Category Archives: People, Organizations & Websites

August 7, 2015

Who should be accountable for NEEDLESS job loss due to medical conditions?

Who do you think should be held accountable when workers needlessly lose their jobs because a newly-acquired or changed health condition or disability?

Right now, none of the professional participants who play front-line roles in the stay-at-work/return-to-work process feels a responsibility to prevent unnecessary job loss.  Doctors, employers, insurance companies, lawyers and so on simply think it’s a shame when it happens — if they are even aware of it.  Unnecessary job loss is being viewed as a private tragedy rather than a sentinel indicator of service and system failure.  A lot more sunshine is needed to illuminate this dark corner.

Gap

Even though OSHA ensures that employers record the number of work-related injuries, lost work-days and deaths, there is no requirement that they record job loss.  Why isn’t it being tracked?   It will almost always be a much worse consequence than the injury itself.   Job loss, especially in someone who was previously healthy but now has some degree of impairment, can be DEVASTATING.   Few people are prepared to deal with this double- barreled challenge.   For the unlucky ones, this means losing their footing in the world of work forever.

We do not even KNOW how many people lose their jobs as the result of work-related injuries much less personal health conditions — and how many fail to find new jobs. I personally don’t think it matters what the cause of the health condition is.

These days, more than a HALF of the people entering the Social Security Disability Insurance program are doing so because of adverse secondary consequences of common health conditions like back pain, joint pain, anxiety, and depression.  But notice this:  there are literally MILLIONS of people who keep working DESPITE back pain, joint pain, anxiety and depression.  These conditions should NOT be forcing people into a bleak future of on-going worklessness, especially because unemployment and poverty will WORSEN their health and well-being — and that of their families.

Needless job loss can occur because of decisions that doctors and employers make as well as decisions made by workers, their lawyers, and insurance companies. Anyone who COULD have actively supported a worker in staying at work but DIDN’T plays a part in unnecessary job loss.  Doctors may thoughtlessly select treatments that worsen instead of improve function, or impose work restrictions that “over-limit” someone who COULD actually perform their job.  Employers may refuse to make temporary adjustments that WOULD permit recovery “on the job” — and as a result workers sit home and begin to believe they really are “too disabled to work”.   Employers can refuse to engage in a real problem-solving discussion with workers that WOULD have let them come back to work with a very minor modification.  Employers can neglect to ask for help from a return-to-work expert who COULD have told them about a $200 piece of equipment or work process alteration that WOULD have made it possible for the worker to keep doing her regular job.  Insurers COULD routinely (instead of occasionally) make career counseling and job finding services available to workers who appear headed for job loss or have already been terminated.  Etc. Etc.

So, who DO you think should be held accountable for job loss in those situations?  You and I as taxpayers are going to pay benefits for the rest of these people’s lives if they end up on SSDI because the right things didn’t happen.  Less than 1% of SSDI beneficiaries ever come back off the rolls.

Here’s a place to see and comment on my DRAFT recommendations for what the government can do to create a lot more visibility for unnecessary job loss due to acquired health conditions and disabilities.  You can also contribute your own ideas on this matter at:  http://workashealthoutcome.epolicyworks.org/

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July 31, 2015

Tell us: Who should be helping workers with health problems keep their jobs?

The US Department of Labor (DOL) wants to engage YOU in dialogue (you employers, insurers, physicians/healthcare providers, managed care companies — and working age individuals whose jobs have been affected by new or changed health conditions.) The dialogue concerns some draft recommendations for Establishing Work and Full Participation in Life as ACCOUNTABLE Health Outcomes.

The recommendations are part of a larger report I have drafted.  It is focused on these questions:
1– How can we reduce the number of working adults who lose their jobs or leave the workforce after their ability to work has been disrupted by a health condition—and conversely, how can we increase the number who get the help they need to stay employed?
2– What will create widely-shared social agreement that preserving/restoring the ability to work and participate fully in life should be seen as KEY OUTCOMES of healthcare for the working age population?
3– Who should be helping working people KEEP THEIR JOBS after acquiring a new or changed disability?    Who should be held accountable when they needlessly LOSE THEIR JOBS?
4– How can that accountability be established—for real?

The DOL’s Office of Disability Employment Policy (ODEP) commissioned this paper.  Many ideas for how to accomplish those things emerged after interviewing about 20 experts in various fields and discussing these issues with a Policy Work Group within ODEP’s SAW/RTW Policy Collaborative.  Because the stay-at-work and return-to-work process is by nature a “team sport”, the reality is that SEVERAL parties will need to be held accountable.

