WORK RELATED INJURIES IN GENERAL PRACTICE. General Practice in ACT 300 GPs in Canberra Varying interests Varying cultural backgrounds Majority.

WORK RELATED INJURIES IN

GENERAL PRACTICE

General Practice in ACTGeneral Practice in ACT

300 GPs in Canberra300 GPs in Canberra Varying interests Varying interests Varying cultural backgroundsVarying cultural backgrounds Majority have been through the RACGP Majority have been through the RACGP

fellowship fellowship 7 years to be a doctor then another 3 year 7 years to be a doctor then another 3 year

post graduate programpost graduate program GP registrar work in practices GP registrar work in practices

GP in ACTGP in ACT

25 + years in Woden in a group practice25 + years in Woden in a group practice

Teaching medical students , GP registrars Teaching medical students , GP registrars

and training nursesand training nurses

Interest in Mental Health Interest in Mental Health

Surrounded by public service departmentsSurrounded by public service departments

Day in the life of a GPDay in the life of a GP

Huge variety of conditions Huge variety of conditions ChildrenChildren Sports Injuries, lacerations, removal of Sports Injuries, lacerations, removal of

lesionslesions ImmunisationsImmunisations Chronic diseases diabetes heart disease Chronic diseases diabetes heart disease

osteoarthritis osteoarthritis Uncommon and rare medical diseasesUncommon and rare medical diseases Aged and Palliative CareAged and Palliative Care

Day in the life of a GPDay in the life of a GP (Cont)(Cont)

Cancer Cancer Mental Health including schizophrenia, Mental Health including schizophrenia,

Stress Stress Acute medical conditions Acute medical conditions Women’s HealthWomen’s Health Winter ailments Winter ailments Ongoing chronic complex medical and Ongoing chronic complex medical and

psychosocial problems psychosocial problems

The Nature of General The Nature of General Practice in ACTPractice in ACT

Persistent GP shortage Persistent GP shortage Time poor Time poor Patient every 15 mins Patient every 15 mins Very patient focused Very patient focused Increase in corporate owned practice in Increase in corporate owned practice in

the ACT. The patient may see a different the ACT. The patient may see a different doctor every time they visit the clinic, doctor every time they visit the clinic, decrease in continuity of care.decrease in continuity of care.

Paper - The Bane of GPs Paper - The Bane of GPs lifelife

Certificates for everything, including childcare Certificates for everything, including childcare Drivers licence taxi vouchers B Class parking Drivers licence taxi vouchers B Class parking Support for community assistance such as Support for community assistance such as

housing, community care housing, community care Items under Medicare ; GP Management and Items under Medicare ; GP Management and

Team Care Arrangement , Mental Health Plans Team Care Arrangement , Mental Health Plans Prescribing of Narcotic medicationsPrescribing of Narcotic medications Comcare and Workers CompensationComcare and Workers Compensation

Predominant Work Related Predominant Work Related DisordersDisorders

Mental Health Disorders Mental Health Disorders

StressStress

Bullying/harassmentBullying/harassment

Perceived excess work usually associated Perceived excess work usually associated with with little support or little controllittle support or little control

Anxiety/ DepressionAnxiety/ Depression Occupational Overuse associated with upper Occupational Overuse associated with upper

limb and neck painlimb and neck pain

Usually on a background of stress / overworkUsually on a background of stress / overwork

Non work related injuriesNon work related injuries

Physical illness needing prolonged time Physical illness needing prolonged time offoff

Chronic pain disorder Chronic pain disorder Mental health illnessMental health illness

PresentationPresentation

Mild sleep disturbance and worry to Mild sleep disturbance and worry to severe anxiety and panic attacks severe anxiety and panic attacks

Depression Depression Patient often feel upsets, a failure, Patient often feel upsets, a failure,

helpless and hopeless helpless and hopeless Angry and a sense of injustice Angry and a sense of injustice PainPain

Features of Work place Features of Work place InjuryInjury

DistressDistress Very little malingeringVery little malingering Industrial issues Industrial issues Sense of InjusticeSense of Injustice

GP issuesGP issues

Patient presents their side of the story, our Patient presents their side of the story, our obligations are to our patient to alleviate obligations are to our patient to alleviate distress.distress.

Limited by privacy and confidentiality re Limited by privacy and confidentiality re informationinformation

Difficulties differentiating between Difficulties differentiating between compensable and non compensable compensable and non compensable injuries, blurring of linesinjuries, blurring of lines

Options for GP are limited Options for GP are limited The GP is not a mediator The GP is not a mediator GPs may not be fully aware of legislation GPs may not be fully aware of legislation

regarding workplace injuryregarding workplace injury

GP ManagementGP Management

Sympathetic ear Sympathetic ear Time off, restriction of duties, part-time Time off, restriction of duties, part-time

hourshours Exercise Exercise EAP or private psychologist (ATAPs and EAP or private psychologist (ATAPs and

Better Access)Better Access) Physical therapies, short role, passive to Physical therapies, short role, passive to

active active Medication Medication Pain management unit Pain management unit GymGym Referral to specialist Referral to specialist Referral to tertiary institutionsReferral to tertiary institutions

Employers RoleEmployers Role

Support and interest by workplace and Support and interest by workplace and case manager is essential. case manager is essential.

Flexibility: different duties, area and Flexibility: different duties, area and hours. hours.

Timeliness, early recognition, early Timeliness, early recognition, early intervention intervention

Stability and continuity in carersStability and continuity in carers

Meetings with GPsMeetings with GPs

Privacy Privacy Meetings with the manager are usually Meetings with the manager are usually

with patient in surgerywith patient in surgery The appointment needs to be long. Check The appointment needs to be long. Check

with receptionist for preferred times.with receptionist for preferred times. Letter of introduction and why case Letter of introduction and why case

manager is attending manager is attending Helps to have a duty statement and Helps to have a duty statement and

possible alternate duties and/or areas of possible alternate duties and/or areas of workwork

Feedback from GPFeedback from GP

Questions, no more than three and fax or Questions, no more than three and fax or email email

To talk to GP need to check with the To talk to GP need to check with the receptionist when best to ring or leave receptionist when best to ring or leave return easy contact.return easy contact.

Good Case Manager Good Case Manager StrengthsStrengths

Keeping regular contact with patientKeeping regular contact with patient Proactive Proactive Flexible Flexible Up to date on information regarding Up to date on information regarding

patient’spatient’s

rights rights