From time to time, we feature the work of alumni whose training funded by the National Institute for Occupational Safety and Health (NIOSH) through COEH has helped them to have a significant impact on the institutions they serve. This issue, we profile Mary Wampler, MD, MPH, who completed a two-year fellowship in occupational and environmental medicine at San Francisco in 1995.
The University of Nebraska Medical Center had no occupational health program before it hired Mary Wampler as its medical director of Occupational Health Services. Employees injured on the job were referred outside for care. When Wampler arrived in the fall of 1995, she found herself almost immediately in charge of employee health services, and her responsibilities quickly grew to include treating hospital employees with workers' compensation injuries. The program she developed has improved service and saved the hospital thousands of dollars.
"We didn't do anything all that remarkable, except we started paying attention to what was happening, which made all the difference," Wampler said. "We started doing case management, and we worked hard with other departments to get people back to work in modified duty positions so that they wouldn't be missing so much work, which ends up being better for the injured employee as well as for the institution. Just those two things saved the hospital quite a lot of money."
Specifically, in 1994, the last full year before Wampler's position was created, the medical center paid an average of $61 per claim for lost wages. In 1996, the first full year in which Wampler's department handled about 85 percent of the workers' comp injuries, the average reimbursement for these cases dropped to $21 per claim, and lost time went to practically zero.
Wampler oversaw the cases herself for the first year, before hiring a case manager. The case manager orchestrates an injured employee's experience from day one, manages all the information about the patient's status, coordinates with everyone involved, answers questions, and generally smooths the path all along the way, so that care is provided efficiently and the employee knows that someone is interested.
Another part of the program that Wampler and her staff take very seriously is the health exam and evaluation they make when a new employee has been hired but has not yet started work.
"These evaluations are routine in my field to make sure a person can do the job for which they've been hired without getting hurt. If someone is at high risk, we try to make very certain that the new job will be structured with restrictions that prevent injury, or we recommend that an employee be placed in a different position," Wampler said. "I like to think that we're keeping people from being injured and saving money by preventing injuries that are ready to happen."
Case management, pre-placement evaluations, and on-going liaison with the departments are "all tried and true methods," Wampler said. "We just paid attention to what was needed. Anyone could achieve good results by instituting these same methods. What we did was not rocket science. I've learned that these things really do work, which is nice, and I've learned the value of having a really good case manager on board. You have to be willing to spend money on staffing, but the program can pay for itself."
She attributes knowing what was needed to her fellowship at San Francisco. "Having the specialty in occupational and environmental medicine made the difference," she said.
PHOTO copyright by Larry S. Fergusen