Penny Markham, A/Registrar & Amanda Le Poidevin, Managing Solicitor Operation of Medical Panels SA  17 April 2009
Overview <ul><li>Key Features of Medical Panels </li></ul><ul><li>Benefits </li></ul><ul><li>Operations </li></ul><ul><li>...
Key Features <ul><li>An independent body separate to WorkCover & WCT  </li></ul><ul><li>An important part of the dispute r...
Why change? <ul><li>Disputes arise from disagreement over medical information </li></ul><ul><li>No avenue for a definitive...
Benefits  <ul><li>Timely and accurate decisions on medical issues </li></ul><ul><li>Support a focus on return to work and ...
Operations <ul><li>Model based on Medical Panels Victoria </li></ul><ul><li>Convenor and Registrar oversee operations with...
Operations <ul><li>Appoint presiding member </li></ul><ul><li>Consider  all  documentation referred  and  examine the inju...
Selection of doctors <ul><li>MPSA Selection Committee formed by the Minister for </li></ul><ul><li>Industrial Relations </...
Doctors Appointed by the Governor <ul><li>85 doctors from 21 specialties were nominated by the Committee to the Minister f...
Medical Practitioners Nominated by Selection Committee <ul><li>Cardiology (1) </li></ul><ul><li>Dermatology (3) </li></ul>...
Medical Practitioners Round 2  <ul><li>Doctors </li></ul><ul><li>Allergy </li></ul><ul><li>Cardiology </li></ul><ul><li>En...
Use of doctors in  Medical Panels Victoria
Facility <ul><li>Based at Level 1/ 44 Currie St </li></ul><ul><li>Specially designed </li></ul><ul><li>Now operational </l...
Consultation processes <ul><li>Completed consultation on MPSA referrals </li></ul><ul><li>process </li></ul><ul><li>Consul...
<ul><li>s98G requires that MPSA be provided with a document specifying medical issues that have been agreed and those in d...
<ul><li>Procedures affecting the day to day management of the panels are contained in the Convenor’s Directions </li></ul>...
Opinions and Reasons <ul><li>The wording of each medical question is scrutinised to ensure  </li></ul><ul><li>it fits with...
Contact us       <ul><li>www.medicalpanels.sa.gov.au   </li></ul><ul><li>Ph: 8204 1530 </li></ul><ul><li>Fax: 8204 1550 </...
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SISA General Meeting - Friday 17th April 2009

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SISA General Meeting - Friday 17th April 2009

  1. 1. Penny Markham, A/Registrar & Amanda Le Poidevin, Managing Solicitor Operation of Medical Panels SA 17 April 2009
  2. 2. Overview <ul><li>Key Features of Medical Panels </li></ul><ul><li>Benefits </li></ul><ul><li>Operations </li></ul><ul><li>Selection of Doctors </li></ul><ul><li>Facility </li></ul><ul><li>How to refer to a medical </li></ul><ul><li>Convenor’s directions – consultation and concepts </li></ul><ul><li>Opinions and reasons </li></ul><ul><li>Contact us </li></ul>
  3. 3. Key Features <ul><li>An independent body separate to WorkCover & WCT </li></ul><ul><li>An important part of the dispute resolution process </li></ul><ul><li>Medical experts making final and binding decisions on medical questions </li></ul><ul><li>Pool of medical practitioners appointed by the Governor in Council on the recommendation of the Minister </li></ul><ul><li>Doctors are experienced and from a range of specialty groups </li></ul><ul><li>From the pool medical panels will be convened to determine particular medical questions referred to it </li></ul><ul><li>Expected number of referrals annually = 1500 </li></ul>
