In the face of increasing frustration with the Victorian WorkCover scheme, it seems the right time to discuss a desire for change shared by many – not least of whom are the medical practitioners of Victoria.

Why is it Victorian doctors and specialists are feeling increasingly fed-up with the system?

Let’s look at some of the reasons.

A GP treating a WorkCover compensable patient often has a more difficult injury to contend with, and less chance of seeing a positive outcome than with a non-compensable patient. When the result is not positive the practitioner experiences less job satisfaction. The patient will probably require more paperwork than other patients, and the case might involve follow-up calls from lawyers, WorkCover and employers. It is difficult to find specialists to refer patients on to – like GPs, many are reluctant to take such patients.

Payment from the employer or WorkCover agent is often slow to arrive and sometimes has to be chased up. There are also additional overhead costs – patient payment for the extra workload has not kept up with the increased costs of provision of care.

It is not, then, surprising to learn that doctors are often reluctant to take on WorkCover compensable patients. In increasing numbers medical practitioners are creating separate waiting lists for such patients, restricting their numbers, or even refusing to see them at all.

Repercussions of this trend are negative for the patient, employers and the community.

Practitioners’ frustration with the system feeds into the lives of WorkCover patients for whom it is increasingly difficult to find GPs and specialists who will take their cases.

In a recent study undertaken by the Australian Medical Association (AMA) of Victoria, over 1150 AMA members responded to a survey assessing doctors’ attitudes towards the treatment of WorkCover and Transport Accident Commission (TAC) claimants. In the free space allotted to ‘Suggested improvements’ to the system, respondents provided many ideas.

Their major suggestions included:

• Provide patient rebates at a level that can cover medical costs
• Enable faster assessment and settlement of claims
• Simplify forms, lessen paperwork and duplication, and facilitate electronic submission
• Lessen adversarial approach by insurers and legal professionals
• Improve certification process – extend beyond 28 days
• Reduce red tape, bureaucracy and number of patients involved in the process
• Remunerate practitioners for telephone consultations

Other suggestions included encouraging employers and insurers to be more supportive of injured workers, increasing the willingness of employers to create positions of modified duties where required, and allowing flexibility of duties and working hours.

The survey showed that with no change in the WorkCover system an average of 55% of respondents would either in full or partially withdraw from seeing patients within the system.

The need for a better return to work process was highlighted, as well as faster approval of scans and faster decision on treatment.

“The personal impact of a four-week delay for specialist care for [a person with] disc prolapse with significant sciatica, or a delay of a week for a psychiatrically disturbed patient should not be underestimated,” the study states.

The delays and difficulties accessing care can cause frustrations for the individual and the treating primary care practitioner, impacting on the patient’s physical and psychological well being.

Studies have shown that delays in appropriate care and delays in return to work are associated with increased likelihood of long-term disability.

It’s not only the individual impacted by delays. There are implications for productivity and costs for employers and the scheme. Cost implications of delayed return to work are significant.

Health and compensation systems rely heavily on input from medical practitioners. By not addressing medical practitioners’ concerns about treating WorkCover patients and the WorkCover system, we risk patients losing access to medical professionals and facing longer waits.

Resources to enhance partnerships with medical practitioners are vital. As is communication that allows industry suggestion to be absorbed by the system it would to improve. Victoria’s WorkCover system stands to gain from such suggestions; prospects for all concerned – ill or injured workers, employers and medical practitioners – would be markedly improved.