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Benefits and Pensions Monitor April 2007

Employees Versus Patients: Does The Same Prescription Apply?

By: Gordon Polk

Thereʼs a time when employees become patients who need to rely upon the public healthcare system for medical treatment. At the same time, the working population utilizes resources and health benefits that are made available by employers.

As consumers of both public and private services, do we make appropriate choices and do we get good value from the services that we receive? To answer this question, we first need to recognize that there is poor integration between public health services and those supplementary health benefits that employees may have at their disposal. On the other hand, employees/patients are discerning consumers and they can make some interesting choices when it comes to optimizing available services.

As employees switch between public services and the utilization of benefits under their extended health plan at work, the facilitator of healthcare is usually the employeeʼs designated physician. At this point, there needs to be some clarification as to how employees migrate into, and back out of, the public health system. For example, we all have the ability to self-diagnose and sometimes we visit our family physician to confirm our diagnosis and/or to obtain the appropriate treatment. Alternately, we may not know what ʻails us,ʼ and so we go to the doctor to get both diagnosed and treated. Within some workplace settings, particularly among larger employers, thereʼs the opportunity to get advice or direction from an occupational health physician, even for medical issues that are not normally specific to workplace health and safety. In turn, an on-site occupational health physician can recommend that the employee seek treatment from his/her family physician.

employee vs. patients

‘Company Doctor’ Or ‘Company Nurse?’

In the role of an occupational health physician or an occupational health nurse, the ʻcompany doctorʼ or the ʻcompany nurseʼ has a unique perspective as to how employees manage their own health. As workers become patients, they rely upon the advice and experience of health professionals, but if their contact with a health professional first occurs in the workplace setting, how does this impact the way they manage their own health?

To find an answer to this question, we sought the input of Dr. Joseph Niedoba, a family physician in Caledon, ON. As well as working at the Headwaters Hospital in Orangeville, ON, for his regular patients, Dr. Niedoba works at the Etobicoke General Hospital with patients who are recovering from cardiovascular events such as strokes and heart attacks. This contrasts with the additional work he does on-site at one of Canadaʼs leading employers for workplace health and wellness – Husky Injection Molding Systems Ltd.

From his multi-faceted roles, Dr. Niedoba is able to provide some insights as to how employee behaviour translates into patient behaviour when it comes to self-health management. We chose to look at the issue of cholesterol control because itʼs an issue that all of us know is important, but then again, each of us places different priorities on the risk factors that contribute to bad cholesterol and to the way we respond to this health condition when we are told we have a problem.

Statin drugs are most commonly used to address problems associated with low-density lipoprotein (LDL) – in other words, bad cholesterol. As a category, these drugs usually represent the highest costs on almost all private drug plans. They are fairly expensive and, given the demographics of our workforce, the rates of utilization make the use of statins a very high profile issue. If we note that these products are maintenance drugs, itʼs apparent that costs for this class of pharmaceuticals will remain on the plan sponsorʼs radar screen for a long time to come.

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