Patients with stress a growing concern for GPs
Patients suffering from work-related stress are contributing to a change in the role of general practitioners in managing workplace injuries, according to a survey in the latest issue of The Medical Journal of Australia.
A survey, conducted two years ago among 450 Western Australian GPs by Dr Grant Russell, from the Centre for Studies in Family Medicine, Ontario, Canada, and Sally Roach, from the Royal Australian College of General Practice, Western Australia, found an alarming number of respondents thought injury management in work-related stress was compromised by the adversarial nature of the workers' compensation system.
In particular, GPs identified the following problems:
- Communication being more difficult because of concerns about patient confidentiality issues;
- Uncertainty about effective methods of negotiation;
- Awareness of the potential for making things worse for the patient;
- Employer liaison.
The authors say that evidence suggests a rise in the adverse effects of psychological stress in the workplace.
"There has been a dramatic increase in the number and cost of workers compensation claims for work-related (occupational) stress," they said.
The survey revealed that most GPs chose not to initiate a workers compensation claim when a patient presented with work-related stress.
In response to a case vignette describing a patient suffering symptoms typical of an anxiety state, which he attributes to difficulties he is having at his workplace, most would have advised the patient take up to a week off work whether or not a claim was lodged, would have involved a psychologist in further management and would have waited for the employer to initiate communication.
Published Australian guidelines for the medical management of occupational stress advocate early intervention; durable, monitored return to work; and effective communication between all parties in the system.
The researchers concluded that intervention to improve the management of work-related stress by GPs would be best directed at addressing the challenges of implementing injury management.
In an editorial in the same issue of the MJA, Drs Ian Steven and E Michael Shanahan pointed out that lodging a workers compensation claim appears to be associated with adverse health outcomes. They noted that GPs would benefit from increased education and skills in the area of treating work-related stress.
According to Drs Steven and Shanahan, increased education and skill sharing of all participants in the compensation system may address some of the concerns about the adversarial system.
They say there should be appropriate research strategies to examine and address these issues systematically to optimise health outcomes in a cost-effective way.
The Medical Journal of Australia is published by the Australian Medical Association.
CONTACT: Dr Grant Russell (08) 9387 1429 (A/H)
(Research) (08) 9381 4547 (A/H - Saturday AM)
Dr Ian D Steven (08) 8238 5623 (B/H)
(Editorial) (0438) 310 677 (A/H)
Ms Sarah Crichton (0419) 440 076
Public Affairs, AMA