1. Comcare Rehabilitation Case Manager Forum WORKING WITH THE TREATING DOCTOR

2. Dr Yan Perumal Qualifications: MBCHB M.Med (Masters Family/Occupational Medicine) FRACGP (Fellow of Royal Australian College of GP) Certificate Dermatology (Monash) Registration: Specialist Family Physician (Special Interest in Occupational Medicine)

3. Dr Yan Perumal Appointments: Clinical tutor, Bond University – Faculty of Medicine Independent Medical Examiner, Workcover QLD Nominated Medical Advisor, Department of Mines and Industries, QLD

4. Health Benefits of Work Australian Faculty of Occupational Medicine and University of Cardiff statements : Compelling evidence for physical and mental health benefits. Musculoskeletal, Cardiovascular, Mental health, Suicide, Self esteem. Previous – FFW/NFFW Current – FFW/NFFW/FFSD “ Use it or lose it”. Importance of appropriate RTW: Recovering while working 20 days off work/70% RTW 45 days off work/50% RTW 70 days off work/35% RTW

5. Work Benefits of RTW Participation and commitment to rehabilitation means: RTW quickly and safely Less disruption to family, work and social life Improved employment and financial security Less time spent recovery from injury Prevention/reduction of long term disability

6. Challenges for the General Practitioner Inadequate understanding regarding workplace environment and assessment of available suitable duties. No formal training at medical school. Solutions- employer to provide specific alternate duties and demands of these tasks. - worksite visits. - education by Occupational medicine practitioners. Reconciling employee needs and expectations with that of employer Empathy usually with worker.

7. Doctor/Employer/Employee Relationships Barriers: Differing interests/concerns Power struggle Worker compensation seeking: Differing patient attitude/behaviour between work related and non- work related injuries Legal involvement Employer non-compliance with restrictions Employee fear of dismissal

8. Engaging and Communicating with the General Practitioner Benefit for employer. Merits of an early partnership. Establishing trust and opening line of communication. Give reasonable notice Send e- mail/fax ahead of meeting or phone call outlining concerns, available suitable duties Book first/last appointment morning session or same in afternoon. Contacting GP – check with practice manager/receptionist regarding best time. Initial contact with GP alone, followed by consultation with worker. Follow up e-mails and faxes. Book adequate time. If impasse reached, consider IME assessment.

9. Case Conferencing Indications Slow progress in treatment. Definition/clarification of suitable duties. Multiple facets to management involving multiple providers. Compensable vs non- compensable issues. Evidence based. Resolving conflict. Independent medical advisor role.

10. Thank You!