The draft report actually makes more than 20 detailed recommendations, but for now, ODEP would like to get feedback from YOU on the 6 main ones.  This is a reality check, to see if we’re on the right track in your opinion.   I ENCOURAGE you to disagree, make corrections, or suggest things that are missing or would strengthen the proposal.   The purpose of this exercise is to IMPROVE the report – and increase the chances that it actually has a positive impact.  The ultimate goal is to help more people stay in the workforce, remain productive contributors, and enjoy the many benefits of economic self-sufficiency and full social participation.

You can look at the recommendations on ODEP’s “crowdsourcing” website even before you decide whether to vote/comment.  I hope you will.   See the invitation from ODEP below to get started.   Again, FEEL FREE to disagree, to point out mistakes, make additional suggestions, etc. etc.

From: Acting Assistant Secretary of Labor – Office of Disability Employment Policy
Sent: Wednesday, July 29, 2015 3:40 PM
Subject: ODEP’s Latest Online Dialogue Discusses Work as a Health Outcome

 ODEP epolicyworks masthead 2015-07-31

Second Stay-at-Work/Return-to-Work Online Dialogue:
Establishing Work and Full Participation as Accountable Health Outcomes

Do you have ideas on how to reduce the number of working adults who lose their jobs or leave the workforce after their ability to work has been disrupted by a health condition—and conversely, how to increase the number who get the help they need to stay employed? If so, the U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) needs to hear from you!

ODEP is hosting the second in a three-part series of important online dialogues, Establishing Work and Full Participation as Accountable Health Outcomes, to gather input on policy recommendations aimed at establishing work and full participation in life as accountable health outcomes. Through the use of an online crowdsourcing tool, interested stakeholders can provide feedback on these six draft policy recommendations.

Participation is easy. Just review the policy recommendations, register, then share your feedback.

Visit http://WorkAsHealthOutcome.ePolicyWorks.org/ before the dialogue closes on Friday, August 14th. If you have any questions, please contact ePolicyWorks@dol.gov.

Looking forward to your participation,
Jennifer Sheehy
Acting Assistant Secretary of Labor for Disability Employment Policy

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July 20, 2015

My “mini-manifesto” to reduce spine disability

You may be interested in the “mini-manifesto” I delivered this past Saturday 7/18 at the Spine 10×25 Research Summit in Chicago hosted by the North American Spine Foundation.  They have declared a worthy and very ambitious goal:  to reduce spine disability by 10 percent by the year 2025.  Thus the name: Spine 10×25. Pronounce it like you’re buying lumber – “10 by 25”.

(You can see the video and listen to my talk —  or even the ENTIRE 8 hour event because it was live-streamed and recorded.  Click here to do so.  Advance the recording by moving the blue dot along the horizontal line.  My talk starts at 5:31:50 and goes until 5:51:30.)

Do you know of any other medical group that has drawn a bold line in the sand like that?  I don’t.  It had never occurred to me that a professional society would set out to measurably move the needle.  They just don’t take on that type of project.  Most healthcare professional associations content themselves with pontificating:  being experts and telling other people what to do and how to do it.

My own professional society (ACOEM – the American College of Occupational & Environmental Medicine) has made many significant contributions to society.  In particular, our evidence-based treatment guidelines are very well regarded and in use by several states.   ACOEM has produced many other useful publications that have had a positive impact.  In fact, some of them were developed under my leadership.  But, in the end, they all amount to pontification.

In 2006, I told ACOEM I didn’t want one of those documents to just sit on an electronic shelf. We had developed it in order to introduce the work disability prevention paradigm and shift the way all stakeholders think about work disability.  Entitled “Preventing Needless Work Disability By Helping People Stay Employed“, that report needed to go out into the world.  Thus, the 60 Summits Project was born to carry it into the 50 US states and 10 Canadian provinces of North America.  We created groups of volunteer professionals who planned and held 20 multi-stakeholder summit-type conferences in 12 states and 2 provinces.  We invited the attendees to consider ACOEM’s 16 recommendations for improving the stay-at-work and return-to-work process.  We asked them to decide if they liked each recommendation, and if so, to make a plan for how they were going to carry it out in their own business, community, and jurisdiction. (60 Summits eventually ran out of money and was mothballed.)

