Texas Closed Formulary – Just Do It

                               So, to recap, the first Phase of TCF has apparently been successful already, and the second Phase has been well defined by the DWC.  So now it just comes down to the willingness of all the stakeholders to proactively start addressing the legacy claims and utilize the element of time to deal with these very difficult claims (and, most importantly, the health and well-being of many injured workers).  The issues have been identified, the table has been set, and now it comes down to execution.

Do I have a business reason for pushing this forward?  Yes, because our methodology matches very closely to the DWC’s intended process.  And our outcomes (high discussion rate, high agreement rate, actual savings by facilitating the discontinuance of inappropriate drugs) exceed those of the industry.  However, after having spent over almost 8 years focused on the prescription drug issue in Work Comp, my passion is personal.

This process works.  I have observed patients go from an egregiously inappropriate drug regimen to one that has a lucid clinical rationale, and even to no drugs at all with a better way to cope with the pain while being more cognitively aware and satisfied.  I have heard a thankful phone call from a patient who initially resisted changes to his drug regimen, but after many discussions with him and his wife and his treating physician about the effect the drugs were having on his life and life expectancy, went through detoxification and now has a much happier existence.  I have overheard conversations with treating physicians who were thankful for the peer dialogue that initiated a personal epiphany for them in how they managed chronic pain.  For this process to work, all stakeholders need to understand the risks associated with maintaining the status quo and have a desire and will to change.

So, now it’s time to just “do it”.  If you're ready to get started, call me.

In this together – Mark

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