By Marcos Iglesias MD, MMM, FAAFP, FACOEM, Senior Vice President, Chief Medical Officer, Broadspire
As a physician and claims professional, I have had the privilege of helping individuals and populations lead fulfilling lives at their job, society and home. Work is valuable, whether it occurs in an occupational, civic or domestic domain. On the other hand, worklessness can be deleterious to an individual’s health and wellbeing, as well as contributing to social and economic problems.
Work is central to the way we and others view ourselves. In addition to its economic and financial benefits, work gives us a sense of identity, purpose and accomplishment, it keeps us intellectually and physically engaged and it connects us to others for a large part of our waking hours. We use our talents at work; we learn at work. Our economic, psychological, social and spiritual needs are met—to some degree—at work.
Worklessness has a significant human toll
When an individual is removed from the work environment for a prolonged time, serious and often long-lasting adverse events can occur.
Of course, loss of income is the most obvious consequence of worklessness. Even with disability safety nets—whether it’s workers’ compensation or other disability systems—workers’ incomes fall and this effect can persist for years after returning to work.
For many individuals, the work environment creates a structure that extends to scheduling, goal setting and psychological rewards. When an employee finds him- or herself out of work, unless they already possess strong coping skills (scheduling, goal setting, resilience, stress management) the inciting event—whether it’s an injury or illness—becomes the tipping point that starts the individual down a road of disability and its consequences.
Finding it difficult to set their own schedules, some individuals may sleep in late, find it difficult to sleep at night, may have daytime tiredness and their appetites may change.
Often, this leads to a loss of self-efficacy, depressed mood, passivity and isolation. With time to ruminate on their condition, some individuals find it difficult to focus on anything other than their pain (which, ironically, makes the pain worse) and the diagnostic label they have been given. They may start seeing themselves as “damaged goods”: someone with “degenerative disc disease” or “fibromyalgia syndrome.” Some may embark on a tiring search for elusive medical solutions that can lead to adverse effects and, ultimately, frustration and anger.
From a medical point of view we know that many individuals who are off work have issues with insomnia and a depressed mood (pain and a lack of schedule, as well as medications, may contribute to that), chronic pain that may be exacerbated by lack of activity and its attending joint stiffness, muscular and aerobic deconditioning.
Drs. Waddell and Burton list some of the medical consequences of worklessness1:
- A two-to-three-fold increase in the risk of poor general health, including higher rates of cardiovascular disease, lung cancer and respiratory infections
- A two-to-three-fold increase in the risk of mental health problems
- An excess mortality of 20%
Other studies have highlighted the risk of an increase in smoking, alcohol abuse, illicit drug use and risky sexual behavior. Suicide rates have been observed to increase by a factor of six (much higher in young men).
Large population studies from several Scandinavian countries have shown a doubling of mortality rates among individuals who are not working.
“…long term worklessness is one of the greatest risks to health in our society. It is more dangerous than the most dangerous jobs in the construction industry, or [working on an oil rig in] the North Sea, and too often we not only fail to protect our patients from long term worklessness, we sometimes actually push them into it, inadvertently…”
The bottom line is this: Not working may be harmful to your health.
As industry professionals we have a duty and a privilege to help restore lives by helping individuals return to work.
1Waddell G, Burton AK. Is work good for your health and well-being? London: The Stationery Office, 2006.
About Dr. Marcos Iglesias
Dr. Marcos Iglesias is Broadspire’s senior vice president and chief medical officer with more than 25 years of experience in workers compensation, disability evaluation and treatment, and insurance leadership.
In addition to being a physician, executive, national speaker and author, Iglesias is known for his compassion for patients, progressive and inspirational leadership, and integrated approach to injured worker care.
Iglesias has a special interest in the prevention and mitigation of delayed recovery and disability. He is driven to help ill and injured workers live active, productive and fulfilling lives, which has led him to develop innovative, comprehensive disability management solutions that focus on returning workers to preinjury function.
Iglesias is board certified in family medicine and utilization review and quality assurance. He is also a fellow of the American Academy of Family Physicians, American College of Occupational and Environmental Medicine and the American Institute of Healthcare Quality.
Before joining Broadspire, Iglesias was chief medical officer and vice president for The Hartford, where he led medical strategy.
Prior to The Hartford, Iglesias was medical director for Midwest Employers Casualty Company.
He has created two innovative early disability intervention telephonic programs to help ill and injured workers recover function by addressing psychosocial risk factors that may be barriers to recovery. These programs have been in use since the late 2000s and have helped hundreds of individuals regain their life after an illness or injury.
Iglesias received his medical degree from the University of Toronto and a master’s in medical management from the University of Southern California’s Marshall School of Business.
Iglesias is fluent in Spanish and English. While away from work, he is an avid runner and an accomplished artist.
Broadspire®, a Crawford company and leading global third-party administrator, offers casualty claim, medical management, accident and health, and disability and leave management solutions, helping increase employee productivity and reducing the cost of risk through early intervention, professional expertise and data analytics. Broadspire’s parent company, Crawford & Company, is the world’s largest publicly listed independent provider of claims management solutions to insurance companies and self‐insured entities with an expansive global network serving clients in more than 70 countries. The company’s mission is to restore and enhance lives, businesses and communities. More information is available at www.choosebroadspire.com and www.crawfordandcompany.com.
Broadspire is a WorkCompWire ad partner.
This is not a paid placement.