Photo: 123RF
The Accident Compensation Corporation (ACC) is looking to tighten up on the medical certification process as the average time of work for those injured increases.
It's looking to set up new prototype agreements with organisations that have proposals for delivering "effective improvements" and already have "substantial reach into primary care".
ACC said it was trying to standardise medical certification practices.
"As the main entry point into the scheme, we see primary care as a critical contributor to this effort," ACC acting chief clinical officer Dr Dilky Rasiah said in a statement.
"The current request for proposal - improving return to work outcome with primary care, is one of the ways ACC is looking at how we can work better with the primary care sector to improve medical certification practice to support better rehabilitation and return-to-work outcomes.
"We're not simply aiming to reduce the number or duration of certificates, although this may occur in some cases, but rather we are aiming to ensure that certification more accurately reflects the individual's injury and recovery potential."
Dr Rasiah said certifying practitioners were uniquely placed to assess and determine a patient's suitability for recovery at work.
In the last financial year, ACC covered more than two million new injury claims and paid for $5 billion worth of treatment and rehabilitation services in total.
GenPro chair and Riccarton GP, Dr Angus Chambers said it appeared ACC was trying to manage public funds but was concerned by their approach.
"That's a responsible thing to do and actually, GPs take that responsibility very seriously, too," he told Nine to Noon. "We've got a great obligation to the patient, but we also have these other obligations as well.
"On principle, I think people would accept that there's a case to be said to address the issue, but we're probably quite concerned in the approach ACC is taking, perhaps globally as well as to this.
"Investing in another bureaucracy to manage the situation, we're really not sure is the right way to go. You can see quite a lot of money being put into a service that is actually separate from general practitioners and while there are linkages, they've got different needs in their organisation. So, we're not really sure that's the way forward."
Dr Chambers said GenPro had struggled to engage with ACC and had been trying to meet with ministers.
He said it would have been a great opportunity to start the conversation about how they could work together to improve processes.
Dr Angus Chambers. Photo: Supplied
Dr Chambers said a standardisation of medical certificates may be being considered.
"It's all very well having guidelines, but every situation is different," he said.
"One of the things we believe that general practitioners and nurse practitioners can offer to the system is a good knowledge of the patient. These things don't happen in isolation. So that kind of relationship is key.
"A guideline may well be helpful. We actually don't even have any evidence of how well or poorly these certificates are being done. So, it would be quite useful to know what's this coming from.
"Is it that injuries are getting more severe or treatment is unable to be accessed, which is leading to increased costs? That would probably be useful to know."
He urged caution over guidelines and clinical oversight but didn't object to the issue being looked at, rather how it was done.
Dr Chambers said there was a risk it could become prescriptive.
"Very much so ... if there is prescription, it means that there's a lack of trust and judgement and we would find that problematic," he said.
"Every case is different ... we would think being prescriptive about it would be problematic. I'm sure they would like to see that from a cost management point of view, because that's one of their focuses here.
"But I could see problems falling out of prescriptive approaches."
Dr Chambers it was unlikely there would be interference by third parties on decisions made by GPs.
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