So Many Words

If you’re reading this you’ve probably seen some of my daily postings on LinkedIn and/or Twitter. Or maybe you’ve read one of the 227 blogposts I’ve published since May 22, 2015. But did you know that I have had 29 published articles? And that my first one was published back on May 14, 2013? It’s been somewhat nostalgic to read back through them all, taking me back through my journey in identifying/understanding the issues and how to articulate my opinions.

So here are my articles, in chronological sequence, just in time for your holiday binge reading!

1. “How to Get Unhooked”, CLM, 5/14/13. Teaser: “As evidence mounts that patient motivation is vital to actual recovery, it’s time for another transition from a ‘medicalization-only’ mindset to a holistic approach that takes into account all of the variables that affect recovery. It’s time for all stakeholders within the system to think more broadly and be open to new concepts that comply with best practices and correspond with treatment guidelines. In other words, maybe the injured workers are not the only ones that need to have their motivations adjusted.” Me in 2018 sounds a lot like me in 2013!This was reprinted by Insurance Thought Leadership on 2/28/15.
2. “Redefining Success”, WorkCompWire, 1/20/14. Teaser: “Let’s simplify what true success is for work comp: restoring the health of the injured worker and settling the claim efficiently. Realistically, the worker might not be restored fully to pre-injury health, but regaining as much as possible is certainly the goal.”
3. “Redefining Detox”, WorkCompWire, 1/27/14. Teaser: “However, if you think of detox only as a chemical weaning process, you can miss the most important component in affecting permanent change: the psychosocial aspect. Removing dangerous drugs without any plan for addressing how claimants can physically and mentally cope with their pain can lead to relapse.”
4. “Industry Spotlight: 20 Questions with Mark Pew, Sr. Vice President, PRIUM”, ClaimWire, 3/20/14. Teaser: “Claimwire: If you were starting your career all over again, what would you do differently? MP: Absolutely nothing. I have probably had as many defeats as I’ve had victories, and I have often learned things the hard way. I have been mentored and have mentored others. Although I never really had a master plan for who I wanted to be when I ‘grew up,’ the interlocking pieces of career steps has been fun to watch in the rear view mirror. Who I am today was built through those experiences, and what I’m doing now is very fulfilling and impactful.”
5. “The Tough Task of Tapering Prescription Drugs”, CLM, 4/30/14. Teaser: “Polypharmacy often arises from using one drug to counter the side effects of another. For example, opioids can cause constipation, requiring stool softeners. In addition, patients’ symptoms can prompt physicians to add other analgesics, tranquilizers, sleep aids, and muscle relaxants. Despite the prevalence of polypharmacy, few guidelines provide protocols for multi-drug tapering.”
6. “Are You Ready for Medical Marijuana?”, CLM, 7/30/14. Teaser: “Regardless, the workers’ compensation industry needs to prepare for expanded use of medical marijuana and requests for reimbursement. This is a complex circumstance that should not be ignored or deferred.” If this were to be categorized as a prediction, consider it prescient.
7. “The Problem of Playing Through the Pain”, CLM, 9/25/14. Teaser: “Compared to the typical workers’ compensation situation, there are higher incentives for NFL players to ‘return to work.’ Everything on a football team, especially in the professional ranks, is based on competition. If the player wants to play—and keep playing—he has to be the best. That means players have to be on the field during practice and games, in the gym for workouts, and in the meeting room to study the playbook. If they are sitting in the training room or on the sideline, they cannot show the coaches that they deserve to play, which could lead to coaches selecting someone else. Players are motivated to return to the field whether they are hurt or not, whether they are 100 percent healthy or not, and whether they are relying on drugs to mask the pain or not.”
8. “Strategies for a Better Return-to-Work Process”, CLM, 11/19/14. The sub-title is “Actions to address prevention, costs, and employee value effectively for better outcomes in workers’ compensation cases.” Teaser: “Being proactive and intelligently applying tactics that best fit a workplace can save not only time and money, but also the relationship between the employer and employee.”
9. “Strategies for a Better Return-to-Work Process”, CLM, 2/17/15. The sub-title is “How to provide not only empathy for injured workers and their families, but also the assurance of proper care.” Teaser: “My father’s passing was a poignant reminder for me that we need to remember that injured workers are people. They are members of families that have encountered life-altering events and now face uncertain futures. A balanced view of the financial implications with an understanding of the injured worker’s personal needs and concerns is difficult. The health crisis I have just navigated through created a new empathy and an understanding of what others are feeling because I’ve personally experienced it.”
10. “Weighing the Use of Compounds”, CLM, 4/27/15. Teaser: “While exorbitant costs certainly are an issue, concerns about patient safety and clinical appropriateness are even more important. If higher costs yield better clinical outcomes for the patient, an argument could be made that the return on investment (ROI) is worthwhile. However, that is often not the case.”
11. “The Implications of Marijuana Legalization to Employers”, The Self-Insurer, June 2015. Teaser: “Whenever a subject is complicated there is an increased possibility of misunderstanding and mistakes – or paralysis by analysis. Given the momentum of cannabis legalization around the country, employers ignore the issue at their peril.”
12. “Mark Pew: Rx Epiphany for Work Comp – MSAs”, WorkCompWire, 6/22/15. Teaser: “Although the Centers for Disease Control and Prevention (CDC) had already recognized the prescription drug epidemic, this new MSA requirement drew attention to many high-cost drug regimens that were doing clinical harm to injured workers. Yes, the monthly drug costs were expensive. Yes, reserves often had to be revised upward on an annual basis. Yes, injured workers often lost the chance to return to work or even function because of their prescription-drug haze. Yes, everyone from claims adjusters to CEOs knew that prescription drugs were a growing financial and clinical problem. However, the work comp industry had been slow to address the issue until forced to follow explicit rules to calculate the lifetime cost associated with continued inappropriate polypharmacy regimens.”
