Thursday, October 21, 2010

Fighting Words - Who Are The Doctors Trying To Help?

Secondary gain is a popular term used in reports written by doctors who work for insurers. It is often used when the doctor can find no evidence for deception or malingering, but still feels the need to diminish the credibility of the injured person.

There is no evidence for lying or conscious deception. So, the term secondary gain is used to say that the injured person is exaggerating, unconsciously. The person is not exaggerating on purpose, but can't help to psychologically magnify their symptoms in pursuit of some type of gain.

One of my patients was very angry when secondary gain was used to suggest that her injuries were caused by this psychological symptom. She identified the real issue, clearly,

"... my injuries have not led to any gains, only losses, that have been building ever since my accident. My benefits pay me only a small portion of what I used to earn when I could work. Every year, I lose more and more. And this does not even count how much my family has lost and suffered."

Losses usually far outweigh any real or potential gains, especially when an injured person has a long-term injury such as chronic pain. It is doctor who has the real gain - dollars, referrals and steady work from insurers.

Fortunately, it is not hard for judges and juries to see this pattern for what it really is.

Yours with care

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