| RSDSA Comments on
ACOEM’s Practice Guidelines In
2010, the American College of Occupational and Environmental Medicine (ACOEM) will be
publishing the third edition of Occupational Medicine Practice Guidelines: Evaluation and
Management of Common Health Problems and Functional Recovery in Workers. The guidelines,
according to ACOEM, are intended to help improve or restore the health of those workers
who incur occupationally-related illness or injuries and are the only “evidence-based
guidelines that focus on returning employees to work within 90 days of an injury or
illness.”
Nevertheless, there is a lot of concern among members of the
RSDSA Board of Directors on how these guidelines affect people with complex regional pain
syndrome (CRPS). Peter Moskovitz, MD, submitted the following comments to the ACOEM on
behalf of the board:
The Reflex Sympathetic Dystrophy Syndrome Association
(RSDSA), as a not-for-profit organization dedicated to the awareness, education, advocacy,
and research for CRPS, also known as reflex sympathetic dystrophy (RSD), would like to
make the following comments on the American College of Environmental and Occupational
Medicine Guidelines. |
Response from ACOEM
Oversight Committee In the preceding
commentary, the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA) explored the
possible effect of ACOEM’s practice guidelines on medical decision-making and on the
utilization review process as they might affect patients with complex regional pain
syndrome (CRPS).
RSDSA raised questions about ACOEM’s guidelines process
and urged it to recognize and affirm certain fundamental principles, including: The
predominant ethical obligation of the practitioner is to the individual patient; each
patient may choose a physician or treatment team; CRPS patients need to obtain an
individually-designed treatment plan for their debilitating physical and psychological
conditions; and that normative recommendations are educational and help to rank potential
diagnostic and therapeutic interventions, but they are not prescriptive.
Background
Medical practice guidelines provide a framework for consistent and reliable
decision-making regarding the diagnosis, management and treatment of injury and illness.
Many organizations publish guidelines, ranging from medical specialty societies to private
health companies. The potential for improved health care as a result makes this effort
important and worthwhile. |