So many words ...

(updated 4/24/20 - added articles #43-46)

(updated 11/21/19 - added articles #41 and #42)

(updated 8/1/19 - added article #40)

(updated 7/22/19 - added article #39)

(updated 7/2/19 - added articles #37 and #38)

(updated 5/13/19 - added articles #35 and #36)

If you're reading this you've probably seen some of my daily postings on LinkedIn and/or Twitter. Or maybe you've read one of the many blogposts I've published since May 22, 2015. But did you know that I have also had many published articles? And that my first one was published back on May 14, 2013? It's been somewhat nostalgic to read back through them all, taking me back through my journey in identifying / understanding the issues and how to articulate my opinions.

So here are my articles, in chronological sequence, just in time for your holiday binge reading!

1. “How to Get Unhooked”, CLM, 5/14/13. Teaser: "As evidence mounts that patient motivation is vital to actual recovery, it’s time for another transition from a 'medicalization-only' mindset to a holistic approach that takes into account all of the variables that affect recovery. It’s time for all stakeholders within the system to think more broadly and be open to new concepts that comply with best practices and correspond with treatment guidelines. In other words, maybe the injured workers are not the only ones that need to have their motivations adjusted." Me in 2018 sounds a lot like me in 2013! This was reprinted by Insurance Thought Leadership on 2/28/15.
2. “Redefining Success”, WorkCompWire Leaders Speak, 1/20/14. Teaser: "Let’s simplify what true success is for work comp: restoring the health of the injured worker and settling the claim efficiently. Realistically, the worker might not be restored fully to pre-injury health, but regaining as much as possible is certainly the goal."
3. “Redefining Detox”, WorkCompWire Leaders Speak, 1/27/14. Teaser: "However, if you think of detox only as a chemical weaning process, you can miss the most important component in affecting permanent change: the psychosocial aspect. Removing dangerous drugs without any plan for addressing how claimants can physically and mentally cope with their pain can lead to relapse."
4. “Industry Spotlight: 20 Questions with Mark Pew, Sr. Vice President, PRIUM”, ClaimWire, 3/20/14. Teaser: "Claimwire: If you were starting your career all over again, what would you do differently? MP: Absolutely nothing. I have probably had as many defeats as I’ve had victories, and I have often learned things the hard way. I have been mentored and have mentored others. Although I never really had a master plan for who I wanted to be when I 'grew up,' the interlocking pieces of career steps has been fun to watch in the rear view mirror. Who I am today was built through those experiences, and what I’m doing now is very fulfilling and impactful."
5. "Four Steps to a Successful Settlement", PRIMA Central's Public Risk magazine (page 14), April 2014. Teaser: "Mutual distrust often sets the tone for settling a complex workers' compensation claim, making it an adversarial process. It doesn't have to be that way."
6. “The Tough Task of Tapering Prescription Drugs”, CLM, 4/30/14. Teaser: "Polypharmacy often arises from using one drug to counter the side effects of another. For example, opioids can cause constipation, requiring stool softeners. In addition, patients’ symptoms can prompt physicians to add other analgesics, tranquilizers, sleep aids, and muscle relaxants. Despite the prevalence of polypharmacy, few guidelines provide protocols for multi-drug tapering."
7. “Are You Ready for Medical Marijuana?”, CLM, 7/30/14. Teaser: "Regardless, the workers’ compensation industry needs to prepare for expanded use of medical marijuana and requests for reimbursement. This is a complex circumstance that should not be ignored or deferred." If this were to be categorized as a prediction, consider it prescient.
8. “The Problem of Playing Through the Pain”, CLM, 9/25/14. Teaser: "Compared to the typical workers’ compensation situation, there are higher incentives for NFL players to 'return to work.' Everything on a football team, especially in the professional ranks, is based on competition. If the player wants to play—and keep playing—he has to be the best. That means players have to be on the field during practice and games, in the gym for workouts, and in the meeting room to study the playbook. If they are sitting in the training room or on the sideline, they cannot show the coaches that they deserve to play, which could lead to coaches selecting someone else. Players are motivated to return to the field whether they are hurt or not, whether they are 100 percent healthy or not, and whether they are relying on drugs to mask the pain or not."
9. “Strategies for a Better Return-to-Work Process”, CLM, 11/19/14. The sub-title is "Actions to address prevention, costs, and employee value effectively for better outcomes in workers' compensation cases." Teaser: "Being proactive and intelligently applying tactics that best fit a workplace can save not only time and money, but also the relationship between the employer and employee."
