Hostname: page-component-7479d7b7d-t6hkb Total loading time: 0 Render date: 2024-07-13T11:21:28.077Z Has data issue: false hasContentIssue false

Examining the Role of Treating Medical Practitioners Practising in the South Australian Workers' Compensation System

Published online by Cambridge University Press:  23 February 2012

D. Christine Roberts-Yates*
Affiliation:
Flinders University, Australia
*
4/26 Robsart Street, Parkside, Adelaide, South Australia 5063, Australia E-mail: dcry1@msn.com
Get access

Abstract

This paper reports conversational interviews with key stakeholders in order to analyse the critical role of the treating medical practitioner in the management of injured workers with a registered WorkCover claim in South Australia. The comments expose the dilemma of treating general practitioners in their dual roles of “gatekeeper” and service provider against a backdrop of the ongoing demands and pressures from claims agents, vested interest groups, litigation, pervading antagonistic process relationships, inflexible work settings and the preoccupation with containing costs. The study highlights the need for treating medical practitioners to understand the WorkCover system and legislation. It is suggested further that their practice would benefit from holistic management, supportive care, clear language, respectful communication, timely medical updates and helpful professional attitudes. It was noted that many medical practitioners favour some redesign of medical management practice encompassing the development of a leadership role and the provision of progressive medical management plans in order to maximise successful return-to-work outcomes for injured workers.

