Aggressive early medical management by a specialist in physical medicine and rehabilitation: effect on lost time due to injuries in hospital employees.

Musculoskeletal injuries to hospital workers are both common and costly. Little advice has been written on how to decrease losses after injury. In a tertiary care hospital with 2700 employees a specialist in physical medicine and rehabilitation evaluated injured employees who were out of work for more than 2 days. Physician management emphasized increasing patient investment in the problem, early assessment of delayed recovery, and effective communication with the employer. There were 61 injuries averaging 6.7 days off per injury. In a previous year, 52 injuries averaged 11.8 days. Employees out for more than 2 days with back pain and seen by the physiatrist (52%) averaged 11 days off per injury whereas others averaged 14.9 days. In this hospital, early management by a specialist resulted in a substantial decrease in time off because of injury.