Then last month, the boldness of the Spine 10x 25 initiative made me realize that even The 60 Summits Project had a pontification angle to it.  Propagating a new way of thinking and discussing a set of recommendations for change is not the same thing as CARRYING them OUT.  I felt compelled to go and check out these NASF people and participate in their Spine 10×25 Research Summit.

My assigned topic was “Precedents and Prospects for Success” in a 15 minute time slot that got expanded to 20.  It seemed important to speak straight and share my ideas about what needs to be true in order for their goal to be realized.  I offered the audience a (draft) conceptual foundation to use as a context for change, as well a summary-level vision of the way things will look in the future WHEN things have ACTUALLY changed and spine disability is BEING REDUCED by 10%.  View it here. Remember to advance the recording to 5:31:50.

I may expand a bit on some of the main points of that mini-manifesto in later posts.  I developed all of those slides at the conference in order to take into account what the speakers said who had gone before me!  Luckily, I also had some time at lunch.  The tight time limit meant a few big ideas got short shrift.

 

 

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July 9, 2015

Here is where healthcare delivers VALUE — at the most fundamental level

When Professor Michael Porter did some “deep thinking” about where value is actually delivered in healthcare, he created a simple table that displays three tiers.   I found his second value tier EXCITING:   a Harvard Business School professor was validating my own “gut feel” about what really counts.   I summarize Porter’s three tiers this way (you can see his own table below this post):

Tier 1:   Delivering a desired health status — Avoiding death; optimizing health or extent of recovery.
Tier 2:   Minimizing the time it takes to restore the normal rhythm of everyday life — the cycle time required to produce a return to full participation in life (or best attainable level).
Tier 3:   Sustaining health or recovery, minimizing recurrences and iatrogenic (care-induced) illnesses and consequences.

Porter’s free article appeared in the December 23, 2010 issue of the New England Journal of Medicine.  In his comments on Tier 2, Porter said:  “Cycle time is a critical outcome for patients — not a secondary process measure, as some believe.”  I have focused most of my professional energy for the last couple of decades on shortening cycle time — because it clearly produces better overall life outcomes.  I hoped Porter’s article would catalyze a lot of discussion and much more attention to Tier 2 — but not much luck so far.

Personally, I believe that the purpose of being alive is to live a fully human life.  From that perspective, the most VALUABLE healthcare services are those that minimize the impact of illness or injury on the rhythm of everyday life.  I want all healthcare professionals to START here:   Our FUNDAMENTAL purpose is to avert premature death, relieve fear and suffering, and to enhance, preserve,or restore as quickly as possible every patient’s ability to participate in the specific activities that make life worth living — which for many includes productive engagement / work.

We are a social species.  We have an innate drive to be useful in some way, to have a role to fulfill.  We are happier when we have a clear purpose in life. Those of us in the middle years of the human lifespan are DESIGNED to work — to hold up our end and contribute to the well-being of our family, clan, community or nation.  The well-being of our country, and even more broadly, the survival of our species depends on maintaining the right balance between dependents and contributors.

The AFL-CIO’s website says this about work:  “Work is what we do to better ourselves, to build dreams and to support our families. But work is more than that. Work cures, creates, builds, innovates and shapes the future. Work connects us all.” As the Episcopal Book of Common Prayer‘s Order for Compline (an evening prayer service) poetically puts it:  “Grant that we may never forget that our common life depends upon each other’s toil.”

From What is Value in Healthcare by Michael Porter, NEJM 363;26 Dec 23, 2010, p 2479

From What is Value in Healthcare by Michael Porter, NEJM 363;26 Dec 23, 2010, p 2479

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July 7, 2015

Free on-line CBT course helps Australians living with pain feel better

An Australian study in the journal Pain reports that a FREE on-line course that employs CBT techniques has worked well in helping patients with chronic pain reduce both distress and other symptoms  — no matter how much contact the patients had with a clinician during the several week course – and it clearly outperformed “usual care.”

The Pain Course was developed by psychologists as part of a non-profit initiative of the Centre for Emotional Health, part of Macquarie University in Sydney, Australia.  Their tagline reads:  “Developing effective, accessible and free psychological treatments …”   Before you get TOO excited, this particular course and the other on-line offerings of ecentreclinic.org which developed it are only open to residents of Australia.

