Amy R. Allen

Uncomfortable Bedfellows: Employer Perspectives on General Practitioners’ Role in the Return-to-Work Process

Abstract Workers’ compensation authorities expect that various stakeholders — insurers, employers, injured workers and healthcare providers — work together to help return an injured worker to early, safe and sustainable employment. To date, research examining interactions between employers and healthcare providers, in the context of return to work, is limited. Based on data gathered via qualitative, in-depth interviews with employers, our paper addresses this gap. We examine the perspectives of a group of employers from Melbourne, Australia who have had experience with return to work and, specifically, their interactions with general practitioners during this process. Our findings indicate that while employers view general practitioners as important decision-makers in the return-to-work process, they often have difficulty making contact with general practitioners and working collaboratively on a return-to-work plan. They feel that general practitioners’ lack of engagement in the return-to-work process is due to the administrative complexity of the workers’ compensation system, limited remuneration and lack of knowledge of the workplace. Employers’ feelings of exclusion, along with a view that some injured workers will ‘cheat the system’, make some employers suspicious of the doctor-patient relationship, making collaboration more difficult. Including employers in an employee’s return to work can signify that they have influence over processes that can profoundly affect their workplaces and provide decision-makers with important information about available duties and workplace organisation. Streamlined administrative processes, higher remuneration for general practitioners and the engagement of return-to-work coordinators can also facilitate the return-to-work process.

Outpatient consultant physician service usage in Australia by specialty and state and territory

Objectives To determine national service usage for initial and subsequent outpatient consultations with a consultant physician and any variation in service-use patterns between states and territories relative to population. Methods An analysis was conducted of consultant physician Medicare claims data from the year 2014 for an initial (item 110) and subsequent consultation (item 116) and, for patients with multiple morbidities, initial management planning (item 132) and review (133). The analysis included 12 medical specialties representative of common adult non-surgical medical care (cardiology, endocrinology, gastroenterology, general medicine, geriatric medicine, haematology, immunology and allergy, medical oncology, nephrology, neurology, respiratory medicine and rheumatology). Main outcome measures were per-capita service use by medical speciality and by state and territory and ratio of subsequent consultations to initial consultations by medical speciality and by state and territory. Results There was marked variation in per-capita consultant physician service use across the states and territories, tending higher than average in New South Wales and Victoria, and lower than average in the Northern Territory. There was variation between and within specialties across states and territories in the ratio of subsequent consultations to initial consultations. Conclusion Significant per-capita variation in consultant physician utilisation is occurring across Australia. Future studies should explore the variation in greater detail to discern whether workforce issues, access or economic barriers to care, or the possibility of over- or under-servicing in certain geographic areas is leading to this variation. What is known about the topic? There are nearly 11million initial and subsequent consultant physician consultations billed to Medicare per year, incurring nearly A

General paediatrics outpatient consultation fees, bulk billing rates and service use patterns in Australia

850million in Medicare benefits. Little attention has been paid to per-capita variation in rates of consultant physician service use across states and territories. What does this paper add? There is marked variation in per-capita consultant physician service use across different states and territories both within and between specialties. What are the implications for practitioners? Variation in service use may be due to limitations in the healthcare workforce, access or economic barriers, or systematic over- or under-servicing. The clinical appropriateness of repeated follow-up consultations is unclear.

Exploring the influence of compensable injury on recovery

Objective: To determine: 1) the mean, median and range of fees for initial and subsequent private outpatient consultations with a general paediatrician in Australia; 2) any variation in fees and bulk billing rates between states/territories; and 3) volume of outpatient general paediatric specialist consultations relative to child population.

Falling through the cracks? An analysis of health and safety resources for migrant workers in Australia

BACKGROUND: Compensable injury is a public health concern and understanding of the factors influencing recovery is crucial to improving physical and psychological outcomes for injured individuals. OBJECTIVE: Based on the bio-psychosocial model of disability (Engel, 1980), the aim of this study is to explore the experiences of injured people in compensation systems, focusing on factors that impact their health and mental well-being. METHOD: Telephone interviews were conducted with 15 compensated injured individuals who had time off work, to explore their experiences post injury. RESULTS: The key outcomes experienced post injury included fear, physical disuse, depression and disability. The results are discussed within the fear-avoidance model of pain (Lethem, Slade, Troupe, & Bentley, 1983) and in relation to a readjustment of sense of self. CONCLUSIONS: The majority of participants were struggling to move beyond their injury and particular road blocks were impeding progression of their recovery. The results of this study offer recommendations for the way compensation systems interact with injured persons and psychological and/or social interventions to help recovery from injury and return to work. Keywords: Compensable injury, pain, sense of self, fear-avoidance model

Do drinking and riding mix? Effects of legal doses of alcohol on balance ability in experienced motorcyclists

Purpose – Many migrants coming to Australia end up in poor quality jobs that can lead to injury or illness. The purpose of this paper is to examine work-related resources available to migrants in Australia to determine whether these contain information on employment standards (ES), occupational health and safety (OHS) and workers’ compensation (WC). Design/methodology/approach – National and state-based websites of government, unions, WC boards and community organizations were searched for relevant materials. Resources were analysed and categorized according to location, content, resource type, audience and language. Findings – We found 175 work-related resources that targeted migrants, or those working with them. The greatest numbers of resources were found in New South Wales, Victoria, and at a national level. There was a lack of comprehensive resources, with most resources containing only general work-related information. Those that had information on ES, OHS and WC generally covered only one topic in ...