  4. 4. Why change? <ul><li>Disputes arise from disagreement over medical information </li></ul><ul><li>No avenue for a definitive ruling on medical matters </li></ul><ul><li>Judges hear competing and often substantially different medical opinions </li></ul><ul><li>Decisions may not be entirely consistent with medical opinion </li></ul><ul><li>Medical practitioners often have an actual or perceived bias toward the party they represent </li></ul><ul><li>Disputes can become protracted and subject to significant delays </li></ul><ul><li>Significant scope for improving the efficiency of resolution of disputes relating to medical information </li></ul>
  5. 5. Benefits <ul><li>Timely and accurate decisions on medical issues </li></ul><ul><li>Support a focus on return to work and a return to the community </li></ul><ul><li>Increase efficiency in resolution of disputes </li></ul><ul><li>Increase consistency of decision making </li></ul><ul><li>Remove the actual or perceived bias in decision making </li></ul><ul><li>Increase quality of decision making according to best practice and the current evidence base </li></ul>
  6. 6. Operations <ul><li>Model based on Medical Panels Victoria </li></ul><ul><li>Convenor and Registrar oversee operations with supporting legal and administrative staff </li></ul><ul><li>Medical questions are referred from a number of sources (Corporation, SI’s, WCT, EML) </li></ul><ul><li>Up to five member multi-speciality medical panels will be constituted to hear a matter </li></ul><ul><li>Constitution of the panel will be tailored to the question and medical condition being considered </li></ul><ul><li>Other consultants may be co-opted as considered necessary by the panel in each case </li></ul>
  7. 7. Operations <ul><li>Appoint presiding member </li></ul><ul><li>Consider all documentation referred and examine the injured worker </li></ul><ul><li>Enable the injured worker to tell them their story </li></ul><ul><li>Discuss the relevant information, results of the examination and each member’s perspective </li></ul><ul><li>The Presiding Member will also confer with legal staff as necessary </li></ul><ul><li>Issue a certificate of opinion and reasons for that opinion to the referrer and injured worker </li></ul><ul><li>A Medical Panel must form its opinion on a medical question within 60 days </li></ul><ul><li>The decisions of the medical panel are final and binding on all parties (judicial review available on grounds of procedural fairness/breach of natural justice) </li></ul>
  8. 8. Selection of doctors <ul><li>MPSA Selection Committee formed by the Minister for </li></ul><ul><li>Industrial Relations </li></ul><ul><li>Prof. Paddy Phillips, Chief MO appointed as Chair of the </li></ul><ul><li>Selection Committee by the Minister </li></ul><ul><li>Stakeholder driven selection process comprising: </li></ul><ul><ul><li>Medical Board of South Australia </li></ul></ul><ul><ul><li>Specialty Colleges </li></ul></ul><ul><ul><li>Australian Medical Association </li></ul></ul><ul><ul><li>Employer representative </li></ul></ul><ul><ul><li>Employee representative </li></ul></ul>
  9. 9. Doctors Appointed by the Governor <ul><li>85 doctors from 21 specialties were nominated by the Committee to the Minister for Industrial Relations and were appointed by the Governor on 12 March 2009 </li></ul><ul><li>Approximately 18 doctors from 13 other specialties and 14 health professionals from 8 health disciplines are also required </li></ul><ul><li>Recruitment is currently underway for the above </li></ul>
