Comcare Rehabilitation Case Manager ForumWORKING WITH THE TREATING DOCTOR

Dr Yan Perumal

• Qualifications:

• MBCHB

• M.Med (Masters Family/Occupational Medicine)

• FRACGP (Fellow of Royal Australian College of GP)

• Certificate Dermatology (Monash)

• Registration:

• Specialist Family Physician

• (Special Interest in Occupational Medicine)

Dr Yan Perumal

• Appointments:

• Clinical tutor, Bond University – Faculty of Medicine

• Independent Medical Examiner, Workcover QLD

• Nominated Medical Advisor, Department of Mines and Industries, QLD

Health Benefits of Work

• Australian Faculty of Occupational Medicine and University of Cardiff statements :• Compelling evidence for physical and mental health benefits.

• Musculoskeletal, Cardiovascular, Mental health, Suicide, Self esteem.

• Previous – FFW/NFFW

• Current – FFW/NFFW/FFSD

• “ Use it or lose it”.

• Importance of appropriate RTW: • Recovering while working

• 20 days off work/70% RTW

• 45 days off work/50% RTW

• 70 days off work/35% RTW

Work Benefits of RTW

• Participation and commitment to rehabilitation means:

• RTW quickly and safely

• Less disruption to family, work and social life

• Improved employment and financial security

• Less time spent recovery from injury

• Prevention/reduction of long term disability

Challenges for the General Practitioner• Inadequate understanding regarding workplace environment and

assessment of available suitable duties. No formal training at medical school.

• Solutions- employer to provide specific alternate duties and demands of these tasks.

- worksite visits.

- education by Occupational medicine practitioners.

• Reconciling employee needs and expectations with that of employer

• Empathy usually with worker.

Doctor/Employer/Employee Relationships • Barriers:

• Differing interests/concerns

• Power struggle

• Worker compensation seeking:

• Differing patient attitude/behaviour between work related and non-work related injuries

• Legal involvement

• Employer non-compliance with restrictions

• Employee fear of dismissal

Engaging and Communicating with the General Practitioner

• Benefit for employer . Merits of an early partnership. Establishing trust and opening line of communication.• Give reasonable notice• Send e- mail/fax ahead of meeting or phone call outlining concerns, available suitable duties• Book first/last appointment morning session or same in afternoon.• Contacting GP – check with practice manager/receptionist regarding

best time. • Initial contact with GP alone, followed by consultation with worker.• Follow up e-mails and faxes.• Book adequate time. • If impasse reached, consider IME assessment.

Case Conferencing Indications• Slow progress in treatment.

• Definition/clarification of suitable duties.

• Multiple facets to management involving multiple providers.

• Compensable vs non- compensable issues. Evidence based.

• Resolving conflict.

• Independent medical advisor role.

Thank You!