If you can't prove it medically, should you get paid for it?

Great Debates
21

The recommendation is just too stark. I think physicians have to be given considerable latitude, because ideopathic illnesses are no less “real” for being so. Even bona fide conversion disorders (a highly controversial diagnostic catagory) are treatable diseases, despite the fact the illness the patient consciously experiences is not the illness they have. It’s perfectly legitimate to try to treat illnesses that evidence-based medicine either has failed thus far to explain, or has overlooked because of, say, rarity.

Now, there are “healers” who employ methods that are unrelated to evidence-based anything, and treat people for “ailments” (like posession, unbalanced chi, engrams, etc.) that, again, do not have, and often cannot have, any evidential basis. My knee-jerk bias is to outlaw monetary compensation for those practices, but I fear that would be unconstitutional.

22

[QUOTE=Jackmannii]
What if that person with persistent pain unrelieved by traditional therapy says that they get relief through past life regression, Ayurvedic herbs, using an electrical zapper to kill their undetectable internal parasites, by having a maze constructed in their backyard or via any of the vast number of supplements, “cleanses” or interventions that have hit the market in recent years? Should our insurance plans (or national health coverage) pay for these things, given the absence of clinical trials showing their safety and effectiveness (most rely on personal testimonials)?
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As an aside, related to this point: I went to school with a man who’d been injured at work. He had terrible back pain, which was almost completely relieved by acupuncture. Of course WCB wouldn’t pay for acupuncture because it wasn’t a “clinically proven” treatment (this was many years ago - I think acupuncture has been given the green light now).

It was a shame that WCB would pay whatever it cost for massage, PT, pain killers, etc, none of which helped but were “traditional” treatments, but not acupuncture that did help, because it wasn’t.

Anyhow - my point is, insurance companies of all kinds (not just WCB) aren’t renowned for being quick to fund treatments that are out of the mainstream, regardless of potential value.

23

I think getting taken is part of the price of providing care and support for those who really need it. Life ain’t perfect.

24

[QUOTE=Foxy40]
Well, my ten years experience in ortho certainly contradicts your “very few people are honestly pain free.” After seeing hundreds of surveillance videos and being duped many times, yes, there are many scammers and no, they really aren’t having much if any pain at all. They are having dollars signs and milking it for all it is worth and what it is worth is a 3% impairment with no objective findings if they milk it long and hard enough.

That 3% costs the insurance companies hundreds of thousands of dollars in unnecessary medical care, supplies, medications that probably get flushed and tests that all come out negative. Oh, but they are “hurting”. Hurting enough to unload an entire moving van or do moves on a basket ball court that Michael Jordan would envy.

Oh, but of course, they can’t work. Can’t stand more than an hour without having excruciating pain. Can’t bend or twist or stoop or drive a car. Certainly can’t go back to their manual labor job. E.v.e.r.

Ahhh, but a Jacuzzi would make me feel so much better, doc. Or a new pillow top mattress. How bout one of those massage chairs? That should do the trick. Now if you would just sign here.

Cynical? You betcha.
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A friend of mine used to do private detective work filming people playing softball while collecting workman’s comp checks. Yep, I’m a little cynical about it to. But there are people who have life impacting injuries where they can’t work nor can they play softball, but the injury is difficult to detect.

If you are going to claim a life impacting back injury that makes your job “too painful,” its a good idea to resign from the bar softball team as well.

(However, I think its probably true that very few people are truly pain free. My wrists hurt, my shoulder hurts, I’ve lived with headaches of varying intensity forever - some days bad enough to spend the day in bed, usually minor enough to function - can I “project” that minor functional headache into blinding pain in order to get out of something - probably wouldn’t be difficult - I know blinding pain and with the minor pain in place, the act of exaggerating its intensity is simple and doesn’t take an Oscar calibre actor.)

25

My husband suffered a terrible knee injury in the Army. One doctor said that he had conversion disorder because after surgery the pain did not go away and nothing that could cause the pain showed on x-rays. A few years later, a sports medicine doctor with VA hospital privileges got interested, and did arthroscopic surgery and resculpted his knee. He also removed three point bone fragments hiding under the patella that nicely explained the pain he reported.

Just days after surgery, he was walking again with canes, and did enough physical therapy that soon he did not even need those. He was missing quite a bit from his knee, but the doctor was able to provide one that kept working for 15 years. He now has a zirconium one.

Just because medicine doesn’t prove something now doesn’t mean that it can’t be proven ever.

Several doctors doubted his story (we moved and medical records were slow to catch up), and did not believe it until they took new x-rays of his knee and saw the sport medicine surgeon’s initial there on the knee in radio opaque dye.

He has fibromyalgia now. That too cannot be positively proven just yet. The doctor did tell us that autopsies of those with reported fibromyalgia do show evidence of deterioration the muscles that does not show up on any diagnostic test during life. Maybe someday they will figure out how to positively diagnose fibromyalgia, but for now they can’t. Nevertheless, it is real, and it is devastating.