Doctor proactive communication, return-to-work recommendation, and duration of disability after a workers' compensation low back injury

Although doctors are increasingly evaluated on the basis of return-to-work (RTW) outcomes, the effect of doctor-patient communication about the workpl ace and RTW after an occupational injury has received little research atten tion, The effect of patient-reported doctor communication on duration of di sability was examined retrospectively in a 3-year cohort of 325 claimants w ith a lost-time low back injury. Although doctor proactive communication wa s associated with a greater likelihood of RTW during the acute phase (< 30 days of disability), this effect disappeared when injury and workload chara cteristics were taken into account. A positive RTW recommendation was assoc iated with about a 60% higher RTW rate during the subacute/chronic phase (> 30 days of disability) only. Prospective studies are needed to confirm thi s effect. The impact of physician communication on RTW is largely confounde d by injury and workplace factors.