Transcript GP and Work Related Injuries

WORK RELATED INJURIES
IN
GENERAL PRACTICE
General Practice in ACT
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300 GPs in Canberra
Varying interests
Varying cultural backgrounds
Majority have been through the RACGP fellowship
7 years to be a doctor then another 3 year post
graduate program
GP registrar work in practices
GP in ACT
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25 + years in Woden in a group practice
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Teaching medical students , GP registrars and
training nurses
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Interest in Mental Health
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Surrounded by public service departments
Day in the life of a GP
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Huge variety of conditions
 Children
 Sports Injuries, lacerations, removal of lesions
 Immunisations
 Chronic diseases diabetes heart disease
osteoarthritis
 Uncommon and rare medical diseases
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Aged and Palliative Care
Day in the life of a GP
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Cancer
Mental Health including schizophrenia, Stress
Acute medical conditions
Women’s Health
Winter ailments
Ongoing chronic complex medical and
psychosocial problems
The Nature of General
Practice in ACT
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Persistent GP shortage
Time poor
Patient every 15 mins
Very patient focused
Increase in corporate owned practice in the ACT.
The patient may see a different doctor every time
they visit the clinic, decrease in continuity of care.
Paper - The Bane of GPs life
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Certificates for everything, including childcare
Drivers licence taxi vouchers B Class parking
Support for community assistance such as housing,
community care
Items under Medicare ; GP Management and Team
Care Arrangement , Mental Health Plans
Prescribing of Narcotic medications
Comcare and Workers Compensation
Predominant Work Related
Disorders
Mental Health Disorders
Stress
Bullying/harassment
Perceived excess work usually associated with
little support or little control
Anxiety/ Depression
 Occupational Overuse associated with upper limb
and neck pain
Usually on a background of stress / overwork
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Non work related injuries
Physical illness needing prolonged time off
 Chronic pain disorder
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Mental health illness
Presentation
Mild sleep disturbance and worry to severe anxiety
and panic attacks
 Depression
 Patient often feel upsets, a failure, helpless and
hopeless
 Angry and a sense of injustice
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Pain
Features of Work place
Injury
Distress
 Very little malingering
 Industrial issues
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Sense of Injustice
GP issues
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Patient presents their side of the story, our
obligations are to our patient to alleviate distress.
Limited by privacy and confidentiality re information
Difficulties differentiating between compensable
and non compensable injuries, blurring of lines
Options for GP are limited
The GP is not a mediator
GPs may not be fully aware of legislation regarding
workplace injury
GP Management
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Sympathetic ear
Time off, restriction of duties, part-time hours
Exercise
EAP or private psychologist (ATAPs and Better
Access)
Physical therapies, short role, passive to active
Medication
Pain management unit
Gym
Referral to specialist
Referral to tertiary institutions
Employers Role
Support and interest by workplace and case
manager is essential.
 Flexibility: different duties, area and hours.
 Timeliness, early recognition, early
intervention
 Stability and continuity in carers
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Meetings with GPs
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Privacy
Meetings with the manager are usually with patient
in surgery
The appointment needs to be long. Check with
receptionist for preferred times.
Letter of introduction and why case manager is
attending
Helps to have a duty statement and possible
alternate duties and/or areas of work
Feedback from GP
Questions, no more than three and fax or email
 To talk to GP need to check with the receptionist
when best to ring or leave return easy contact.
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Good Case Manager Strengths
Keeping regular contact with patient
 Proactive
 Flexible
 Up to date on information regarding patient’s
rights
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