Most Victorian GPs not recommending RTW: study

RTWMatters team

A study shows that Victorian GPs are unlikely to recommend alternate duties for injured workers.

A new study shows that Victorian GPs are unlikely to recommend alternate duties for injured workers.

This is despite the fact that it is now widely agreed that work is good for people.

“The past decade has seen substantial health policy reform aimed at increasing labour force participation by injured and ill workers,” say the authors of the collaborative study undertaken by academics from the Institute for Safety, Compensation and Recovery Research (ISCRR) and Monash University’s Department of General Practice and Department of Epidemiology and Preventative Medicine.

These researchers say there is “a growing body of evidence showing that safe work is good for health and that return to work (RTW) after injury or illness can promote recovery.”

Despite this, the study’s examination of over 120,000 medical certificates provided to injured workers in Victoria from 2003 to 2010 found that more than 70% of initial medical certificates issued by GPs advised injured and ill workers to not work. Less than a quarter of medical certificates recommended workers return to work on modified duties. This study is the first of its kind in the world with such a large population involved.

“This has significant implications given the growing body of evidence showing that safe work benefits health and that returning to work after injury or illness can promote recovery,” said ISCRR Chief Research Officer Dr Alex Collie.

Some of this evidence includes the Australasian Faculty of Occupational and Environmental Medicine’s (AFOEM) 2011 Consensus Statement on the Health Benefits of Work.

It found that:

  • Work is generally good for health and wellbeing;
  • Long term work absence, work disability and unemployment have a negative impact on health and wellbeing;
  • Work is an effective means of reducing poverty and social exclusion;
  • Work practices, workplace culture and work-life balance are key determinates of individual health, wellbeing and productivity;
  • Good outcomes are more likely when individuals understand the health benefits of work, and are empowered to take responsibility for their own situation; and
  • Health professionals exert a significant influence on work absence and work disability, particularly in relation to medical sickness certification practices.

Dr Collie says that the working days lost to over-protective medical certificates are highly relevant amidst the current debate on increasing national productivity, as well as scrutiny of the viability of our national compensation systems.

“We know that GPs play a front line role in returning injured workers to work as they as the first point of contact with the health care system for many injured workers and the main gatekeepers to workers compensation and disability benefits,” said Dr Collie.

The study also found that GPs were more likely to issue unfit-for-work certificates for patients suffering from mental health conditions, compared with other illnesses.

“In our study workers with fractures, traumatic injuries, back pain and strains, musculoskeletal disorders and other diseases were more likely to receive certificates recommending a return to work than workers with mental health conditions,” said Dr Collie.

“Our results are consistent with studies in the UK which showed that the highest proportion of unfit-for-work certificates was written for workers with mental health conditions. Only 4% of Victorian workers with mental health conditions received a certificate recommending a return to work with modified duties in this study.”

Researchers concluded that the high proportion of medical certificates recommending complete absence from work presents “major challenges” to return to work, labour force productivity, the viability of the compensation system, and long-term social and economic development.

“There is substantial variation in the type and duration of medical certificates issued by GPs. People with mental health conditions are unlikely to receive a certificate recommending alternative duties. Further research is required to understand GP certification behaviour.”


To read the study, please follow this link to the Medical Journal of Australia:

Published 21 October, 2013 | Updated 22 October, 2013