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Penny Markham, A/Registrar & Amanda Le Poidevin, Managing Solicitor
Operation of Medical Panels
SA 17 April 2009
Overview
Key Features of Medical Panels Benefits Operations Selection of Doctors Facility How to refer to a medical Convenor’s directions – consultation and
concepts Opinions and reasons Contact us
Key Features
An independent body separate to WorkCover & WCT
An important part of the dispute resolution process Medical experts making final and binding decisions
on medical questions Pool of medical practitioners appointed by the
Governor in Council on the recommendation of the Minister
Doctors are experienced and from a range of specialty groups
From the pool medical panels will be convened to determine particular medical questions referred to it
Expected number of referrals annually = 1500
Why change?
Disputes arise from disagreement over medical information
No avenue for a definitive ruling on medical matters Judges hear competing and often substantially different
medical opinions Decisions may not be entirely consistent with medical
opinion Medical practitioners often have an actual or perceived
bias toward the party they represent Disputes can become protracted and subject to significant
delays Significant scope for improving the efficiency of resolution
of disputes relating to medical information
Benefits
Timely and accurate decisions on medical issues
Support a focus on return to work and a return to the community
Increase efficiency in resolution of disputes Increase consistency of decision making Remove the actual or perceived bias in
decision making Increase quality of decision making according
to best practice and the current evidence base
Operations
Model based on Medical Panels Victoria Convenor and Registrar oversee operations
with supporting legal and administrative staff Medical questions are referred from a number
of sources (Corporation, SI’s, WCT, EML) Up to five member multi-speciality medical
panels will be constituted to hear a matter Constitution of the panel will be tailored to the
question and medical condition being considered
Other consultants may be co-opted as considered necessary by the panel in each case
Operations
Appoint presiding member Consider all documentation referred and examine the
injured worker Enable the injured worker to tell them their story Discuss the relevant information, results of the
examination and each member’s perspective The Presiding Member will also confer with legal staff as
necessary Issue a certificate of opinion and reasons for that
opinion to the referrer and injured worker A Medical Panel must form its opinion on a medical
question within 60 days 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)
Selection of doctors
MPSA Selection Committee formed by the Minister for Industrial Relations
Prof. Paddy Phillips, Chief MO appointed as Chair of the Selection Committee by the Minister
Stakeholder driven selection process comprising:Medical Board of South AustraliaSpecialty CollegesAustralian Medical AssociationEmployer representativeEmployee representative
Doctors Appointed by the Governor
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
Approximately 18 doctors from 13 other specialties and 14 health professionals from 8 health disciplines are also required
Recruitment is currently underway for the above
Medical PractitionersNominated by Selection Committee
Cardiology (1) Dermatology (3) Endocrinology (1) Gastroenterology (2) General Medicine (1) General Practice (21) General Surgery (1) Infectious Diseases (1) Neurology (2) Neurosurgery (3) Obstetrics and Gynaecology (3)
Occupational Medicine (9) Ophthalmology (1) Orthopaedic Surgery (10) ENT surgery (3) Pain Medicine (2) Psychiatry (11) Rehabilitation Medicine (4) Rheumatology (4) Thoracic Medicine (1) Urology (1) Vascular Surgery (1)
Medical PractitionersRound 2 Doctors Allergy Cardiology Endocrinology Gastroenterology General surgery Infectious diseases Oncology Ophthalmology Oro-maxillofacial surgery Plastic & reconstructive surgery Public health medicine Respiratory medicine Urology Vascular surgery
Other health professionals Chiropractic Dentistry Neuropsychology Occupational therapy Orthotist Physiotherapy Prosthodontist Psychology
~ closes 5th June 2009 ~
Use of doctors in Medical Panels Victoria
Medical Panels Victoria - Top 10 Specialties & Average Number of Cases by Month 2007
050
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Facility
Based at Level 1/ 44 Currie St Specially designed Now operational
Consultation processes
Completed consultation on MPSA referrals process
Consulted on Convenor’s Directions with stakeholders
Consulted with employee and injured worker groups about frequently asked questions
s98G requires that MPSA be provided with a document specifying medical issues that have been agreed and those in dispute
Referral is accompanied by medical reports, notes, surveillance film, photographs of scars and so on
Working party has endorsed referral form – available on website
How to refer
Procedures affecting the day to day management of the panels are contained in the Convenor’s Directions
The Minister may issue Ministerial Guidelines
Working party discussion Final draft for Convenor and Minister
endorsement
Convenor’s Directions
Opinions and Reasons The wording of each medical question is scrutinised to ensure it fits within the parameters of the definitions of a “medical question” If any question is unclear or is not (even broadly) within the definitions of a “medical question”, the Convenor may decide not to put the question to the Panel. The answer to any medical question contained in a Certificate of Opinion and must be accepted as final and conclusive by any body /person. A Certificate of Opinion can only be clarified if it is considered to be non-responsive by the referring person/body and the Medical Panel agrees. Detailed reasons for the opinion will be distributed to the referrer and the worker
Contact us
www.medicalpanels.sa.gov.au
Ph: 8204 1530
Fax: 8204 1550
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