1. Shoulder surgery in workers’ compensation patients What the figures say! John North Michael Francis

2. Declaration John North Chairman, Orthopaedic Assessment Tribunal Michael Francis Secretary, Medical Assessment Tribunals (Q-COMP) Data supplied by Q-COMP

3. Hypothesis Surgery for ‘adhesive capsulitis’ Significantly worse outcomes Workers’ compensation patients Compared to non-operative treatment

4. Data & Assumptions N= 531 Claimants in the Qld workers’ compensation scheme Documented diagnosis of ‘adhesive capsulitis’ Finalised claims 1 January 2005 & 31 December 2010 Only included claims where –time lost from work –medical expenses paid Overnight hospitalisation payment = surgery

5. What the figures say! Surgery led to MORE: Statutory workers comp’ payments Time off Allied health costs P.I. quantum Common law quantum

12. Does this mean that surgery for workers’ compensation patients should never occur? Defined indications for surgery Stringent surgical approval process Non-operative options fully explored Informed consent must be comprehensive

13. Conclusion Figures correlational only BUT strongly suggest that Surgical intervention for compensated patients ‘adhesive capsulitis’ should always be carefully considered by surgeons, insurers and patients.

14. QUESTIONS?