On 12 Aug 1996 18:46:04 GMT, [log in to unmask] wrote:
>
>How are the rest of you getting on with the requestors of MED4 and the
>follow-up questionnaire?
I was sold the new system on the basis that after a Med4 and possible
follow up questionnaire I would not have to sign any more sick notes
which would:
a) save me paperwork.
b) avoid the sometimes difficult conflict of interest when you are
trying to maintain a therapeutic relationship and prevent
lead-swinging at the same time.
In practice what has happened is quite commonly I will do a Med4 only
to find I am asked for another one a few months later. I have just
completed the third Med4 in 9 months for one patient whose diagnosis
has not changed. My local DSS tell me this is "normal" practice for
the BA doctors who look at the Med4 and judge this patient unfit for X
months (always the same figure I wrote on the Med4) without needing an
All Work Test (i.e. without needing any work on the BAMS doctor's
part) and ask for "new medical evidence" at the end of this period
(i.e. another Med4 from the GP).
Surely this is wrong - at the very least against the spirit of the
new system. The practical result is that I am still the one making
the medical assessments except that now I also have all these extra
questionnaires to fill in as well. What do the BA doctors actually do
to justify their pay???
Also, my patients have often been asked for a Med3 by the DSS while my
Med4 is still current, because their previous Med3 had run out.
Excuse the rant but it's a subject I feel very strongly on!!
Dr David Evans
Cardiff
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