WHY SHOULD SOMEONE HAVE A PSYCH EVAL BEFORE LUMBAR FUSION

In Texas, in the Work Comp world, we have some bizarre guidelines. For example, if a person is losing strength in the leg(s), losing bowel or bladder function, has tingling or numbness, and the treating doctor feels they have a disc lesion, obtains an MRI that validates the doctor's diagnosis, and if they refer this patient to a neurosurgeon who examines the patients, reads the MRI personally, and determines they need surgery soon, all that is NOT enough to get surgery. According to the AMA guides (Fifth edition) and ODG guidelines, prior to any lumbar fusion, the patient has to have a psychiatric or psychological evaluation. What is the purpose of this. If they are losing leg strength and feeling, losing bowel and bladder, limping, and have an objectively identifiable lesion on MRI, what does it matter if they are mad as a hatter. If you let them deteriorate further until the damage is irreversible, someone is going to end up having to pay MORE money, and the patient becomes less able to function and work, than if you let them have the damn surgery they need !

This kind of stalling tactic whereby you force the patient to get their psyche evaluated, when there is absolutely NO question they need surgery, is sheer lunacy.

Category:

Science & Technology

Tags:

• surgery
• fusion
• lumbar
• texas
• ama guides
• psychological
• psychiatric
• evaluation
• prior to fusion
• bizarre