In a comment about Tilting at Windmills, Richard Gilley made the following statement:
“The total Tasmanian workers compensation medical benefit spend for 2014/15 was $43 million. HIC payments to Tasmanian GPs (NRAs) in 2014/15 were $130 million i.e. not counting private consultations or over the rebate fees, up to 33% of GP payments were workers compensation related.”
To me a suggestion that workers compensation made up to 33% of a doctor’s income seemed grossly inaccurate, based on discussions with GP colleagues.
I attended a meeting of ANZSOM tonight, for a presentation entitled “Occupational Medicine in Tasmania’ from Dr Mark Spearpoint. Dr Spearpoint referred to data from “the Beach Study” (Bettering the Evaluation and Care of Health) from the Family Medicine Research Centre.
The report from 2013-14 includes the following table:
This table indicates that only 1.7% of GP encounters were claimed as workers compensation.
The study also provided the following detail about work-related attendances at GP practices. This showed that 2.4 per 100 of GP encounters related to work-related problems, but this rate did not mean that all these encounters were funded through workers compensation.
I also talked to a well-respected general practitioner in a ‘somewhat’ occupationally focussed practice and he analysed his billings which indicated that less than 7% of billing income relates to workers compensation.
The calculation method used by Richard Gilley to suggest a third of doctor’s income come from compensation payments is seriously flawed, probably because use of the medical benefit spend of $43 million in the Tasmanian workers compensation scheme as the numerator in his calculation includes many other types of payments not just payments to doctors. His denominator of $130 million is probably also an underestimate as it does not take into account income from consultations not funded by HIC.
I hope however to get comments from the data experts at WorkCover Tasmania.
Although as an occupational physician I agree with Richard that GP’s could do better with greater emphasis on better management of workers compensation cases, the reality is that workers compensation is considerably less than 10% of an average GP’s work and there is likely to be a lot more focus on non-work related chronic disease management i.e. diabetes and hypertension.
Richard’s data is probably wrong by an order of magnitude. There needs to be alternative means to get GP’s interested other than by suggesting a significant proportion of their income is from compensation systems, which it is not.