1. WORK RELATED INJURIES IN GENERAL PRACTICE

2. General Practice in ACT  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

3. GP in ACT  25 + years in Woden in a group practice  Teaching medical students, GP registrars and training nurses  Interest in Mental Health  Surrounded by public service departments

4. Day in the life of a GP  Huge variety of conditions Children Children Sports Injuries, lacerations, removal of lesions Sports Injuries, lacerations, removal of lesions Immunisations Immunisations Chronic diseases diabetes heart disease osteoarthritis Chronic diseases diabetes heart disease osteoarthritis Uncommon and rare medical diseases Uncommon and rare medical diseases Aged and Palliative Care Aged and Palliative Care

5. Day in the life of a GP (Cont) Cancer Cancer Mental Health including schizophrenia, Stress Mental Health including schizophrenia, Stress Acute medical conditions Acute medical conditions Women’s Health Women’s Health Winter ailments Winter ailments Ongoing chronic complex medical and psychosocial problems Ongoing chronic complex medical and psychosocial problems

6. The Nature of General Practice in ACT  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.

7. Paper - The Bane of GPs life  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

8. Predominant Work Related Disorders  Mental Health Disorders StressBullying/harassment Perceived excess work usually associated with little support or little control Anxiety/ Depression Anxiety/ Depression  Occupational Overuse associated with upper limb and neck pain Usually on a background of stress / overwork

9. Non work related injuries  Physical illness needing prolonged time off  Chronic pain disorder  Mental health illness

10. 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  Pain

11. Features of Work place Injury  Distress  Very little malingering  Industrial issues  Sense of Injustice

12. GP issues  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

13. GP Management  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

14. 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

15. Meetings with GPs  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

16. 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.

17. Good Case Manager Strengths  Keeping regular contact with patient  Proactive  Flexible  Up to date on information regarding patient’s rights