Here’s a bit more about this group from their website:   “We comprise a team of psychologists, psychiatrists, and research staff….The eCentreClinic is a specialised research clinic that develops and tests state-of-the-art free online treatment Courses for people with symptoms of worry, panic, social anxiety, OCD, PTSD, stress, depression, low mood and other health conditions including chronic pain. We built the eCentreClinic because millions of Australian adults suffer with these symptoms and conditions each year. But, most do not seek help or see a mental health professional. We believe that people have a right to helpful information and to know about practical, proven, skills that help. We hope that by providing this information and supporting people to learn these skills via the internet more people will learn to master their symptoms and conditions. By doing this we hope they will also improve their quality of life and that of their families and communities.

Here’s a link to the abstract.   It is is an open access (free) article, so you can also download a pdf of the entire article here.

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June 18, 2015

Nancy’s super-simple guide to pain

Nancy Grover’s June 15 column on Work Comp Central is a super simple guide to pain for anyone who isn’t really interested in the latest science of neurophysiology — but who wants a basic understanding of how the science of pain is changing our view about how to treat it.

Nancy interviewed me and wrote her column after reading a white paper entitled Red Herrings and Medical Over-Diagnosis Drive Large Loss Workers’ Compensation Claims released by Lockton Companies.  I am one of the co-authors, along with Keith Rosenblum, senior risk consultant at Lockton Companies and Dr. David Ross, a Florida neurologist who is CEO of NeuroPAS Global,

Our goal was to draw attention to an issue that is driving UP costs for payers and driving DOWN quality and outcomes for patients.  In short, all of us (physicians and patients, claims payers, employers, lawyers, judges, etc.) have been getting seduced by the false certainty created by “objective findings” of diagnostic imaging, especially by MRIs.

Before proceeding with invasive procedures and expensive/risky surgeries (that often fail to relieve the pain or create worse problems), we really should be making a good faith effort to identify (and treat) other things that are either causing or worsening the patient’s distress.  Before that first cut is made — are we sure all soft tissue problems have been identified, and then treated by skilled professionals using evidence-based methods?   Have all emotional, psychological, and other human issues known to manifest as bodily distress been identified, and then treated by skilled professionals using evidence-based methods?

If you’re a WorkCompCentral subscriber, read Nancy’s excellent column Low Back Ache: A Pain in the Brain.  If you’re coming to the SIIA conference which is October 18-20 in Washington DC, plan to attend our session on Medical Red Herrings — I’ll see you there!   (SIIA = Self Insurance Institute of America)

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June 18, 2015

Pain-free without surgery — despite horrible-looking MRI

Sounds like at least one spine surgeon is in danger of working himself out of job.  Several years ago, David Hanscom, MD in Seattle developed an alternative to spine surgery called the Defined Organized Comprehensive Care (DOCC) program.  He says it helps people suffering with chronic back pain to calm down their nervous systems, starting with the anxiety and anger that chronic pain causes.  He offered the DOCC program to patients when he wasn’t sure that surgery was going to relieve their pain.  A lot of them got remarkably better — so better that they declared themselves pain-free.  The number of surgeries he did dropped, but his patient outcomes improved overall.  The non-surgical patients got better, and the surgical ones did too — because now he was only operating on the ones where it was crystal clear they needed the operation.

Then he took it up another notch.  Based on the success of the DOCC program, Dr. Hanscom decided to try using it to prepare people who had already been scheduled for surgery to have a smooth post-operative recovery.  We’re talking about people with horrible-looking MRIs that revealed structural problems entirely consistent with their symptoms.  The result has stunned and delighted him.  He says that more than 40 of these people have decided they don’t NEED surgery anymore after the DOCC program because their pain has pretty much gone away!   See more about this surprising development on his recent blog posting.

And if you work with people with back pain, or have the problem yourself, go to Dr. Hanscom’s website Back-in-Control.com and start calming down YOUR nervous system too.  The DOCC program is all laid out on the website — and it’s free.  All that’s needed is an open mind and the willingness to try a different path up and out of that deep hole.

