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Duluth doctor aids injured workers

Dr. Brian Konowalchuk said that he has seen the medical establishment fail injured workers all too often, and he wants to do something about it. "Issues in the system have led to lost employee time away from work and delays in useful medical info...

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CLINT AUSTIN / NEWS TRIBUNE SMDC athletic trainer Chris Grebeck helps John Kmiech, a groundskeeper with Duluth Clinic, work through physical therapy stretches at SMDC on the afternoon Kmiech, who has had two back surgeries, occasionally needs physical therapy to help manage his pain.

Dr. Brian Konowalchuk said that he has seen the medical establishment fail injured workers all too often, and he wants to do something about it.

"Issues in the system have led to lost employee time away from work and delays in useful medical information being acquired by employers," Konowalchuk said.

That's why he helped pull together a conference designed to help doctors and employers communicate better.

The Duluth Clinic, the Mayo Clinic and Minnesota Power have joined forces to put on a "workability" conference in Duluth on Thursday and Friday.

Konowalchuk, a Duluth Clinic physician specializing in occupational health, has watched with frustration as ill or injured workers struggle to navigate their way through a labyrinth of bureaucracies involving medical professionals, insurance companies, the workers compensation system and employers' human resources departments.

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"A lot of people who suffer a relatively minor injury end up with a significant disruption of employment," he said, faulting inefficiencies in the system.

"It seems that as the costs of the system have gone up, our positive outcomes have gone down," Konowalchuk noted. Often, injured workers wind up in a world of hurt after lengthy delays.

"It can result in a cascade of events that leads to relationship problems, loss of self-esteem and diminished income," often including job loss, he said.

Konowalchuk said people who are unable to return to work also run the risk of becoming sedentary, complicating their recoveries and sometimes leading to lasting disabilities.

However, the system doesn't need to work that way, said Inez Wildwood, a human resources manager for Minnesota Power.

She believes one of the keys is helping people return to work as soon as possible, if only on a limited basis.

"All the research points to the fact that we heal better and quicker if we can focus on resuming our lives," Wildwood said. "People heal better when they're on familiar turf and have the support of their friends. It can help them avoid becoming depressed and discouraged."

Theresa Erickson, 40, of Embarrass has been out of work for nearly a year because of nerve problems that developed in her right arm while on the job at Blue Cross/Blue Shield. Her condition has resulted in chronic pain and a loss of function in the arm.

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Now under the care of Konowalchuk, Erickson is undergoing physical therapy in hopes of returning to her keyboarding job on a part-time basis.

"I'm eager to get back to work," she said, adding: "It's easy to get depressed, staying home all the time."

While Erickson described her husband and three sons -- ages 12, 14 and 18 -- as extremely supportive, she said: "Sometimes I feel as if I've become a burden, because there are certain things I just can't do any more."

But Konowalchuck believes that successfully returning people to work on a limited basis will require better communication between doctors and employers. He noted that doctors graduate from medical school without being taught the ins and outs of writing effective work restrictions that enable patients to return to work incrementally. It's often easier for a physician to simply excuse a person from work entirely until the patient has been able to make a full recovery. Konowalchuk believes doctors should be offered training to help them identify and communicate a patient's evolving abilities during recovery.

Wildwood said employers also need to be respectful of physicians' busy schedules. She said the last thing they need is more complicated paperwork to fill out. That's why she and others have helped develop a simple form that can help doctors inform employers about what types of work may be appropriate for employees recovering from an illness or injury.

The benefits of developing a support system for returning people to the work force can be immense.

Companies such as Minnesota Power that actively work to accommodate the needs of impaired employees tend to have fewer problems with them down the road, said Jim Peterson, an attorney who handles many workers comp cases for the Duluth firm of Falsani Balmer Peterson Quinn & Balmer.

"They save a lot on attorney fees and litigation," he said.

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Konowalchuk said there are other benefits, in the form of increased productivity.

He noted that since SMDC Health System began more actively reaching out to help injured workers, it has seen a marked reduction in lost time. He noted that in 2003 the average injury claim at SMDC resulted in 72 lost work days, as opposed to just an average of just 10 lost days in 2007.

One of the beneficiaries of this approach has been John Kmiech, a Duluth Clinic groundskeeper, who has undergone two back surgeries in the last decade, after an on-the-job shoveling injury.

He recalls that before those surgeries, he was doubtful he would be able to retain his job.

"It was very scary," Kmiech said. "I didn't think I would be able to go back to groundskeeping, but I decided that all I could do was try."

With proper care and support, Kmiech has twice returned from surgery.

Chris Gebeck, a Duluth Clinic athletic trainer who has worked with Kmiech, said having a positive attitude and maintaining the will to overcome adversity is critical to patients' success. "It's huge," he said.

"He [Kmiech] could easily have said, 'I hurt too much,' but he didn't want to labeled simply as someone with a disability," Gebeck said. "Around here, we try not to talk about disabilities but about what people are able to do."

PETER PASSI covers business and development. He can be reached weekdays at (218) 279-5526 or by e-mail at ppassi@duluthnews.com .

Peter Passi covers city government for the Duluth News Tribune. He joined the paper in April 2000, initially as a business reporter but has worked a number of beats through the years.
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