Type
Articles
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aitken, R.C.B., & Cornes, P. (1990). To work or not to work: That is the question. British Journal of Industrial Medicine, 47, 436441.Google ScholarPubMed
Annandale, E. (1998). The sociology of health and medicine: A critical introduction. Cambridge, UK: Polity.Google Scholar
Appel, D., & Borba, P. (1994). The impact of managed care on workers' compensation claim costs. In Grannemann, T. W. (Ed.), Review, regulate or reform? What works to control workers' compensation medical costs (pp. 166184). Cambridge, MA: Workers' Compensation Research Institute.Google Scholar
Argyle, M. (1991). Co-operation: The basis of sociability. London: Routledge.Google Scholar
Baer, N. (1997). Disability payments continue to climb: “Tell us what you see, not what you think”, CPP tells Mds”. Canadian Medical Association Journal, 156(1), 6164.Google ScholarPubMed
Bale, A. (1989). Medicine in the industrial battle: Early workers' compensation. Social Science Medicine, 28, 11131120.CrossRefGoogle ScholarPubMed
Bloch, F.S., & Prins, R. (2001). Who returns to work and why? A six country study on work incapacity and reintegration. London: Transaction.Google Scholar
Bollen, M., Martin, G., & Pers, P. (2000). Case managers and GPs: A new dawn in co-operation? Paper presented at the 3rd Annual Conference of Case Management: Fact or fiction? Melbourne, Australia.Google Scholar
Bricher, G. (2000). Disabled people, health professionals and the social model of disability: Can there be a research relationship? Disability & Society, 15(5), 781793.CrossRefGoogle Scholar
Burry, H.C. (1990). Accident compensation: Gates and gatekeepers. Medical Journal of Australia, 152, 450451.CrossRefGoogle ScholarPubMed
Cameron, S.J. (1996). Workers' compensation: What role the doctor? Medical Journal of Australia, 164, 2627.CrossRefGoogle ScholarPubMed
Carey, T.S., & Hadler, N.M. (1986). The role of the primary physician in disability determination for social security insurance and workers' compensation. Ann intern Med, 104, 706710.CrossRefGoogle ScholarPubMed
Castellani, B., & Wear, D. (2000). Physician views on practising professionalism in the corporate age. Qualitative Health Research, 10(4), 490506.CrossRefGoogle Scholar
Crisp, R. (2000). A qualitative study of the perceptions of individuals with disabilities concerning health and rehabilitation professionals. Disability and Society, 15(2), 355367.CrossRefGoogle Scholar
Cohen, M., Nicholas, M., & Blanch, A. (2000). Medical assessment and management of work-related low back or neck/arm pain. Journal of Occupational Health and Safety, 16(4), 307317.Google Scholar
Dworkin, R.H., Handlin, D.S., Richlin, D.M., Brand, L., & Vannucci, C. (1985). Unravelling the effects of compensation: Litigation and unemployment on treatment response in chronic pain. Pain, 23, 4959.CrossRefGoogle Scholar
Edmonds-Wilson, E. (2002). Submission to the review of workers' compensation and occupational health, safety and welfare systems in South Australia. Adelaide, Australia: AMA.Google Scholar
Feuerstein, M., & Thebarge, R.W. (1991). Perceptions of disability and occupational stress as discriminators of work disability in patients with chronic pain. Journal of Occupational Rehabilitation, 1(3), 185195.CrossRefGoogle ScholarPubMed
Field, D., & Taylor, S.E. (Eds.) (1998). Sociological perspectives on health, illness and health care. London: MPG.Google Scholar
Frankford, D., & Konrad, T. (1998). Responsive medical professionalism: Integrating education, practice and community in a market-driven era. Academic Medicine, 73, 138145.CrossRefGoogle Scholar
Greenough, C.G., & Fraser, R.D. (1988). The effects of compensation on recovery from low-back injury. Spine, 14(9), 947955.CrossRefGoogle Scholar
Gribich, C., McGartland, M., & Polgar, S. (1998). Regulating workers' compensation: The medico legal evaluation of injured workers in Victoria. Australian Journal of Social Issues, 33(3), 241261.CrossRefGoogle Scholar
Hafferty, E., & Light, D. (1995). Professional dynamics and the changing nature of medical work. Journal of Health and Social Behaviour, 132153.CrossRefGoogle ScholarPubMed
Helman, T. (1996). Legal complications can make it hard work for GPs. Australian Doctor, 6667.Google Scholar
Hoff, T. (1999). The social organisation of physician-managers in a changing HMO. Work and Occupations, 26(3), 324351.CrossRefGoogle Scholar
Imershein, A.W., Hill, A.S., & Reynolds, A.M. (1994). The workers' compensation system as a quality of life problem for workers' compensation claimants. Advances in Medical Sociology, 5, 1812000.Google Scholar
Kelly, M.P., & Field, D. (1996). Medical sociology: chronic illness and the body. Sociology of Health and illness, 18, 241257.CrossRefGoogle Scholar
Lu, L. (1997). Social support, reciprocity and well-being. Journal of Social Psychology, 137(5), 618628.CrossRefGoogle ScholarPubMed
