The workers comp buzzword of the era seems to be “Opioids.” Whether it’s big Pharma creating ever stronger varieties and then using money and muscle to co-opt doctors, or physicians dispensing from a kind of pharmacy in their offices and over-prescribing on a grand scale, Opiates rule the day. Everyone talks about them and many try to do something to counter what is turning, or, in some areas has turned, into a bona fide epidemic.
The Opioid problem is relatively easy to understand. Greed throws a Fancy Dress Ball, and everyone shows up. And there are villains. Joe Paduda has been shining an arc light on many at his highly influential Managed Care Matters blog. He deserves great credit for making it just about impossible for people to ignore this issue. Joe does outrage well.
We’ve also written about it often, for example, recently focusing on my home state of Massachusetts and the Zohydro ER wars.
Which brings me to Dr. Jennifer Christian, a heroine of mine of considerable distinction.
Jennifer, or Dr. J, as she’s sometimes known to friends, does not go after the easy answers. Smart and articulate, she never settles for a quick fix when something more profound is needed. Unfortunately, quick fixes seem to be what everyone clamors for these days. In any event, before I get to the main point of this screed, I want to take just a moment of your time to sing Dr. Christian’s praises.
I’ve known Jennifer since Managed Comp, which many readers (I hope) recall as the nation’s largest managing general underwriter and which I co-founded with Tufts Associated Health Plan in 1987. Jennifer became Managed Comp’s Chief Medical Officer in the mid 1990s and thus began to have an impact on how injured workers were treated on a large scale. Earlier in her career she had tremendous success reducing frequency and severity (by 68%) at Maine’s Bath Iron Works, where 8,000 iron workers were breaking records in their workers comp race to the bottom.
After Managed Comp, she founded Webility, her consulting company, and, in 2001, the Work Fitness & Disability Roundtable, still going strong with more than 1,300 worldwide members from all areas of workers comp and disability management. The Roundtable just published issue number 3,206.
In 2006, Jennifer, a woman of big ideas, created the 60 Summit Project, whose mission was to “Propagate the work disability prevention paradigm across North America.” From 2006 to 2012, she fashioned 60 Summit groups in all 50 states and 10 Canadian Provinces.
As Chair of the Work Fitness & Disability Section of the American College of Occupational & Environmental Medicine (ACOEM), Jennifer was instrumental in creating the ACOEM Guidelines, which emphasize a systems and evidence-based treatment of the whole person.
So, why am I heralding this remarkable physician? Here’s why: Over time, Jennifer came to realize more and more that, as we say at Commonwealth Care Alliance, “Healthy is harder for some.” And the ACE Study proved that. Haven’t heard of the ACE Study? It’s a 17,000 person study and collaboration between the Centers for Disease Control and Kaiser Permanente. ACE stands for Adverse Childhood Experiences, and the the study produced a 10-question tool that can predict injuries that will more than likely have difficult outcomes unless systemic and personal intervention is applied. I say “personal,” because Jennifer believes that what’s required in those kinds of cases is not the traditional approach to working with injured and disabled people. She realizes that returning those unfortunates to good health requires the assistance of a guide or coach, trained, experienced and good at helping people see what is in their best interest, who will lead them to find the tools and resources they need to make themselves better.
Sounds touchy-feely, doesn’t it? A little soft? So what? Jennifer is proving that it works.
She’s created a program she calls Maze-Masters, and is piloting it with a couple of insurers (confidential, at the moment). She’s hoping that as she builds success after success, insurers will see the benefits to this one-on-one, personal approach. I think insurers and employers will always do what is in their economic best interests, so I’m hoping she trumpets the cost savings above all else, because that’s the way the world works.
I’m also hoping that at least one insurer, a super-regional perhaps, dives into Maze-Masters with both feet. Better yet, SSDI, Social Security’s Disability Insurance program, is fertile ground for this kind of effort.
Lately, I’ve been writing about people, Quixotes all, charging great big windmills. Some will say this is another windmill charge. Not me, though. That is small mind thinking. Disability in all its forms with all its problems (think about those opioids) requires great big minds thinking great big ideas. That’s Jennifer Christian in a nutshell.
Oh, one last thing, just in case you’re wondering: I have absolutely no connection or involvement, economic or otherwise, in anything Jennifer is doing. I just admire the woman.