Humanising Workers Compensation: the missed opportunity

Humanising Workers Compensation: the missed opportunity

– by James Ellis from http://www.frameworkgroup.com.au

imageIn preparation for dipping my toe into the public arena of the RTW summit I read through the training material generously provided by the energetic convenor, Mark Stipic. I’m a podcast addict and I’ve been absorbing Mark’s podcasts (RTW Nation) on my daily bike ride. His positivity is infectious.

Mark encourages the presenters to give some thought to our “why?”. I find this exercise difficult. Given that so much of our decision making is non conscious, I find myself wondering if my ‘why’ can be accurate or, at best, just a random grab at plausibility.

So rather than articulate something that can only be temporary and incomplete, because I’m always changing my mind, I’m more attracted to the thinking of Psychologist, Dr Jordan Peterson[1] who suggests;

“Think, learn and talk & get yourself strong enough so you can stand up for what you think is true – that’s not what is true because what the hell do you know? You don’t know a damn thing – everything you say is gunna be stupid but you have to say it in order to be corrected and maybe you won’t be so dumb and then maybe other people won’t be either and we can muddle through a little longer without having everything fall apart.”

This forum provides an opportunity for me to frame myself up as an expert. But I’d rather not. Not because I’m modest, the humility I muster doesn’t come easily. After 20 years in the injury support arena I find myself easily seduced by the idea that I’m an expert. What a comfortable little space that is. It takes considerable cognitive effort to keep raising doubts and remind myself that I’m a student. Conveniently in this endeavour, I’m also a father, a role that provides a fertile environment for raising awareness of one’s fallibility and biases.

Daniel Kahneman[2] ponders…

“the puzzling limitation of our mind: our excessive confidence in what we believe we know, and our apparent inability to acknowledge the full extent of our ignorance and the uncertainty of the world we live in.”

And, as if it’s not interesting enough that we’re largely overconfident, it seems that, even when presented with explicit evidence that we’re overconfident, we remain overconfident.

So with my fallibility and overconfidence in mind I submit my thesis for scrutiny.

 

I feel like we’re missing an opportunity.

My thesis is that by caring for people authentically, not only do we support their recovery, but we can strengthen their relationship with their work, with their colleagues and with their employer.

‘Injury management’ tends to be treated as a cost control exercise. I wish I had a dollar for every time I have heard words to the effect that…

“the worker’s health is of course, our main concern, but, you know (*tortured facial expression with paternally raised eyebrows*), we also have to have a commercial focus”.

It’s a comment that seems to arise when the list of unknowns grows beyond an organisation’s comfort zone. It’s the beginning of binary and pejorative narrative that reveals a disconnect between an organisation’s espoused values[3], (often words to the effect of people being their greatest asset) and the underlying assumption that commercial considerations are somehow incompatible with a colleague’s wellbeing. The disruption surfaces the underlying assumptions.

This narrative reveals how our thinking can become infected by the anthropological assumption that people are cogs in the wheels of a ‘commercially focussed’ organisation, it allows us to wind back support. It allows for dehumanisation.

 

I have also heard the ubiquitous argument that good injury management leads to lower premiums and, the prevention is better than cure trope, continually expressed as truisms. But I worry that these are close cousins of the commercial focus theme. I understand both but my observation is that they fertilise attributions with a dehumanising trajectory in the form of trendy reductionist interventions and narratives.

Having made this point, I want to be explicit. A commercial focus and/or a preventative emphasis aren’t to be dismissed. I’m just suggesting wariness about what comes next.

For example;

When the school principal started the conversation with the caveat that “you know me James, you know me to be a caring and compassionate person right?”, I couldn’t help thinking of the ubiquitous precursor, “no offence, but…”, that so often precedes a gratuitous insult. And then, the third party report that the worker had been seen at a bbq, laughing and socialising and, clearly, “in no pain at all”. My response, which suppressed my intuitive reaction, was tempered. “I don’t want this to sound patronising” I stumbled. “Go ahead” I was encouraged, “speak your mind”. “Ok” I started, “how do we measure someone else’s pain experience?”. The response was reflexive, “oh I know, of course, yes…” as we nodded and bonded over the greyness. But we both knew a suppressed assumption had surfaced. That easy oversimplification that allowed plausibility to trump[4] accuracy – had been put on the table. “Can you be sure his injury is genuine?” I was asked of a man who has devoted the last 13 years of his career to working with teenagers who have been rejected by mainstream high schools. “How can we tell he’s not trying to secure a non-teaching role?” I was asked of a man who had had his forearm jammed in a door by a violent student and had subsequently had surgery and has not ridden his beloved surfboard for more than a year. A man who has not been able to enjoy his holidays and is fearful of recurrence in an unpredictable and volatile environment where the police are on a first name basis with the staff.

