The compensable injury

The complexities and interferences in the doctor-patient relationship during the treatment of the compensably-injured workman create an unusually high incidence of delayed recovery, complications, and permanent disability. Many persons, once injured, never return to economic self-sufficiency. Among the factors that may have a bearing in producing this situation are: The psychological context of the injury itself; the personality of the patient; the "reverse incentive" created by reward for illness; third-party interference from attorneys, insurance claims adjusters, and union representatives; consequent hostility of the patient toward a doctor he usually has not chosen; and, too often, hostility of the physician toward his patient. Iatrogenic complications may also be present when ill-advised surgical procedures are used in the presence of psychological complications. To improve the situation the adversary system should be removed and outside interferences in treatment should be reduced. Physicians treating patients in such circumstances should learn more about psychiatric diagnosis and management. They should give more attention to remotivation and rehabilitation.