10. “Strategies for a Better Return-to-Work Process”, CLM, 2/17/15. The sub-title is "How to provide not only empathy for injured workers and their families, but also the assurance of proper care." Teaser: "My father’s passing was a poignant reminder for me that we need to remember that injured workers are people. They are members of families that have encountered life-altering events and now face uncertain futures. A balanced view of the financial implications with an understanding of the injured worker’s personal needs and concerns is difficult. The health crisis I have just navigated through created a new empathy and an understanding of what others are feeling because I’ve personally experienced it."
11. “Weighing the Use of Compounds”, CLM, 4/27/15. Teaser: "While exorbitant costs certainly are an issue, concerns about patient safety and clinical appropriateness are even more important. If higher costs yield better clinical outcomes for the patient, an argument could be made that the return on investment (ROI) is worthwhile. However, that is often not the case."
12. “The Implications of Marijuana Legalization to Employers”, The Self-Insurer, June 2015. Teaser: "Whenever a subject is complicated there is an increased possibility of misunderstanding and mistakes - or paralysis by analysis. Given the momentum of cannabis legalization around the country, employers ignore the issue at their peril."
13. “Mark Pew: Rx Epiphany for Work Comp – MSAs”, WorkCompWire Leaders Speak, 6/22/15. Teaser: "Although the Centers for Disease Control and Prevention (CDC) had already recognized the prescription drug epidemic, this new MSA requirement drew attention to many high-cost drug regimens that were doing clinical harm to injured workers. Yes, the monthly drug costs were expensive. Yes, reserves often had to be revised upward on an annual basis. Yes, injured workers often lost the chance to return to work or even function because of their prescription-drug haze. Yes, everyone from claims adjusters to CEOs knew that prescription drugs were a growing financial and clinical problem. However, the work comp industry had been slow to address the issue until forced to follow explicit rules to calculate the lifetime cost associated with continued inappropriate polypharmacy regimens."
14. “Rx Epiphany for Work Comp – Death Benefits”, WorkCompWire Leaders Speak, 6/30/15. Teaser: "What is not up for debate is that an injured worker dying from an overdose (intentional or unintentional) of prescription drug(s) paid by work comp is an issue for payers."
15. “A Formulary for Success”, CLM, 7/27/15. Teaser: "Yet the true goal of a workers’ compensation drug formulary is to produce better clinical outcomes for the injured worker. The grand bargain of workers’ compensation includes the premise of returning the injured worker back to health and work as efficiently and effectively as possible. It has been proven that a workers’ compensation drug formulary can help clean up past issues and proactively limit new issues from the overuse and misuse of prescription drugs."
16. “THC Presence Versus Impairment”, CLM, 9/24/15. Teaser: "This information makes it clear that impairment from marijuana is intense, short-lived, and can be difficult to separate from the mere presence of the drug. And therein lies the problem."
17. “The Land of ‘Just Right’”, CLM, 11/23/15. Teaser: "A balanced life with appropriate priorities and discipline can yield not only better clinical outcomes for injured workers, but also better financial outcomes for employers and payers. In some cases, that means a change in approaches by injured workers and employers. Having more is not necessarily bad, but sometimes more is less, which means sometimes less is more. And when the appropriate balance is found, everyone becomes a citizen of the land of 'just right.'"
18. “Can Marijuana Solve the Opioid Epidemic?”, CLM, 2/16/16. Teaser: "So, can marijuana solve the opioid epidemic? It is a perplexing and intriguing question. Not only is it a complicated question, but also it can be an emotional question for proponents and opponents ... The answer may be dictated by the biases of the one who is asking the question."
19. "Positive PDMP Progress", WC Magazine by CLM (page 28), April/May 2016. Teaser: "For all that progress, there remain hurdles for fully tapping the potential of PDMPs. The bad news is that the hurdles are systemic and require both time and money. The good news is they are not insurmountable given time, money and a change in attitudes."
20. “The Intersection of Wellness and Workers’ Compensation”, The Self-Insurer, Sep 2016. Teaser: "So a healthy and happy employee has a positive effect on both the employee and employer. That is both intuitive and statistically proven. But how does that intersect with workers' compensation?"
21. “Dangerous Confusion on ‘Painandsuffering’”, Insurance Thought Leadership, 9/9/16. Teaser: "The biggest problem is unrealistic expectations – patients often are told or come to believe they will be pain-free. When they’re not, and their condition becomes chronic, it sows doubt in the mind of both the patient and clinician."
22. “Marijuana and Workers’ Comp”, Insurance Thought Leadership, 11/15/16. Teaser: "This is a workers’ compensation issue. The NFL is an employer. The players are employees. The gridiron is a workplace. Pain and injury are realities for the vast majority if not all players/employees at some point in their careers."