13. “Rx Epiphany for Work Comp – Death Benefits”, WorkCompWire, 6/30/15. Teaser: “What is not up for debate is that an injured worker dying from an overdose (intentional or unintentional) of prescription drug(s) paid by work comp is an issue for payers.”
14. “A Formulary for Success”, CLM, 7/27/15. Teaser: “Yet the true goal of a workers’ compensation drug formulary is to produce better clinical outcomes for the injured worker. The grand bargain of workers’ compensation includes the premise of returning the injured worker back to health and work as efficiently and effectively as possible. It has been proven that a workers’ compensation drug formulary can help clean up past issues and proactively limit new issues from the overuse and misuse of prescription drugs.”
15. “THC Presence Versus Impairment”, CLM, 9/24/15. Teaser: “This information makes it clear that impairment from marijuana is intense, short-lived, and can be difficult to separate from the mere presence of the drug. And therein lies the problem.”
16. “The Land of ‘Just Right’”, CLM, 11/23/15. Teaser: “A balanced life with appropriate priorities and discipline can yield not only better clinical outcomes for injured workers, but also better financial outcomes for employers and payers. In some cases, that means a change in approaches by injured workers and employers. Having more is not necessarily bad, but sometimes more is less, which means sometimes less is more. And when the appropriate balance is found, everyone becomes a citizen of the land of ‘just right.'”
17. “Can Marijuana Solve the Opioid Epidemic?”, CLM, 2/16/16. Teaser: “So, can marijuana solve the opioid epidemic? It is a perplexing and intriguing question. Not only is it a complicated question, but also it can be an emotional question for proponents and opponents … The answer may be dictated by the biases of the one who is asking the question.”
18. “The Intersection of Wellness and Workers’ Compensation”, The Self-Insurer, Sep 2016. Teaser: “So a healthy and happy employee has a positive effect on both the employee and employer. That is both intuitive and statistically proven. But how does that intersect with workers’ compensation?”
19. “Dangerous Confusion on ‘Painandsuffering’”, Insurance Thought Leadership, 9/9/16. Teaser: “The biggest problem is unrealistic expectations – patients often are told or come to believe they will be pain-free. When they’re not, and their condition becomes chronic, it sows doubt in the mind of both the patient and clinician.”
20. “Marijuana and Workers’ Comp”, Insurance Thought Leadership, 11/15/16. Teaser: “This is a workers’ compensation issue. The NFL is an employer. The players are employees. The gridiron is a workplace. Pain and injury are realities for the vast majority if not all players/employees at some point in their careers.”
21. “Time to Clean Up the Mess”, CLM, 4/11/17. Teaser: “Clearly, what’s next for pain is thinking about it differently. Patients, clinicians, and payers need to be willing to try and pay for different treatments.”
22. “Paying for the Person”, WorkCompWire, 5/9/17. Teaser: “So is the BioPsychoSocial movement only talk? Or is it something that we as an industry not just understand but actually underwrite? Are we being “penny wise” and “pound foolish” by paying for the wrong things or not paying enough for the right things?”
23. “Thursday Thought Leader”, LegalNet, 6/9/17. Teaser: “I try to take difficult and complex subject matter and make it accessible to all. I speak in simple language. I infuse everything I do with the personal passion for change that drives me. I try not to be inconsiderate or rude or arrogant to anyone I meet, but instead be respectful while being firm in my convictions. I think the fact that I have come so far in such a relatively short time in a way that I could never have imagined (believe me, I look at what I am doing now and it blows my mind) keeps me humble.”
24. “The game-changer for the opioid epidemic”, DORN Companies, 10/4/17. Teaser: “Within one year, the clinician’s role in the epidemic could no longer be ignored and the only path forward requires their involvement. In this case, mandatory involvement.”
25. “Big Opioid Pharma = Big Tobacco?”, Insurance Thought Leadership, 10/20/17. Teaser: “Whether you believe the opioid epidemic is real or not (I do), or whether you think at least some of the deaths from illicit street heroin and fentanyl are a consequence of over-prescribing prescription opioids (I do), I think we can all agree it’s wrong for a company to tell its customers there is no danger when there really is (and when the company knows it).”
26. “Moving Beyond the Buggy Whip”, CLM, 10/23/17. Teaser: “If medical care is paid by each service performed, then the result will likely be more services billed. If medical care is paid based on the clinical outcomes, then the result will likely be a more strategic and holistic approach.”
27. “’The Intersection of Medicine and Disability’ from NWCDC”, WorkCompWire, 12/14/17. Teaser: “A return to function – reducing impairment (and thereby disability) – is also the paramount goal for a clinician. But an equally important goal is reducing worklessness – a fairly new term that is broader than unemployment as it includes people who are economically inactive (including those who are sick and disabled).”
28. “Clinical and Legal Advocacy in a WCMSA”, CLM, 12/15/17. Teaser: “Their long-term use never stays static – the claimant’s overall condition deteriorates, side effects compound, dosages increase due to tolerance, more drugs are introduced, and premature death is a legitimate possibility – so the simplified calculation does not reflect reality.”
29. “A Culture of Whole-Person Wellness with Mark Pew”, DORN Companies, 10/3/18. Teaser: “The primary key is creating a culture of wellness, modeled by management and infused into every inch of the business. But it’s not just physical wellness as often is the focus. It’s whole-person wellness – mind, body, soul. Every aspect of the human experience.”

There were three more articles (“The Ethics of an Antidote,” “Don’t Take That Pill,” and “Positive PDMP Progress) that are no longer available online from the publisher.

I already have several scheduled for publishing in 2019, along with some surprising new content that I will be launching in January.

So stay tuned…I haven’t run out of words yet.