Monday, April 07, 2003

MedPundit has a summary of a book review that's available to NEJM subscribers, of the book Whiplash and Other Useful Illnesses. The review's central point, and Ms. Smith's, is this:

There have been studies that show that injuries take longer to resolve when there are unresolved compensation issues - such as lawsuits and worker’s compensation. And although this is only anecdotal evidence and nothing to base public policy on, I’ve noticed in my practice that patients recover in a matter of days to weeks when they’re the ones at fault, compared to patients who are the victims of accidents, who take months to get better.

And the time for recovery does clearly seem to be related to compensation. This is what happens. A person has an accident, and as a result sprains their neck. As in any sprain, the pain is at its worst the first few days, then it gradually gets better. But, even when things are mostly better, there are still, on occasion, twinges of brief pain that come and go. For the person not involved in litigation, these twinges are barely noticed because they’ve moved on. Their injuries are no longer a major focus of their lives. They perceive these twinges as nothing more than the usual aches and pains that everyone suffers now and then.

But, the person who is trying to get compensation for their injuries, either through the legal system or the worker’s comp system, has the constant fear that things might get worse. Once they settle the case, that’s it. No future claims will be paid by the other party. So, when they feel those twinges, their inclination is to wonder if they might be harbringers of worse things to come, of disabilities that won't be compensated. That anxiety only serves to magnify the pain. Which keeps the case open. Which costs society a lot of money.
I've wondered about this for some time. We get a broad range of folks in here -- most are decent sorts, some are nose-to-the-grindstone, some are a tad more... relaxed. But to a one, the longer litigation drags on, the longer their healing seems to be arrested.

There are two points here, to which Ms. Smith is not alluding:

First, it costs money to get medical treatment. A lot of our clients get little to no medical treatment, because the insurance companies (cough, the ones we're suing) won't pay for medical treatment -- so of course healing takes longer during litigation. (A couple of our cases started because the buggers wouldn't even pay out for medical bills of all things.) Worker's comp cases frequently end up in the system because the insurer decides that the herniated disc you're suffering from isn't that bad. Just walk it off.

Second, the actual stress of a case is enormous. Most people don't experience litigation, but for those of us on the inside one way or another, you can see these folks worrying -- unpaid bills from the injury and healing time, lost credit, waiting medical treatment, and so on, can really eat at you. I can't imagine that has no impact on one's recovery.

Blinkered system, really. If it weren't the least bad one we have, I'd junk it in a heartbeat.

No comments: