Physical Medicine & Rehabilitation - Pain Management Physician - Southfield, Michigan

Physical Medicine & Rehabilitation Physician
Southfield, Michigan

We are hiring a Physical Medicine and Rehabilitation (PM&R) doctor, working in the auto claims sector. You will typically perform independent medical examinations (IMEs), peer reviews, and medical record reviews. These roles differ from clinical practice, focusing on providing objective, expert medical opinions to resolve insurance disputes rather than treating a patient directly.
Common PM&R roles in auto claims.

Independent Medical Examiner (IME)

• Evaluate claimants: Conduct comprehensive physical exams of individuals who have been injured in a car accident to assess their condition.
• Assess causation: Provide an opinion on whether the claimant's injuries were caused by the auto accident.
• Review treatment: Determine if past and present medical treatments are necessary, reasonable, and appropriate.
• Establish prognosis: Offer a prognosis for the claimant's recovery and the necessity of any future treatment.
• Determine work status: Assess the claimant's ability to return to work, potentially with restrictions or accommodations.
• Prepare reports: Create detailed, evidence-based reports that answer specific clinical questions from the insurance carrier or legal counsel.

Peer Reviewer / Physician Advisor

• Review medical records: Evaluate medical records and treatment plans submitted by treating physicians to determine if the care is medically necessary and within standard guidelines.
• Perform utilization review: Conduct reviews of prospective, concurrent, or retrospective claims and appeals to ensure compliance with nationally recognized, evidence-based criteria.
• Conduct peer-to-peer discussions: Engage in phone discussions with a claimant's treating physicians to discuss clinical findings and coverage determinations.
• Maintain documentation: Accurately document all findings and rationale for coverage decisions in accordance with regulatory requirements.

Expert Witness

• Provide expert testimony: Give objective and medically credible testimony in legal proceedings, such as depositions or trials.
• Form expert opinions: Create written reports and provide opinions on complex aspects of a claim, including the severity of injuries, the impact on daily life, and long-term care needs.
• Focus on specialized areas: Testify on specific topics such as traumatic brain injury (TBI), chronic pain, spinal cord injury, or life care planning.

Key Skills and Qualifications:

• Licensure and certification: Active and unrestricted U.S. medical license (M.D. or D.O.) and board certification in Physical Medicine and Rehabilitation.
• Clinical expertise: Extensive experience diagnosing and treating musculoskeletal, neurological, and other injuries common to auto accidents, such as whiplash, soft-tissue damage, and spinal injuries.
• Analytical skills: Ability to analyze complex medical data and apply evidence-based guidelines to render objective, defensible opinions.
• Communication skills: Excellent written and verbal communication skills to articulate medical reasoning clearly and concisely in reports and testimony.
• Attention to detail: Meticulous review of medical records to identify discrepancies or errors in a claimant's file.
• Legal and regulatory knowledge: Up-to-date knowledge of relevant state and federal regulations governing insurance, medical necessity, and utilization review.
• Technology proficiency: Experience using digital platforms for managing cases, reviewing documents, and generating reports

Expanded Responsibilities of a Physical Medicine and Rehabilitation Physician

Managing Chronic Pain
PM&R physicians are experts in addressing chronic pain conditions through non-surgical interventions. They utilize spinal injections, nerve stimulation, or targeted physical therapies to reduce pain and improve mobility.

Enhancing Mobility and Functionality
These physicians focus on improving a patient’s ability to perform daily activities. They prescribe mobility aids such as wheelchairs, braces, or walkers and oversee physical therapy programs to rebuild strength and endurance.

Rehabilitation After Injuries
PM&R physicians lead rehabilitation efforts for patients recovering from traumatic injuries. They guide patients through therapies to regain motor skills, adapt to physical limitations, or achieve as much independence as possible.

Preventing Secondary Complications
A critical role of PM&R physicians is to prevent complications like pressure ulcers, contractures, or infections, which can arise from prolonged immobility or disability. They proactively manage these risks through regular evaluations and preventive measures.

Implementing Assistive Technologies
PM&R physicians often introduce patients to cutting-edge assistive technologies, including robotic exoskeletons, advanced prosthetics, or voice-activated devices, to enhance functionality and quality of life.

Diagnosing Physical Impairments: Using medical imaging, physical exams, and patient histories to identify the root causes of impairments.

Creating Treatment Plans: Developing comprehensive rehabilitation strategies tailored to individual patients, which may include physical therapy, medications, or assistive devices.

Collaborating with Healthcare Teams: Working with physical, occupational, and other specialists to deliver holistic care.

Performing Procedures: Administer treatments like joint injections and nerve blocks or prescribe prosthetics and orthotics.

Counseling Patients and Families: Educating patients and their families about rehabilitation and setting realistic recovery goals.