23. "The Ethics of an Antidote", WC Magazine by CLM (page 8), Dec 2016 / Jan 2017. Teaser: "Setting aside nonmedical use of prescription opioids, this co-prescribing of naloxone could create an ethical dilemma for prescribers, pharmacists, and patients. The dilemma could create an epiphany and prompt a change in prescribing behavior, or it could create a defensive posture to protect against liability by prescribing for both. Is it ethical to prescribe an opioid without naloxone? Is it even ethical to prescribe an opioid?"
24. “Time to Clean Up the Mess”, CLM, 4/11/17. Teaser: "Clearly, what’s next for pain is thinking about it differently. Patients, clinicians, and payers need to be willing to try and pay for different treatments."
25. “Paying for the Person”, WorkCompWire Leaders Speak, 5/9/17. Teaser: "So is the BioPsychoSocial movement only talk? Or is it something that we as an industry not just understand but actually underwrite? Are we being “penny wise” and “pound foolish” by paying for the wrong things or not paying enough for the right things?"
26. “Thursday Thought Leader”, LegalNet, 6/9/17. Teaser: "I try to take difficult and complex subject matter and make it accessible to all. I speak in simple language. I infuse everything I do with the personal passion for change that drives me. I try not to be inconsiderate or rude or arrogant to anyone I meet, but instead be respectful while being firm in my convictions. I think the fact that I have come so far in such a relatively short time in a way that I could never have imagined (believe me, I look at what I am doing now and it blows my mind) keeps me humble."
27. “The game-changer for the opioid epidemic”, DORN Companies, 10/4/17. Teaser: "Within one year, the clinician’s role in the epidemic could no longer be ignored and the only path forward requires their involvement. In this case, mandatory involvement."
28. “Big Opioid Pharma = Big Tobacco?”, Insurance Thought Leadership, 10/20/17. Teaser: "Whether you believe the opioid epidemic is real or not (I do), or whether you think at least some of the deaths from illicit street heroin and fentanyl are a consequence of over-prescribing prescription opioids (I do), I think we can all agree it’s wrong for a company to tell its customers there is no danger when there really is (and when the company knows it)."
29. “Moving Beyond the Buggy Whip”, CLM, 10/23/17. Teaser: "If medical care is paid by each service performed, then the result will likely be more services billed. If medical care is paid based on the clinical outcomes, then the result will likely be a more strategic and holistic approach."
30. “’The Intersection of Medicine and Disability’ from NWCDC”, WorkCompWire, 12/14/17. Teaser: "A return to function – reducing impairment (and thereby disability) – is also the paramount goal for a clinician. But an equally important goal is reducing worklessness – a fairly new term that is broader than unemployment as it includes people who are economically inactive (including those who are sick and disabled)."
31. “Clinical and Legal Advocacy in a WCMSA”, CLM, 12/15/17. Teaser: "Their long-term use never stays static - the claimant’s overall condition deteriorates, side effects compound, dosages increase due to tolerance, more drugs are introduced, and premature death is a legitimate possibility - so the simplified calculation does not reflect reality."
32. "One Crucial Way Aviation Safety Could Help Advance Health Care Programming", LegalNet, 6/9/18. Teaser: "What if treatment guidelines were not viewed as a medical-legal burden but as a conversation starter? As an organized method by which all stakeholders can assess options? As an opportunity to accelerate the delivery of care compliant with the guidelines and to slow things down when care is complicated or non-standard? As a way to help deliver better, more consistent care? In other words, as a checklist?"
33. “A Culture of Whole-Person Wellness with Mark Pew”, DORN Companies, 10/3/18. Teaser: "The primary key is creating a culture of wellness, modeled by management and infused into every inch of the business. But it’s not just physical wellness as often is the focus. It’s whole-person wellness – mind, body, soul. Every aspect of the human experience."
34. "The conundrum of an impaired workforce for Workers’ Compensation self-insurers", Self-Insurance Institute of America, Inc. (SIIA) Endeavors publication, March 2019. Teaser: "So what is impairment? There are two potential definitions of being 'impaired' according to Merriam-Webster: (1) 'unable to function normally or safely (as when operating a motor vehicle) because of intoxication by alcohol or drugs' (2) 'diminished in function or ability'. Both come down to the productivity of an employee for an employer. In other words, can they do the job."
35. "The Chronic Pain Conundrum", EWC magazine, April 2019. Teaser: "So the conundrum is not whether chronic pain can be managed. It can. The question is how it will be managed and whether the patient and provider can leverage the full scope of available tools to find a combination that helps that person with that condition at this point in time. It is both complex and simple at the same time. But it is possible."