MacKenzie, E.L., Morris, J.A. Jr., Jurkovich, G.L., Yasui, Y., Cushing, B.M., Burgess, , et al. (1998). Return to work following injury: The role of economic, social and job related factors. American Journal of Public Health, 88(11), 16301637.CrossRefGoogle ScholarPubMed
McAnaney, D., Webster, B., Lohan, M., & Wynne, R. (2001). Disability management: A system of response or a response to a system? Australian Journal of Rehabilitation Counselling, 7(1), 239249.CrossRefGoogle Scholar
Max, W., Rice, D.P., & Trupin, L. (1996). Medical expenditures for people with disabilities. Disability Statistics Abstract, 12, 14.Google Scholar
Merrill, R.N., Pransky, G., Hathaway, J., & Scott, D. (1990). Illness and the workplace: A study of physicians and employers. Journal of Family Practice, 31, 5558.Google ScholarPubMed
Morrison, D.L., Wood, G.A., & Munrowd, D. (1998). Management practices, medical interventions and return to work: Final report. Perth, Australia: WorkCover, WA.Google Scholar
O'Donnell, C. (2000). Motor accident and workers' compensation insurance design for high quality heath outcomes and cost containment. Disability and Rehabilitation, 22(1–2), 8896.CrossRefGoogle Scholar
Pransky, G., Benjamin, K., Hill-Fatouchi, C., Himmelstein, J., Fletcher, K., Katz, J., et al. (2000). Outcomes in work-related upper extremity and low back injuries: Results of a retrospective study. American Journal of Industrial Medicine, 37(4), 400409.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Pransky, G., & Himmelstein, J. (1996). Evaluating outcomes of workers' compensation medical care. In Kimpan, K. (Ed.), Workers' compensation medical care: Effective measurement of outcomes (pp. 1132). Cambridge, MA: Workers' Compensation Research Institute.Google Scholar
Relman, A. (1998). Education to defend professional values in the new corporate age. Academic Medicine, 73(12), 12291233.CrossRefGoogle ScholarPubMed
Reville, R.T. (1999). The impact of a disabling workplace injury on earnings and labour force participation. In Haltiwanger, J., Lane, J., Spletzer, J.R., Theeuwes, J. & Troske, K. (Eds.), The creation and analysis of employer—employee matched data. Amsterdam: Elsevier Science.Google Scholar
Roberts-Yates, D.C. (2002a). Claims/injury management and rehabilitation for injured workers: Initial results of a partnership approach. Australian Journal of Rehabilitation Counselling, 8(1), 3950.CrossRefGoogle Scholar
Roberts-Yates, D.C. (2002b). The dilemma of the case manager in workers' compensation: Decision maker, system player, paralegal/medical specialist, mediator or enemy. Australian Journal of Rehabilitation Counselling, 8(2), 99114.CrossRefGoogle Scholar
Roberts-Yates, D.C. (2003). Concerns and issues of injured workers in relation to claims/injury management and rehabilitation: The need for new operational frameworks. Disability and Rehabilitation, 25(16), 898908.CrossRefGoogle ScholarPubMed
Rodwin, M. (1993). Medicine, money and morals: Physicians' conflict of interest. New York: Oxford University Press.CrossRefGoogle Scholar
Royal Australian College of General Practitioners (RACGP), WA Research Unit. (2000). Stress, compensation and the general practitioner. Perth, Australia: Western Australia Workers' Compensation and Rehabilitation Commission.Google Scholar
Royal Australian College of Physicians (RACP), Health Policy Unit, (2001). Compensable injuries and health outcomes. Sydney, Australia: Australian Faculty of Occupational Medicine (AFOM).Google Scholar
Rubinstein, A. (1982). Mediterranean back and other stereotypes. Australian Journal of Social Issues, 17, 295303.CrossRefGoogle Scholar
Russell, G.M., & Roach, S.M. (2002). Occupational stress: A survey of management in general practice. Medical Journal of Australia, 176, 367370.CrossRefGoogle ScholarPubMed
Saunders, C. (2002). Compo too stressful. Medical Journal of Australia, 36, 61.Google Scholar
Segrin, C., & Flora, J. (2000). Poor social skills are a vulnerability factor in the development of psychosocial problems. Human Communication Research, 26(3), 489514.CrossRefGoogle Scholar
Strunin, L., & Bodin, L. (1997, 10). The human costs of occupational injuries. Paper presented at the National Occupational Injury Research Symposium, Morgantown, WV.Google Scholar
Tate, D.G. (1992). Factors influencing injured employees return to work. Journal of Applied Rehabilitation Counselling, 23(2), 1720.CrossRefGoogle Scholar
van der Sluis, C.K., Eisma, W.H., Groothoff, J.W., & ten Duis, H.J. (1998). Long term physical, psychological and social consequences of severe injuries. Injury, 29(4), 281285.CrossRefGoogle ScholarPubMed
Wood, G., Ying, E., Morrison, D., & Munrowd, D. (1999). The role of GPs in the workers' compensation system. Journal of Occupational Health and Safety, Australia/New Zealand, 15(4), 311324.Google Scholar