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Dear All I am not sure that an OH physician is really necessary for all of the actions outlined by Kate. If, for example, an employee working on a computer developed a tendonitis, I think it would be appropriate for the OHA to liaise with GP for specific information on diagnosis, advise employer on work modifications and on reporting under RIDDOR. Many OHAs work in isolation without the benefit of specialist OH physician advice, perhaps with only a GP with OH diploma. I might feel that the appropriate referral in this case would be to a specialised physiotherapist/osteopath/ disability employment advisor rather than an OH physician. Where they are essential is if litigation is anticipated,(no matter how simple the case) and commonly for ill health retirement cases(although some schemes will accept GP report/opinion) I am in a lucky position to work closely with OH Physicians, I generally write all letters ,and draft the more complex ones and show to OHP to discuss before posting. Diane ----- Original Message ----- From: "Kate Venables" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, October 14, 2002 11:21 AM Subject: Re: GP and OH Professionals Dear list - sorry, I need to expand. If the issue is diagnosis of occupational disease, medical assessment for fitness to carry out particular work or in relation to adjustments in the workplace etc, the employer really should be asking an occupational physician for an opinion. If it is a question of obtaining copies of test results or hospital summaries, the employer again needs input from an occupational physician. This leaves a third area, of asking the GP to clarify a diagnosis or treatment where the patient is unsure. I agree that the GP should communicate clearly with a colleague and it does not matter if that colleague is another doctor or a nurse. Have I missed something out? - Kate >>> Amanda Dowson <[log in to unmask]> 14/10/02 10:33:44 >>> I appreciate that you may feel that getting an Occ Physician to write to GPs rather than OH nurses, may elicit a better response. But isnt it a sad state when the initials after a persons name is all that is required to get an appropriate and professional report on a patient. By doing this are we acknowledging the OPs superior letter writing skills, interpreting of report skills, or a general superciliousness on the part of some GPs when responding to nurses ? Amanda > ---------- > From: Kate > Venables[SMTP:[log in to unmask]] > Reply To: Kate Venables > Sent: Friday, October 11, 2002 11:40 AM > To: [log in to unmask] > Subject: Re: GP and OH Professionals > > Dear list - the, admittedly rather narrower issue, of request for > pre-payment of fees for doctor-to-doctor communications, has been on the > agenda of the BMA Occupational Health Committee, was raised at the BMA's > Annual Representative Meeting last year, and has been discussed by the OH > committee's chair with the Chair of the GPs committee. Susan Robson (OHP, > Manchester University) is the OH committee chair. Can I suggest that the > authors of all of the excellent, creative and practrical comments posted > to this list should copy them to Sue [log in to unmask] ? > > There are some very important issues here around the responsibility within > a GPs NHS terms and conditions of service to provide information relevant > to the patient's health and welfare in the workplace. > > Lindsey - maybe you need an occupational physician for the information > required? > > Best wishes to all - Kate > > > >>> <[log in to unmask]> 11/10/02 09:56:14 >>> > Having not logged on for a few days, I have had the chance to read the > original email and all the replies (twice) and thought I would add my own > thoughts. Sorry Bashyr, good try at calling a truce, but this one drives > me nuts - (my professional opinion!). > > 1) There are some brilliant and caring GPs out there, but there are also > far too many who really let the side down. All too often our OH service is > hampered by poor quality, slow, costly reports that are of no benefit to > anyone - particularly the employee/patient. And that's when they arrive. > > 2) I've always regarded services as things you pay for once you have > received them. I don't ask a plumber to mend my taps and pay him an hours > wages before he turns up. And if GPs don't like being compared to > plumbers, I would treat lawyers in the same way. > > 3) Although I am aware of the pressures on GPs and the NHS in general, I > find it unacceptable that this sort advice, which is not sought free of > charge, is often not available to support Occupational Health Departments > in their role as a small but important part of the primary healthcare > team. There has been much research recently to show the benefits of the > workplace on health and recovery. Should we not receive the support we > seek, employees may well deteriorate and place an even more onerous burden > on other services, particularly if they lose their job. > > 4) Mark, I'm sure your information about Government contracts and > expectations is true but it staggers me. Not only do we now have a > Government that expects its own departments and NDPBs (Quangos) to be > leaders in OH, while threatening to tax any OH initiative that has the > slightest bit of imagination attached to it, they are now telling us to > manage absence with the best of British industry, yet don't even > officially provide the avenue for a major, and arguably, the most > important source of health information. > > Beyond the rant, please take this as another request for the Hallam Street > information and address. I'll also lay down a challenge to the GPs on the > list. How about getting this issue on the Royal College of GPs agenda. > I'm sure you will have plenty of volunteers on the list willing to address > their next conference. Count me in. > > Lindsey Hall > National OH Manager > Environment Agency > > PS Great Debate - These sort of issues really need one. >