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Doctors demand WorkCover review
21 October 2010.
Patients injured at work could face greater difficulty finding a doctor to treat them unless the WorkCover scheme undergoes a major shake-up, an AMA Victoria survey reveals.
"A number of doctors have already stopped seeing WorkCover patients," said AMA Victoria spokesperson and orthopaedic surgeon Dr Gary Speck. "A larger proportion will stop treating WorkCover patients over the next few years unless things improve."
The AMA Victoria survey shows doctors are frustrated with the insurer’s red tape, poor processes and inadequate reimbursement of fees for patients.
"WorkSafe’s claim and treatment approval process can be long and complicated so patients are forced to wait longer than necessary for treatment,” Dr Speck Said. “This inevitably leads to poorer outcomes. It also puts psychological pressure on the patient and delays their return to work."
According to an independent study of return to work trends, the number of patients who were out of work six months after their claim has increased by one third – from 23 per cent of patients in 2005-06 to 31 per cent of patients in 2008-09.
Dr Speck said doctors encountered an enormous amount of red tape when treating WorkCover patients. "There are often lots of hiccups along the way, particularly when the insurer questions whether your recommended treatment is best for your patient.
"Doctors want to look after their patients not manage their insurance claim."
A 2007 independent review of Victoria’s accident compensation legislation undertaken by QC Peter Hanks recommended a review of WorkCover fees and return to work initiatives as soon as possible. However the Victorian Government dismissed the recommendation, saying it did “not consider a comprehensive review of fee schedule is warranted at this time".
AMA Victoria’s survey respondents demanded a review of fees, along with payment for telephone consultations and improved return to work initiatives.
To cover costs, some doctors said they were considering charging WorkCover for paperwork. Others would begin billing patients directly and leave WorkCover to reimburse the patient.
"The Victorian Government and Opposition must ensure action is taken to improve return to work initiatives and patient rebates to ensure Victorians injured at work have timely access to medical care," Dr Speck said.
BACKGROUND
AMA Victoria’s October 2010 survey involving 332 doctors found:
15.5% of respondents no longer see any WorkCover patients
38% spend less than 3% of their time on WorkCover patients
89.2% of respondents believe the payments offered by WorkCover are inadequate for treatment, paperwork and telephone consultations with WorkCover agents
47.2% say the payment is significantly less than for other patients
97% were disappointed that the Government rejected the Hanks Review recommendation for an independent review of WorkCover fees and return to work initiatives, saying an independents review of fees and return to work initiatives would be welcomed
40.7% believe a more realistic fee schedule would improve access for WorkCover patients
47.5% say a more realistic fee schedule would improve access if the paperwork and administrative issues were also addressed
85% would see more WorkCover patients if they were paid the AMA fees list or the AMA fees list plus a paperwork/telephone allowance
In response to WorkSafe’s red tape requirements, almost half (48.7%) think they should charge WorkCover for the additional time on paperwork
84.9% say the best way to deal with WorkSafe’s request for information by phone is to charge WorkCover for the time taken on phone calls or ask WorkCover to put their request in writing and charge for the report
If WorkCover rebates don’t rise sufficiently over the next few years:
54% would see fewer WorkCover patients
48.1% would charge patients privately and ask WorkCover to reimburse the patient
30.8% would charge WorkCover directly for the additional bureaucratic requirements
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