The discussion about suitable duties was equally as frustrating and familiar. After doing my best to prime a busy school principal by using the word ‘creative’ several times. After doing my best to emphasise the unique skill set of a man who has spent his career anticipating violent outbursts and distracting and encouraging and listening to rejected teens, I posed the question, “how can we utilise this man’s special skills” in an outpost where staff have been seeking him out to help them problem solve during his theoretical absence? The answer, sadly, demonstrated and confirmed Ken Robinson’s lament[5] that schools and educational institutions value a structured, industrialised routine over creativity. “We’ll have to carry him” he said.

 

 

 

Nassim Taleb[6] speaks of anti-fragility. He asks the question, what is the opposite of fragile? The most commonly anticipated response is ‘robust’? Robust is a word that is often used to describe an organisation with ‘good systems’ or a person who is ‘strong’.

But Taleb isn’t satisfied. He asks what if the opposite of fragile is something, or someone, that/who gets stronger as a result of being damaged or hurt. This isn’t a new concept, just a new word – anti-fragile. We love to talk about personal growth in response to adversity. A broken bone invokes a physiological response that lays down more bone at the fracture site. Muscles that are challenged and stressed become stronger.

In fact he takes this further…

“Taleb[7] looks at modern society with a critical eye. He examines how it intends to smooth out life by interfering in massive systems like the economy. Taleb argues that this interference does not make society a better place but that it actually destroys the volatile environment that is essential for antifragility.”

Taleb argues for an evolutionary paradigm. Where volatility ensures mistakes. Where mistakes provide the stimulus for learning, growth and creativity. When we’re paralysed by our fear of mistakes, or pre-occupied looking for someone to blame, the opportunity for learning, growth and creativity is diminished. The opportunity is missed.

 

When people are injured at work their lives are disrupted. The fear of the unknown looms large. When we care for them authentically they notice. When we care for them to care for the premium I think they notice that too. Authentic care can be transformative, it can make them stronger. It can inflate their discretionary effort, their sense of belonging and their self-efficacy. And it can impact the carers too. I was heartened to hear an insurer recently state that they have given their claims managers permission to care.

Injuries provide us with an opportunity to care. And by care I mean genuine interest. The interest we show, and it has to be authentic, is inadvertently therapeutic.


[1] https://www.youtube.com/watch?v=DAncrmE6YV0

[2] Kahneman, Daniel Thinking Fast and Slow

[3] Schein, Edgar H., Organizational Culture and Leadership (2010), John Wiley & Sons, San Franscisco

[4] How apt is the word ‘trump’ in this phrase?

[5] https://www.youtube.com/watch?v=iG9CE55wbtY&t=57s

[6] Taleb, Nassim Nicholas (2012) Antifragile: Things that gain from disorder. Random House, USA.

[7] ― from “Summary of Antifragile: Things That Gain from Disorder by Nassim Nicholas Taleb|Key Concepts in 15 Min or Less”

James Ellis

James Ellis

Managing Director at The Framework Group
James Ellis
B.App.Sc (Physio) After finishing High School I experimented with a range of vocations including 12 months as a midshipman in the Royal Australian Navy, a false start studying Engineering at UNSW and a very enjoyable 5 years as a gym instructor at a variety of gyms in Sydney. I graduated as a Physiotherapist from the University of Sydney in 1991. After 12 months as an intern in the public hospital system in NSW I travelled to Michigan, USA, where I obtained experience in an outpatient facility servicing the local community and the adjacent private hospital. I then returned to Australia and obtained a full time position at the Hills Street Sports Medicine Centre in Gosford, NSW, treating sports injuries. In 1995 I founded Hills Street Occupational Rehabilitation Service which later became Hills Street Group and, more recently, Framework Group. Over the past 19 years we have grown to have several franchised teams throughout NSW. I really enjoy the daily challenge of problem solving in the complex arena of workplace injury management. At Framework, we focus on humanising injury management. We've developed a unique model of injury management that allows our employer clients to maintain and enhance their relationships with their workers which, in turn, has very positive commercial implications. We believe that injury management provides employers with a portal through which they can demonstrate how much they care about their team. We believe that mistakes and injuries are inevitable, because people are fallible, but this same fallibility provides opportunities for learning and enrichment of relationships.

Do you have any thoughts? Please share them below