CBC recently reported that some physicians have started writing prescriptions for physical activity. Dr. Michael Rutledge, a Medical Officer of Health for Southern Health in Manitoba, identified exercise as “a wonder drug that can treat dozens of diseases including diabetes, hypertension and obesity….[with] no negative side effects”. He feels that more serious conversations need to be initiated by health care providers, and he finds that a written prescription “on actual paper” helps the patient value, and heed, the advice. Of course, the prescription doesn’t come with a “DIN” number, so I can’t be reimbursed for my gym membership under my drug plan, but there are many forms of exercise that are free.
What if physicians prescribed ergonomics assessments? It’s not so far fetched…..after a motor vehicle accident or other long-term absence, in fact, it’s quite common for employees to present doctor’s notes to their employer, suggesting that an ergonomics assessment should be completed upon return-to-work. The employer typically pays for this assessment. We get calls for these types of assessments all the time. Employees may have seen their co-workers go through the process and know that they can ask for an assessment. Possibly, the company’s claims coordinator routinely organises an assessment. Makes sense, right? But this type of return-to-work assessment typically occurs only in office environments. It’s much less common for us to be asked to assist a worker in health care, industry, or service.
According to the 2015-2016 Annual Report published on the College of Physiotherapists of Ontario website, as of March 31, 2016, there were 8,506 registered Physiotherapists with the College. In addition to PTs, of course, thousands of family physicians, PT assistants, OTs, and kinesiologists also work every day to treat work-related and non-work related musculoskeletal injury. AFTER they occur. All of this treatment happens AFTER an injury occurs. And ALL of this work happens in an effort to bring the worker back to a condition where s/he can return to work. The SAME work that caused the injury. None of these efforts have any impact on prevention of future injuries. We just keep on treating injuries and sending people back to the same jobs.
The Association of Canadian Ergonomists reports that there are 600 members across Canada. The Canadian College for the Certification of Professional Ergonomists reports a total of 237 CCPEs as of 2015, which means 237 people have a relevant degree which includes hundreds of hours of ergonomics coursework, plus 4-5 years of full time ergonomics work experience. (60 more “Associate Ergonomists” were in the process of attaining the experience for full certification.) The ACE and CCPE directories are not working right now, so my research isn’t going as planned. However, if we assume that 50% of the Certified Professional Ergonomists in Canada are based in Ontario (likely a high estimate), then we would have roughly 150 practicing Ontario ergonomists. Even if we assume that all ACE members are practicing ergonomics, there would only be roughly 300 ergonomists in Ontario. This means that there would be over 25 PTs practicing treatment for every ergonomist employed in this province. (I’m not implying that PTs only treat work-related MSDs – people visit PTs for other types of injuries as well. My point is that we seem to have a lot more money going into treatment than we invest in prevention.) We have a staff of 3 full-time ergonomists, and we are spread out in Cambridge, St. Marys, and London. In these three cities, there are probably at most, two dozen ergonomists employed full time. Yet, when I drive by any of the many rehab clinics in the city, the parking lots are full of staff and clients. I’m positive that many of these clients are working to recover from the effects of poor ergonomics.
It’s great that physicians are thinking more proactively. We’d love for them to take one step further….write a prescription for an ergonomics assessment, before the employee loses time from work. And, consider prescribing an ergo assessment for employees in non-office jobs.
And while we’re dreaming….We’d love for these assessments to be funded in the same way that other prescriptions are funded. Let us bill the WSIB or the insurance provider for a service that will, ultimately, save them money!