The Metrics of Caring

The intersection of medical care and business is a tortured place.  Money and medicine have a long history of conflicting and difficult, practical and moral choices.  In the short time I have been writing on patient education, it seems to me, this is especially so in the injured worker experience.  Talking about the value of patient education after injury inevitably raises the question of cost and return on investment.  It is a little bit of an odd question when you consider OSHA Safety Training. OSHA training is typically mandated, regardless of ROI or cost.  We educate all workers to avoid injury and question the need to educate any worker after injury.  In true industry speak – if Safety Training is Just In Case, then Injured Worker Education would be Just In Time.  But the workers’ compensation system seems to be struggling with the quandary of how to quantify the metrics of caring.   

What is the value of educating an injured worker about the importance of engaging in her or his own recovery?  After all the money has been spent on repairing injuries small and large, what is the value of demonstrating to the worker that a good coach can teach them the way to get better faster and stay better longer?  What is the value of teaching an injured worker that the food they eat can either help or hinder their recovery?  The emerging science of ERAS (Enhanced Recovery After Surgery) through nutrition is a new idea to most case managers and a complete mystery to the injured worker.  What metric can we apply to letting a recovering worker know that daily exercise will increase their blood flow and facilitate a more rapid healing process?  What is the measurement of value to helping the worker know that quality rest does not come from being doped into unconsciousness on pain killers? What is the value of removing the sense of isolation and loss that workers often struggle with in their recovery by simply calling once a week to check in, letting them know their employer is committed to restoring them to good health and returning them to work?    

When I sat down to write The Optimized Patient book, I didn’t think about who might need the help.  I didn’t think about how much help was needed or how it might be received or used.  I only cared about the fact that what I learned and benefitted from could help thousands of people who are facing some of the most difficult moments of their lifetime.  Was it worth my time and money to take a year off and write the book?  Did I need – or ever want – an ROI on my time and resources?  Not really.    

So, we come to the question, “What are the metrics of caring?”  At workers’ compensation conventions I talk about helping the injured worker track their recovery through a highly sophisticated self-assessment tracking software.  It’s important to workers and their employers that progress be tracked and quantified.  Astonishingly, patient progress can be tracked and is  being tracked with precision data points.  And as valuable as that tool is, it begs the question, “Does the worker feel he or she is being treated fairly and with care by “the system?”  I believe encouraging videos, educational audios and specialized nutrition planning provided by the employer says something more than the numbers may say.  It says my employer genuinely cares about my outcome.  And as good as recovery tracking software may be, the metric of caring, above all else, comes directly from the injured worker.  I believe the metric of caring is measured in the level of appreciation from a recovering worker in the pricelessness of a heartfelt “thank you” for the doctoring – and – showing the way to their best and fastest recovery.