36. "How to Address Impaired Workers on Your Jobsite", Construction Business Owner, 5/6/19. Teaser: "Impairment affects a worker’s ability to do that, whether it’s through diminished ability to function and operate on the jobsite or the total inability to work ... Ultimately, managing impairment is about whether the employee can do the job they were hired to perform."
37. "What’s Next for Pain – Pharma?", WorkCompWire Leaders Speak, 6/25/19. Teaser: "The primary question to be asked about any of the above medications, especially in regards to chronic pain, is should these medications be used every day for the rest of a patient’s life. Relying on medications today likely means relying on them into the foreseeable future, and most of these are not recommended for 'eternal' use."
38. "What’s Next for Pain – Not Pharma?", WorkCompWire Leaders Speak, 7/2/19. Teaser: "So if drugs do not work for everyone, what does? Nothing, actually. Every individual is unique. The source of their pain is unique. Their body chemistry and how they metabolize chemicals is unique. Their past experience with pain (and life’s difficulties) is unique. Their level of fitness (physically, emotionally, psychologically, financially, relationally) is unique. Their number and severity of health co-morbidities is unique, as are the medications and supplements they may be taking for those conditions. Their social determinants of health in the past, right now and anticipated in the future are unique. In addition, their condition changes over time (usually for the worse), so even those variables become more variable. In other words, an individual is an individual."
39. "Do You Remember When?", originally on WorkersCompensation.com on 7/11/19. Teaser: "If you or someone you know allows their past to dictate their present and future, ACT (Acceptance and Commitment Therapy) and other forms of psychotherapy can be a great help to get out of neutral and into drive (another thing I remember—manual transmission). If you can count your many blessings – name them one by one—you will probably realize that your future is brighter than you thought. Just because you “remember when” doesn’t mean you need to be stuck there. #BioPsychoSocialSpiritual"
40. "Managing the Risk Impacts of Opioids in the Workplace", IRMI's Employment Practices Liability Consultant (EPLiC), Summer 2019 edition, subscription required. Teaser: "While we remain in the midst of an epidemic, progress is being made, largely driven by awareness of the problem and efforts by the government, medical community, community groups and employers"
41. "Contruction + Impairment = Big Problem", Utility Contractors' Association of New England (UCANE), Sep 2019 edition on page 51. Teaser: "When taking all of this information into consideration, the construction industry is uniquely impacted by impairment and the implications are huge. Could driving under the influence be a problem for a construction company operating 13-ton dump trucks? Could being cognitively impaired create quality or safety issues for the construction worker on either the 1st or 10th floor of a new building? Could intoxication be a hazard to the constant movement of people and things at a construction site? Not only is the answer yes to each of those questions (and more) but the results could be catastrophic by even a single person being impaired."
42. "Measures for Better Monitoring & Managing Employee Stress", Construction Business Owner, 11/20/19. Teaser: "If the workplace stress level, whether originating there or brought from home by the employee, is so high as to be unmanageable, then it can have a significant negative impact on productivity through lowered attention to detail, quality of work and their team. Adding to this is the natural contagion of stress because, although it may be specifically related to one person, relationship or scenario, it almost always affects others."
43. "A Refresher on Pain", WorkersCompensation.com, 2/27/20. Teaser: "Although I had a smartphone available for research, helpful advice from clinicians, and hundreds of my own PowerPoint presentations that discuss proper pain management, I still did less right than a coin flip."
44. "Understanding Employee Stress", HomeCare magazine, 3/2/20. Teaser: "The lesson for all is to not let stress become chronic or continual, because science (and common sense) prove its negative effects."
45. "The Age of Tele-Everything", WorkersCompensation.com, 4/16/20. Teaser: "The physical presence considered essential prior to March 2020 has been quickly redefined. Not by academic studies or whitepapers but being forced to put into practice a different paradigm and then seeing the results were not dramatically different."
46. "As Baby Boomers Leave Workers’ Comp, Knowledge Transfer Has to Happen Immediately", Risk & Insurance, 4/20/20. Teaser: "Since often that wisdom is in the “gut” and not on paper, replicating that with other people is difficult. That means we have one very short decade to get focused on transferring that knowledge into documents (and maybe even into artificial intelligence)."