Healthcare workers and physicians are currently on the front lines in the battle against COVID-19, but the workers’ compensation industry may have additional other reasons to worry about providers. There is an expected physician shortage and “doctor deficit” that experts say may be felt more strongly in the workers’ compensation sector than in other areas of care, perhaps due to fee schedule restrictions and additional paperwork involved.

“Physicians are going to go to where it’s the easiest to practice and make a living, and generally that’s not going to be in the workers’ comp system,” said San Francisco-based Dr. Robert Goldberg, chief medical officer and senior vice president for Healthesystems LLC. With the aging of the general workforce, too few individuals becoming physicians and a growing population, “it’s a great formula to make things worse,” he said.

 The United States is expecting to see a shortage of up to 122,000 physicians by 2032, according to the Association of American Medical Colleges. The National Center for Health Workforce Analysis predicts that 39 states will experience a shortage of primary care physicians within the next five years.

The extent of these shortages may be impacted by geographic region, doctor distribution per population and state fee schedules, experts say.

In a study of workers’ compensation fee schedules in 45 states, WCRI found that the states’ reimbursement rates “varied substantially”, noting that where fee schedule rates for physical medicine were close to or below the Medicare rate that “such a level might potentially jeopardize access to quality primary and physical medicine care for injured workers.”

George Furlong, senior vice president of program outcomes and analytics for Sedgwick Claims Management Services Inc. said that certain specialties may see a decline if providers can “get similar reimbursement rates and a lot less hassle through the commercial market.”

Dr. Dinesh Govindarao, chief medical officer for Pleasanton, California-based State Compensation Insurance Fund, says many doctors who leave the workers’ comp system point to paperwork, delays in treatment and lack of autonomy as reasons they left.

Mr. Furlong said there an increasing challenge to find workers’ comp providers in areas like cardiology, oncology and psychiatry. He said that a lot of times, fee schedules don’t address the treatments of psychiatry networks and even though traditionally doctors in those fields haven’t been needed on a large scale, there is an increasing need for their specialties.

If there is a physician shortage it could lead to slower recoveries and longer disability periods, leading to potentially higher incidents of chronic injury.

Telemedicine is being used to combat physician shortages, particularly in rural areas. This technology is still new in workers’ comp but maybe the recent events will push it to the forefront.

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