When I started in general practice 30 years ago, I realised immediately that most GPs have little interest or acumen in occupational health; but it quickly became a passion of mine.
Unfortunately, the system, or more accurately the systems (there are 11 main workers’ compensation schemes in Australia – one for each state and territory, plus three Commonwealth schemes), are not set up to make GPs rush into this field.
Between 80–90% of compensable workplace injuries are managed by GPs, but they do so with the same tools they use in standard general practice, rather than the special interest and skills needed in this specialised area.
Further education and orientation are important for contemporary, evidence-based care for injured workers.
Last year, I wrote about the struggles GPs face when interacting with workers compensation schemes, believing that acknowledging these challenges is vital as a first step to improving the system for better patient outcomes and to encourage more GPs to participate.
The RACGP also provided a response to an independent review of the Safety, Rehabilitation and Compensation Act 1988, the legislation which underpins the Comcare workers’ compensation scheme, with our response outlining opportunities and recommendations for addressing challenges.
Were two people to sustain the same injury in different settings, a person injured at work (which results in a compensable claim) has a significantly higher chance of poor heath outcomes and long-term disability than a person injured outside such a setting.
Long-term work absence, work disability and unemployment following workplace injury or illness can have a significant impact on the long-term health and wellbeing of workers, their families and their communities. It also has a significant impact on our health system.
Extended time off work is, mostly, not valuable for the workers’ recovery.
Expedited and efficient treatment, utilising modifications where required, will often improve recovery and return to work, especially when communicated directly with the workplace.
Establishing good communication channels between all parties, including the workplace, allows for a consistent and supportive team approach, with shared goals and mutually beneficial outcomes.
Whilst there are complexities in treating injured workers, the focus needs to be on individual, evidence-based care for the person involved – the workplace is a key participant, but the patient must be the primary treatment emphasis.
Workplace injuries are often complex, requiring diverse skills in patient engagement, establishing trust, identifying all relevant issues, including past, unrelated medical and psychological issues, and referral to appropriate allied health and other medical specialists, and a subsequent collaborative team approach.
Quality time is required for quality care. Inevitably for many time-poor GPs, finding this is a challenge.
I am a huge advocate, along with the data, for immediate rehabilitation from the time of the injury or event, with rapid involvement of allied health and other medical specialists a key to earlier recovery.
If appropriate time, trust, and engagement can be generated, rapid and precise treatment of an injured worker can be obtained, leading to improved outcomes in shorter periods of time, to everyone’s benefit.
Connected to appropriate care is respectful billing – there should be solid remuneration for work of high value and consequent recovery of the injured worker.
In the RACGP’s submission, we called for service items to be increased – at a minimum service items should align with the AMA Fees List.
Arbitrary challenges by insurance companies on service billings, especially in the first month of consultation, often results in additional paperwork to justify charges and dissatisfaction and disillusionment with delivery of time-consuming quality care.
So, despite the challenges why do I love this work?
I get immense satisfaction from developing strong patient engagement, providing evidence-based management of the issue, witnessing enthusiastic rehabilitation from both patients and the workplace, and being part of the journey to recovery and return to pre-injury duties.
It’s seeing people get their lives back, and for their families, getting their special person back.
Source: News GP
