyde, M.A., Mayo Clinic
CEAP-certified EAP program supervisor,
Division of Preventive and Occupational Medicine
EAP professional for 15 years Consults with Mayo and other
organizations on employee productivity, satisfaction, and employee change initiatives
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1) Recognize the value of a well defined relationship between EAP providers and physicians.
2) Understand the confidentiality issues affecting communications.
3) Be able to list three common triggers that would generate consultation between EAP and MD.
4) Be able to structure effective communication.
5) Be able to list 4 medical conditions which masquerade as behavioral and or performance problems.
6) Understand the resources your MD is able to utilize to clarify behavioral or work performance issues.
Learning Objectives
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The Mayo Model How EAP functions in the
medical center Differences from being external
Mayo Clinic Model
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Hidden Medical Conditions
Medical masquerades unmaskedTriggers
Introductory case studies
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Hidden Medical Conditions
Medical Masquerades unmasked– Dementia– Cancer– Infection– Diabetes– MS
Triggers – sudden changes in performance or behavior
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48 Year Old RN
Occasionally acting unusual in the workplace May use foul language in appropriately
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48 Year Old RN
Has type one diabetes for 30 years No longer able to sense when her sugar is low Changed jobs to allow more flexibility in testing
sugars
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35 Year Old Janitor
New hire who was a “good worker” but couldn’t perform event set up
Saw EAP who wondered about a learning disorder Saw employee health, got tested. Did have a
learning disorder EAP and medical participated in an
accommodation meeting. Now a star employee
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Establish the EAP Physician Relationship
Benefits/Power of the relationshipJob site consultation
Communication
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Benefits/Power of the Relationship
Workplace Diagnostics
1. Performance
2. Attendance
3. Behavior and satisfaction
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EAP Job Site Consultation
Culture History Leadership Recent changes Sociology workplace dynamics
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EAP Communication
3-way communication, workplace, provider and client
Consultation services to all parties. Eap most appropriate back to workplace.
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Barriers to Communication
ConfidentialityLack of integration
Concerns about over “medicalizing”
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Confidentiality and Privacy
Respecting the wishes of the patient/client is paramount. Relationships between EAP and Occupational medicine are complex and dependent on issues such as:– EAP confidentiality practices– HIPAA compliance– Level of integration between providers and also
with the workplace.
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HIPAA
…Permitted Uses and Disclosures. A covered entity is permitted, but not required, to use and disclose protected health information, without an individual’s authorization, for the following purposes or situations: … (2) Treatment, Payment, and Health Care Operations; ……
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“Medicalizing” Behavior
Deciding when bad behavior is a medical issue can be a difficult process
Fears of treating these “character” issues as medical issues can prevent early consultation
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“Medicalizing” Behavior
Doctors answer the questions they get asked When obtaining medical consults ask focused
questions– Rather than the question is this patient depressed?
Does this patient have a medical reason they can’t get to work on time?
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Lack of Provider Integration
Many employees have EAP providers and occupational medicine providers and primary health care providers who are in different systems and who are not used to working in an integrated fashion
Many providers do not understand EAP and what services may be provided
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Solutions
Relationship with occupational providers
Referral forms
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Develop Relationship with Occupational Providers
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Proposed Referral Form
Incorporating authorization within the referral form Address HIPAA
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Medical Issues vs. Job Fit
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Consequences of Chronic Poor Job Fit
Final common pathway in unfortunate employment circumstances is often depression and anxiety
Solving* this dilemma requires a multidisciplinary approach
*solving implies an outcome with productive employee, minimal missed work, minimal medical costs.
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Is there a Medical Issue?
Employee presents with physical symptoms or emotional symptoms sufficient to warrant diagnosis
Alleges that her work (co-workers, supervisor etc.) has led to these problems, or the problems at work prevent returning there
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“My job made me sick”
– Ask the Medical provider to focus on the medical facts• What is the diagnosis?
• What is the treatment plan?
• What tasks can the patient currently perform?
• Are there medical issues which would prevent the employee from returning to prior work tasks?
– Provide the medical provider with collateral information when possible (specific feed back about performance issues or concerns from supervisor)
– EAP takes the lead on addressing legitimate complaints about work conditions
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Common Pitfalls in Navigating These Cases
Being inflexible in modifying “minimum time in job” rules before allowing transfer
Not managing behavioral or “character” issues up front and aggressively
“Medicalizing” Job fit issues Best resource in dealing with this is communication
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Best Case
Intervene in “job fit” issues early Focus on job fit as a human capital issue Address medical questions as concretely as possible
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Case: 56 year old New Mayo employee
Hired after completion of transcriptionist training Unable after several weeks to maintain the error free rate
required Referred by supervisor with a question can she hear
adequately
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Outcomes
Hearing test normal
EAP for support
Supervisor found alternate job for this individual in the work area she handles customer service calls doing corrections.
A “good” employee in a bad job fit may look like a “bad” employee.
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Resources to Consider
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Neuro-psycho metric Vocational interest and aptitude Worksite “diagnostic” analysis
Resources to Consider Using
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Physical testing and training - occupational/work hardening– Cardiac rehab– Pulmonary rehab– Brain rehab– Special senses analysis and accommodation– Other specialty partners: diabetic, dermatology, allergy– Bio-dynamics lab
Resources to Consider Using
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Questions?