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June 15, 2015

Introducing Dave Clarke MD & the Psychophysiological Disorders Society

I had the honor of meeting a innovator in medical CARE on Sunday:  David Clarke, MD, founder of the Psychophysiological Disorders Society.   He is a gastroenterologist by trade who has developed expertise in diagnosing and compassionately treating what he calls “stress illness”  — distressing symptoms and even physiological upsets  — without any actual evidence of disease.  Stress illness is an extreme version of the body expressing what is going on in the brain (upsetting thoughts, feelings, emotions, memories, etc.)  However, we are ALL familiar with the more common everyday versions of this same thing:  sweaty palms and butterflies in stomach when worried, blushing when embarrassed, diarrhea or constipation before or after a stressful event.  Although we don’t THINK of these things as the brain expressing itself through the body, that’s what it is.

Stress illness occurs for many reasons, but one of them is because other communications channels are blocked.  Long before I got my professional education, my family taught me that people who bottle up their feelings —  who won’t let themselves cry or be angry — are going to have those feelings leak out somewhere else.  It’s a form of pent-up tension..

Dr. Clarke’s book (and audio CD) are on Amazon, entitled “They Can’t Find Anything Wrong“.  You will find many case stories that illustrate (a) the power of stress to cause bodily dysfunction / symptoms; (b) the healing impact of simply noticing then acknowledging the contribution that stress is making to symptoms; and (c) the various sources of stress:  current life predicaments; childhood trauma; PTSD; anxiety and depression.  As Dr. Clarke said, some of his patients were “cured” as soon as he listened and ask questions until they SAW the connection — and accepted it.  Others needed to learn more — read a book or two, look things up on the web.  A third group needed to spend some time working with a good mental health professional to learn how to feel and release the pent-up stress, and then learn better ways to deal with the ups and downs of life.

There are several medical terms for this puzzle of distress without disease:   medically-unexplained physical symptoms (or MUPS), somatization, and functional disorder are among the most widely used.  They all describe cases in which the patient feels sick and is complaining of symptoms but there is no objective evidence of pathology .  Often, an organ or system is not functioning normally, but there is no sign of any disease process.  In other words the “doctors can’t find anything wrong!”

I wondered if there are any estimates for how frequently this occurs.  Turns out this type of disorder accounts for a surprisingly large fraction of all visits to doctor’s office — estimated by various researchers as 25 to 60%.

Maybe we should think of it this way:  Just like our facial expressions sometimes betray us even when we’re trying to keep a poker face — our bodies do the same thing.  The body is just another channel the mind / spirit / brain can use to express itself — whether we are aware of it or not, and whether we want it to or not!

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June 12, 2015

First-ever CDC-sponsored “disability prevention” event

Even if you missed it, you can still listen in to a milestone event:   the first-ever public webinar hosted by a federal government agency on the topic of “disability prevention.”   The umbrella hosting agency was the CDC (Centers for Disease Control) which is the main preventive health arm of the Federal government.

The webinar was actually put together and co-sponored by two specialized units buried deep inside the CDC:  the Center for Workers’ Compensation Studies and the Office for Total Worker Health within NIOSH (National Institute of Occupational Safety and Health).  It was an EXCELLENT kick-off  that I hope reflects a sea change and expansion of focus at NIOSH — and maybe eventually the CDC.

Two invited experts spoke about SECONDARY PREVENTION:  mitigating the impact of injuries and illnesses after they occur by preventing adverse consequences.   This is quite different from NIOSH’s traditional focus on PRIMARY prevention:  avoiding the injuries or illnesses in the first place.

The event wasn’t perfect.   Listen carefully and you’ll notice vocabulary problems — a signal that the speakers, the sponsors, and the audience are not yet quite on the same page.   Various people used the word “disability” to describe quite different  things.   For example,  some spoke about  preventing medical or anatomical problems:    obesity, diagnoses, symptoms, anatomic losses and impairments.   The invited outside speakers referred mostly to the dynamic impact of injuries/illnesses on everyday life:  loss of ability, activity limitations, work absence, loss of jobs and livelihoods, descent into a life of poverty and economic dependency.

The speakers’ POWERFUL AND FACT-FILLED presentations with many citations made the nature and extent of the problem of preventable adverse consequences of injuries very clear. They ALSO made it clear that these problems are NOT unique to workers’ compensation.  They are just EASIER to DETECT in comp because both medical AND wage replacement costs are captured in a single dataset.  Even the Q&A portion of the event featured good questions, pithy remarks, and revealing comments from listeners which led to stimulating dialogue.

The featured speakers were:

You can download pdf’s of the speakers’ powerpoint presentations at the end of the webinar.  If you would like a copy of the unedited transcript from the session, please email vqq3@cdc.gov.