  10. 10. Medical Practitioners Nominated by Selection Committee <ul><li>Cardiology (1) </li></ul><ul><li>Dermatology (3) </li></ul><ul><li>Endocrinology (1) </li></ul><ul><li>Gastroenterology (2) </li></ul><ul><li>General Medicine (1) </li></ul><ul><li>General Practice (21) </li></ul><ul><li>General Surgery (1) </li></ul><ul><li>Infectious Diseases (1) </li></ul><ul><li>Neurology (2) </li></ul><ul><li>Neurosurgery (3) </li></ul><ul><li>Obstetrics and Gynaecology (3) </li></ul><ul><li>Occupational Medicine (9) </li></ul><ul><li>Ophthalmology (1) </li></ul><ul><li>Orthopaedic Surgery (10) </li></ul><ul><li>ENT surgery (3) </li></ul><ul><li>Pain Medicine (2) </li></ul><ul><li>Psychiatry (11) </li></ul><ul><li>Rehabilitation Medicine (4) </li></ul><ul><li>Rheumatology (4) </li></ul><ul><li>Thoracic Medicine (1) </li></ul><ul><li>Urology (1) </li></ul><ul><li>Vascular Surgery (1) </li></ul>
  11. 11. Medical Practitioners Round 2 <ul><li>Doctors </li></ul><ul><li>Allergy </li></ul><ul><li>Cardiology </li></ul><ul><li>Endocrinology </li></ul><ul><li>Gastroenterology </li></ul><ul><li>General surgery </li></ul><ul><li>Infectious diseases </li></ul><ul><li>Oncology </li></ul><ul><li>Ophthalmology </li></ul><ul><li>Oro-maxillofacial surgery </li></ul><ul><li>Plastic & reconstructive surgery </li></ul><ul><li>Public health medicine </li></ul><ul><li>Respiratory medicine </li></ul><ul><li>Urology </li></ul><ul><li>Vascular surgery </li></ul><ul><li>Other health professionals </li></ul><ul><li>Chiropractic </li></ul><ul><li>Dentistry </li></ul><ul><li>Neuropsychology </li></ul><ul><li>Occupational therapy </li></ul><ul><li>Orthotist </li></ul><ul><li>Physiotherapy </li></ul><ul><li>Prosthodontist </li></ul><ul><li>Psychology </li></ul><ul><li>~ closes 5 th June 2009 ~ </li></ul>
  12. 12. Use of doctors in Medical Panels Victoria
  13. 13. Facility <ul><li>Based at Level 1/ 44 Currie St </li></ul><ul><li>Specially designed </li></ul><ul><li>Now operational </li></ul>
  14. 14. Consultation processes <ul><li>Completed consultation on MPSA referrals </li></ul><ul><li>process </li></ul><ul><li>Consulted on Convenor’s Directions with </li></ul><ul><li>stakeholders </li></ul><ul><li>Consulted with employee and injured worker </li></ul><ul><li>groups about frequently asked questions </li></ul>
  15. 15. <ul><li>s98G requires that MPSA be provided with a document specifying medical issues that have been agreed and those in dispute </li></ul><ul><li>Referral is accompanied by medical reports, notes, surveillance film, photographs of scars and so on </li></ul><ul><li>Working party has endorsed referral form – available on website </li></ul>How to refer
  16. 16. <ul><li>Procedures affecting the day to day management of the panels are contained in the Convenor’s Directions </li></ul><ul><li>The Minister may issue Ministerial Guidelines </li></ul><ul><li>Working party discussion </li></ul><ul><li>Final draft for Convenor and Minister endorsement </li></ul>Convenor’s Directions
  17. 17. Opinions and Reasons <ul><li>The wording of each medical question is scrutinised to ensure </li></ul><ul><li>it fits within the parameters of the definitions of a “medical </li></ul><ul><li>question” </li></ul><ul><li>If any question is unclear or is not (even broadly) within the </li></ul><ul><li>definitions of a “medical question”, the Convenor may decide </li></ul><ul><li>not to put the question to the Panel. </li></ul><ul><li>The answer to any medical question contained in a Certificate </li></ul><ul><li>of Opinion and must be accepted as final and conclusive by </li></ul><ul><li>any body /person. </li></ul><ul><li>A Certificate of Opinion can only be clarified if it is considered </li></ul><ul><li>to be non-responsive by the referring person/body and the </li></ul><ul><li>Medical Panel agrees. </li></ul><ul><li>Detailed reasons for the opinion will be distributed to the </li></ul><ul><li>referrer and the worker </li></ul>
  18. 18. Contact us       <ul><li>www.medicalpanels.sa.gov.au </li></ul><ul><li>Ph: 8204 1530 </li></ul><ul><li>Fax: 8204 1550 </li></ul>

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