Case Background
Mr. C was operating a high pressure water gun when he lost control injuring his knee.
Mr. C sustained a deep penetrative laceration to the knee joint.
The injury provided significant levels of disability and he had developed a co-morbid depressive episode and agoraphobia prior to Medicess’ instruction. This was compounded by a past history of psychological problems.
In addition to the physical and psychological issues, the relationship Mr. C had with the employer degraded and presented barriers such as lack of cooperation, support and compliance with a return-to-work.
Medicess Involvement
Overview:
- Work status – employer contact
- Telephone triage
- Medical notes obtained
- Physical examination
- Private treatment provided by Medicess and coordinated with NHS services
- Worksite Assessment
- Return-to-work monitoring and coordination of vocational services
Immediately upon notification, all parties were contacted for collaborative engagement with the rehabilitation process. Medicess established an in-house multi-disciplinary team based on the clinical requirements of Mr. C. This consisted of a Medicess Doctor, Psychologist, Physiotherapist and an Employment Consultant.
Following a Physical Examination, review of the medical notes and liaison with the treating parties, an objective clinical view was established on the best delivery and integration of a treatment programme to advance this gentleman’s care, within, and parallel to the NHS.
The Medicess in-house team worked together with Mr. C, the treating NHS and appointed private Professionals, the employers, Solicitor and Insurer to ensure the optimal, appropriate and timely coordination of rehabilitation.
A summary of how the team operated is as follows:
Medicess Physiotherapist
NHS Physiotherapy services, in isolation, had not fully assessed this gentleman’s needs and overall presentation. Prior to Medicess’ instruction, Mr. C was provided one session of Physiotherapy providing advice and then discharging. This was insufficient to address the injury.
Medicess immediately provided private Physiotherapy which was focussed on a bio-psychosocial approach to the management of pain, pacing and progressing levels of physical function.
Treatment was coordinated with the Medicess in-house Psychologist who coordinated Clinical Psychology treatment. This enabled a coordinated approach to treatment as both the Psychological and Physical interventions were inextricable.
Self directed rehabilitation timetables were provided to the patient upon completion of the treatment to ensure ongoing progression of recovery. The treating Physiotherapist was advised to make these vocationally orientated.
Medicess Psychologist
Psychological symptoms were unchecked on the NHS and the Medicess Psychologist ensured that the GP was made aware and an appointment was made immediately. The GP provided appropriate medication for the short term and endorsed Medicess’ recommendation to provide Clinical Psychology treatment.
The Medicess in-house Psychologist coordinated monitored and coordinated the treatment with consideration of the past psychological history. This treatment was also coordinated with the in-house Physiotherapist who coordinated Physiotherapy treatment.
Alongside physical recovery, the Psychologist ensured that treatment focussed on vocational re-integration.
Medicess Doctor (Occupational Physician)
The Medicess in-house Doctor provided guidance to the overall direction of rehabilitation with consideration to the effects of the medication management in place and possible escalation of treatment for diagnostic and invasive therapies, if deemed appropriate.
The Medicess in-house Doctor provided certification of the worksite assessment which facilitated the GP agreement.
Medicess Employment Consultant
Developments in the physical and psychological condition were coordinated with the timely return to the workplace. The Medicess Employment Consultant continued liaison with the employers to develop and progress relations to ensure that a return-to-work would be possible. As a complete recovery was achieved, Mr. C was able to return safely to pre-injury hours and duties.
Benefits of our involvement
Without the involvement of Medicess, the psychological problems experienced by Mr. C may have remained unchecked and progressively worsened. The team approach ensured that the appropriate professionals worked respectively within their skills set to coordinate and effect treatment which resulted in expediting recovery and return-to-work.
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