The Division of Workers’ Compensation is convening its Designated Doctor Program Focus Group on March 10, 2022, between 9:00 and 10:00 a.m. Those interested in attending may access the meeting via Zoom with meeting ID 968 9261 8132. Stakeholders are invited to raise ideas and concerns on the topic designated doctor billing and reimbursement.
The topic could not be timelier. In recent months, system participants have noticed a marked uptick in the rate at which designated doctor exams are being rescheduled. When that occurs, parties (but perhaps not the DWC) receive notice from the designated doctor’s office of the need to reschedule the exam. The reason most often cited is a “scheduling conflict,” but without any further information.
Reasons for this noticeable increase in rescheduled exams may be the ever-dwindling number of available designated doctors. According to data accumulated by the Texas Department of Insurance, the ratio of medical doctors to chiropractors on the available designated doctor list has held steady: since February 2020 (the earliest month made available by TDI’s ‘Designated Doctors and Appointments by County and Month’ chart), medical doctors have consistently comprised between 25 and 26% of the available designated doctors in Texas. Adding doctors of osteopathy to that number raises the percentage of availability to 29%, again, a consistent figure of the past two years.
However, the alarming data involve the overall number of medical doctors, doctors of osteopathy, and chiropractors in the Texas work comp system. That number has decreased proportionately for each of the three aforementioned groups, falling from 376 in February 2020 to just 265 as of January 2022. As a point of reference, in September 2012 there were 1,247 designated doctors appeared on the list.
The precipitous drop in the number of available designated doctors means that each remaining physician is called upon to examine injured workers far more frequently. Combining the increasing demand on their time with the stagnant rate of reimbursement for the assignments has led to something of a mass exodus from the system, a trend that may not slow or reverse as long as remuneration rates remain fixed, low, and out of synch with the changing costs of living.
Or, as one designated doctor pleaded in a cover letter accompanying a recent reimbursement bill: “I am really good with peanut butter and jelly sandwiches, but I am tired of them!”