Blogs under ‘RTWcare’

Robert Aurbach | Published: September 12, 2017

The terms of reference for a recent Parliamentary inquiry into workplace bullying reference a Productivity Commission estimate, stating that bullying costs the Australian economy between $6 billion and $36 billion annually. The toll is staggering and begs for a response to the question, “What can be done?”

Readers of this column would be aware that I am no fan of the term “bullying”. It carries the implicit labels of victim and perpetrator, which are disempowering and binary – you either are bullied or you’re not, either the victim or not.

The instances of the legitimate use of...

Robert Aurbach | Published: October 13, 2015
That resilience is learned also fits with our common experience – sometimes we “discover” new ways of coping through experience or training.
So how do we learn to be resilient?  If it’s behaviour, we learn it the same way we learn many other behaviours – through practice.  Think of any complex behaviour: playing a scale on an instrument, kicking a footy, forming words without having to think about how to move our mouths to make the correct sounds, “working the room” at a social function.  We learn by practice.
The Practice Effect is how we learn virtually all complex...
Dr Mary Wyatt | Published: August 25, 2015
Patient histories are by nature unreliable as people’s recollection skills are never perfect. We are human after all. My estimate, based on research and everyday experience, is that the history of long term health problems is only about 50% accurate.
I’m a doctor but have also been a patient - not very often, but often enough to know that my recollection is just as poor as the patients I see.  
I’ve been in situations where I’ve been asked about my past history and forgotten it. Only a day or two later have I realised that I should have mentioned x or y, relevant...
Dr Mary Wyatt | Published: July 28, 2015
First of all, policy makers need to get interested in this area. Taking the lead on this is a significant initiative, so I think it is up to the policy makers to map out a plan. They need to involve a number of subject matter experts, including research specialists and people with the capacity to translate research, and it would need to be collaborative.
Medical specialists can also make a substantial contribution. Organisations such as the Faculty of Occupational and Environmental Medicine possess the knowledge but not the funding ability. 
The Dutch have created a...
Dr Mary Wyatt | Published: May 26, 2015

The challenge we face is that a person’s recollection of their health problems is not reliable.  

I’ll use back pain as an example.  

Studies of large groups of people tell us that back pain is common. 20% or more of the population has a long term back complaint, where they experience some level of back discomfort or soreness on most days.  More than 30% of people experience intermittent episodes of back pain. Only about 30% of the working age population have never experienced back pain.

New and better quality studies suggest that people can move from one of these groups to...

Robert Aurbach | Published: April 07, 2015

The scenario is familiar. The regulator is dictating procedures, limitations or reporting requirements that are stifling innovation and your effectiveness. Worse, your industry is being blamed for lacklustre results, in an environment where good outcomes are next to impossible to achieve.

Alternatively, the regulator is treading water in an environment that demands action if fair access and opportunity are to be achieved.

You can try to live with it, and play along with a system that seems completely uninformed about the needs and demands of your role, or you can try to...

Dr Mary Wyatt | Published: March 10, 2015

A United States study published on March 14 found when patients requested specific medications from the treating doctor, they were much more likely to be prescribed that medication.¹

Actors were sent to see doctors about musculoskeletal problems. Some of the actors requested medication they said they had seen advertised on TV, or medication friends had taken, while some actors were instructed to leave any medication up to the doctor. Those who requested specific meds were much more likely to get that medication.

This doesn’t come as a surprise. Pharmaceutical companies can...

Robert Aurbach | Published: February 10, 2015

Some people "get it" better when they see it in print. Some people give more credibility to something that has been published. To date there have been few resources to encourage and empower injured people to take an active role in their own recovery. That "hole" is about to be filled.

I have been fortunate to be a "beta version" reviewer for a new publication that will likely be of value to you and the people you serve. "Living Abled" by Dr Christopher Brigham is the culmination of many years of experience and development by an occupational physician who has struggled with how to...

Robert Aurbach | Published: January 13, 2015

A recent study* confirmed what many of us expected, based upon experience at the coal face.

An injured person's expectations regarding recovery are a far better predictor than anything else for the course of their recovery.

People who expect to do well generally do so, despite other "flags" indicating a poor likelihood of return to work. People with expectations that were not as good had poorer outcomes. Much poorer outcomes.

This is not "just another study". This was a well-designed study by one of the most respected research organisations in the world, studying a...

Robert Aurbach | Published: December 09, 2014

How strange. We have a lot of knowledge about work restrictions with regard to physical injury. Back injuries generally don't like sitting. Shoulder injuries generally don't like overhead lifting. You know the drill.

But when it comes to psychological injury, the understanding of GPs and other health professionals seems to get much more limited. Rest and separation seem to be the only things that get prescribed in most cases. And, there's evidence that this is a prescription for the worsening of the condition in many cases.

Stress, depression, abusive situations and anxiety all...

Robert Aurbach | Published: November 25, 2014

There are many systems for "flagging" people at risk. The intent is to identify people who are predicted to have poor outcomes so that additional resources can be channelled to them, improving the probability of an injured worker's return to life. The intent is good, but, with a few notable exceptions, these flagging systems carry with them dangers that may undo the intended good.

Flagging systems are based on statistical observations about things happening in the injured person's life and their recovery outcomes. When the two things happen together more frequently than pure chance...