Clinical An Approach to Care of Injured Workers Urgent message: Appropriate treatment of workplace injuries and illnesses minimizes long-term disability while promoting rapid return to work and safer work environments. David M. Rosenberg, MD, MPH hysicians rendering care to injured workers must be knowledgeable regarding these injuries and the necessary types of treat- ment. Also, they must provide this care in an empathetic and caring manner, cou- pled with aggressive intervention to promote prompt healing. However, physicians must also realize that early return to work is not only important for maintaining the functional capacity of the injured worker, but also minimizes long-term and unnec- essary disability. For example, it has been shown that the risk for developing a chronic pain syndrome after an acute musculoskeletal injury is reduced eight- fold when early activation is initiated. 1 Early return to work also avoids positive reinforce- ment of issues one wants to avoid, such as receiv- ing disability income or inappropriate family and community sympathy, reduced responsibil- ity, and the use of disability to resolve conflicts. 2 Clearly, knowledgeable injury care avoids iatro- genic disability while promoting well being and optimal activity. 3 To help with the return-to-work process, the provider must allay the worker’s fears regarding the perceived seriousness of an illness where appropriate, as well as concerns of long-term impairment and disability. 4 Along these lines, discussions must include the natural history of the illness and the expected outcome. w w w. j u c m . c o m © Getty Images P JUCM T h e J o u r n a l o f U r g e n t C a r e M e d i c i n e | A p r i l 2 0 0 7 21