Do make time to listen to it!  It will make you think.   Even though I attended the live event, I listened again because the VIIRPM was very high .  [VIIRPM = Very Important Information Rate Per Minute (smile) ].  Here’s a link to the webinar recording (audio plus slides)   https://nioshtwh.adobeconnect.com/p9law27cnd3/.

I’ve been wondering:   What do those vocabulary problems mean for us?  We need to agree on a lexicon, a shared language in which we use terms the same way across all Federal programs and our society (NIOSH, EEOC/ADA, ODEP, Social Security Disability, etc.)  I’ve already suggested a conference on this to the NIOSH people. In addition, we also need an even bigger term to cover ALL the preventable bad stuff that happens in so many domains of life  — and can turn what should have been a short-term hiccup in life into its ruination.   Here’s a laundry list of outcomes we want to avoid:  (a) preventable impairment and functional loss (due to inadequate or ineffective treatment), (b) preventable secondary medical conditions (such as obesity and depression); (c)  iatrogenic illness (such as opioid addiction and drug side effects); (d) over-disabling (due to false beliefs and lack of patient education), (e) avoidable job loss and withdrawal from the workforce, and (f) people leading purposeless lives of social isolation, economic dependency, and poverty who COULD be participating fully in human life!  These are the poison fruits of a system whose gaps and holes reflect a lack of commitment to assuring that the right things happen when a working person’s life is disrupted by injury or illness — no matter the cause.  So, we also need a big term to describe what we DO want to happen, and the better outcomes we want.

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June 8, 2015

Two worthwhile conferences in Chicago this week

Two conferences on worthy topics are going on simultaneously in Chicago this week.   One is a first-time event on a topic that deserves more attention:  the special workplace risks faced by workers with disabilities and their employer’s responsibilities under OSHA and the ADA.  The other is a 35th annual workers’ compensation and occupational medicine event that delivers high quality programs every year.  The profile of attendees at the two conferences also will probably be quite different.  Which one will expand your horizons and be most useful in your career or your service to clients?  Read on, learn more, and take your pick — if you can get to Chicago this week!

To my knowledge, a conference on Promoting Health & Safety for Workers with Disabilities being held on June 9 in Chicago may be the first of its kind.  It explores the implications of the Americans with Disabilities Act (as amended) for workplace safety and health programs.  I predict this will be the bottom line:  Individualized protection plans are a natural part of “reasonable accommodation” — and the need for them should be part of any template for the interactive process.

Beth Marks, RN, PhD, came up with the idea and is the main organizer of the event. Originally trained as a nurse, she believes that people with disabilities who are trying to lead full lives and work deserve support.  She also has personal familiarity with the kinds of unusual workplace hazards faced by workers with vulnerabilities.  Among her many roles, she is co-Director of the National Organization of Nurse with Disabilities (NOND.org)

This event is being hosted by the NIOSH-funded ERC and the NIDRR-funded RRTC at UIC.  It is being co-sponsored by a unique set of organizations:  unions, disability advocacy groups, medical centers and other ERCs,  (Pardon the acronyms:  To fully disclose who is hosting it: the Illinois Occupational and Environmental Health & Safety Education and Research Center funded by the National Institute of Occupational Safety and Health in the School of Public Health at the University of Illinois at Chicago  in collaboration with the Rehabilitation Research and Training Center on Developmental Disabilities and Health in the Department of Disability and Human Development in the College of Applied Sciences at the University of Illinois at Chicago.  Now, is that better? )

The second event is the 35th Annual SEAK Conference on Workers’ Compensation and Occupational Medicine.   Historically held on Cape Cod every summer, this SEAK meeting is being held in Chicago this year while the Massachusetts conference facility is being remodeled.   I have attended, spoken at, and conducted all-day workshops at this annual event many times.  It is an information-rich but not overly academic learning opportunity.  That’s because the focus is on practical application:  how to use information or how to do something important. (SEAK also offers other educational events on more specialized topics.)  The speakers come from a variety of disciplines (medicine, nursing — especially case management, law — including judges, and insurance).  They tend to have deep expertise in their topics, and the pace is lively.  The focus is mostly on the mechanics of workers’ compensation, with less emphasis on wellness, prevention, safety, large issues of social justice, etc.

If you decide to go to one of these events, please let me know which one you attended — and whether it was worth your while!

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