60 Minutes, the ACC hatchet-men and Dr Vic Du Plessis’s 60 Minutes plea – let me stand up in court?

Lauda Finem

We have a post coming soon on this particular ACC Minister Judith Collins who  yesterday according to Fairfax New Zealand:

……pledged to examine the independence of a small group of doctors claimed to be receiving large payments in return for medical assessments that help the corporation take costly long term claimants off its books.

In series of articles in recent years the Herald has reported concerns about a small group of doctors being used by the corporation to reject claims for elective surgery on grounds of pre-injury “degenerative” conditions.

However reports this week claimed the corporation was similarly using a select group of medical assessors who could be relied on to produce medical assessments of long term claimants that allowed the corporation to end their entitlements.

Yesterday, Green ACC spokesman Kevin Hague said he’d obtained data under the Official Information Act showing a small group of doctors were being paid up…

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About Tasworkdoc

As an occupational physician in private medical practice in Hobart, Tasmania - the southernmost state of Australia, I see workers referred by their general practitioners with various types of work-related injuries and diseases. These are mostly musculoskeletal injuries, both of traumatic and gradual onset as well as various associated psychological disorders. With interaction with patients for treatment and providing advice about rehabilitation, I have the opportunity, first-hand, to observe interactions between individual patients and compensation systems. I also conduct independent medical assessments, including impairment assessments for musculoskeletal injuries and asbestos-related disease compensation. This provides another perspective of workers within compensation systems.
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10 Responses to 60 Minutes, the ACC hatchet-men and Dr Vic Du Plessis’s 60 Minutes plea – let me stand up in court?

  1. Tasworkdoc says:

    I have only just seen this post. The question is:
    Is this happening in Australia?

  2. John Quintner, Consultant Physician in Rheumatology and Pain Medicine says:

    Peter, it would surprise me to learn that the New Zealand ACC was leading the way. By some strange process of logic, it would seem they believe that the more money you pay to medical examiners/assessors, the more independent their medical opinions become.

  3. Soula says:

    Yes and yes, and I welcome any media enquiries. I’ll speak up, afterall my compensation has been cut as per Denise Cossgrove’s ‘low-hanging fruit’ plans and I have nothing to lose. Here’s my Victorian experience: http://www.pudendalnerve.com.au/category/work-system/
    Grand finale post up next week.

  4. Pingback: Small group of IMEs paid up to $500,000 to deny claims and surgery | A Workcover Victims DiaryA Workcover Victims Diary

  5. Tasworkdoc says:

    To be fair to the IME doctors, the amounts earned from ACC would be the gross payments made for assessments, not necessarily the doctor’s ‘take home’ pay, but the amounts are substantial and it does legitimately raise concerns about whether a doctor can be independent in such circumstances.

    • Soula says:

      Impossible to be independent when you’re given guidelines and questions too I believe. Especially when it comes to chronic pain.

  6. John Quintner, Consultant Physician in Rheumatology and Pain Medicine says:

    The definitions of independent are worth remembering – freedom from outside control, not subject to the authority of another person, and not depending on another for livelihood or sustenance. When strictly applied, it becomes obvious that no medical practitioner can be truly independent.

    More relevant to the context of this discussion is the question whether or not IMEs rely upon a body of current scientific evidence when formulating their expert opinions and making recommendations to interested parties. In other words, have they made it absolutely clear in their reports that the cause they are serving is that of science and not that of mammon? I know that this requirement imposes a heavy burden of responsibility upon IMEs but when the former is not the case their opinions are likely to be met with a degree of skepticism.

    A prominent Perth barrister once gave good advice when he said that the writing of medico-legal reports should be undertaken with an awareness that an imaginary Judge is always looking over one’s shoulder.

  7. Tasworkdoc says:

    I agree John – true independence is hard to achieve – I think the goal is to make IME assessments more independent. As well as imagining a judge looking over your shoulder, another strategy is to think about the range of opinions you could potentially express as an independent doctor, including consciously thinking about an opinion that might suit the party asking for the report. Then ask yourself ” does the evidence truly support that” or does another opinion better fit the evidence?

  8. John Quintner says:

    Peter, by a sheer coincidence I heard today that one of the doctors featured on 60 minutes has visited our Australian shores in order to provide a compensation insurer, which shall be nameless, with the benefit of his expertise in the management of long term compensation claims. News spreads fast! Your question has been answered in the affirmative.

  9. Justice Seeker says:

    Of course this is happening in Australia. I have experienced this myself and once my complaints made obvious what was going on, the insurer wrote to me saying they were changing their practices regarding the way they are using IMEs and IMCs. In a phone call with the insurer’s Operations Manager I was advised of two doctor’s they would no longer be using due to my complaints, obviously because the lack of independence was so apparent!!!
    We have good evidence this is widespread. One other insurer even put it in writing that the assessor was one of their preferred assessors and that they only use IMEs who are also AMSs at the Workers Compensation Commission so how can those assessors remain independent when carrying out work for both. The evidence is very clear in WCC/court cases that certain assessors reports are dismissed because they are completely contrary to all treatment evidence. There are some cases where the doctor is not provided any treatment evidence or very limited or biased reports. The referral from the insurer’s solicitor in one of my assessments told the IME what they wanted him to find. In one court case the doctor was said to have carried out more hours of assessments in a day than hours in a day.
    There are a number of well known “hired guns” and many people have made complaints all over the country but there is no effective system to deal with such doctors as the burden of proof is too high for the Health Care Complaints Commission and WorkCover don’t seem to know how to deal with these doctors either.
    Like to have full disclosure laws relating to who is being used regularly and how often claims are denied on the basis of reports from those used most to see if there is a correlation.

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