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Doctor Proactive Communication, Return-to-Work Recommendation, and Duration of Disability After a Workers’ Compensation Low Back Injury

Dasinger, Lisa K. PhD; Krause, Niklas MD,MPH,PhD; Thompson, Pamela J. MPH; Brand, Richard J. PhD; Rudolph, Linda MD,MPH

Journal of Occupational and Environmental Medicine: June 2001 - Volume 43 - Issue 6 - p 515-525
Original Articles

Althoughdoctors are increasingly evaluated on the basis of return-to-work (RTW)outcomes, the effect of doctor–patient communication about the workplaceand RTW after an occupational injury has received little research attention.The effect of patient-reported doctor communication on duration of disabilitywas examined retrospectively in a 3-year cohort of 325 claimants with alost-time low back injury. Although doctor proactive communication wasassociated with a greater likelihood of RTW during the acute phase (<30days of disability), this effect disappeared when injury and workloadcharacteristics were taken into account. A positive RTW recommendation wasassociated with about a 60% higher RTW rate during the subacute/chronic phase(>30 days of disability) only. Prospective studies are needed to confirmthis effect. The impact of physician communication on RTW is largelyconfounded by injury and workplacefactors.

From thePublic Health Institute, Berkeley, Calif. (Dr Dasinger, Dr Krause, MsThompson); the Division of Occupational and Environmental Medicine (DrKrause), the Division of Adolescent Medicine/Pediatrics (Ms Thompson), and theDepartment of Epidemiology and Biostatistics, School of Medicine (Dr Brand),University of California, San Francisco; and the Division of Workers’Compensation, Department of Industrial Relations, State of California (DrRudolph).

Addresscorrespondence to: Dr Niklas Krause, Division of Occupational andEnvironmental Medicine, University of California, San Francisco, 2140 ShattuckAvenue, Suite 709, Berkeley, CA 94704-1228; e-mail:nkrause@uclink4.berkeley.edu.

Copyright© by American College of Occupational and EnvironmentalMedicine

© 2001 Lippincott Williams & Wilkins, Inc.