Deciding Whether to Operate if a Personal Injury Claim is Open

Personal injury litigation was associated with poorer recovery after hand surgery, but it's not as bad as one might have anticipated

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Smart Practice: Tap the brakes before offering elective surgery to someone with an open personal injury claim, but you don’t necessarily have to decline to do the procedure.

What’s the Claim?

An unusually well-controlled large-database study found that patients with a personal injury claim had more pain, less function, and a lower likelihood of returning to surgery three months after minor and one year after major hand or wrist surgery. The main surprise here, at least to me, was that the “differences” in mean pain and function scores generally were not large enough to be clinically important. When analyzed as percentages, the likelihood of seeing a clinically important benefit in pain or function was in the ballpark of only 10% greater in those not involved in litigation. A difference, to be sure, but not a huge one. The biggest discrepancies were in return to work — on a per-week basis, those involved with litigation were 32% less likely to return to work after minor surgery and 45% less likely after major surgery.

How’s It Stack Up?