Help
“You have provided for my information the documents as outlined in your schedule of documents. This was both adequate and appropriate for the purpose of carrying out an Initial Medical Assessment.”
Strangely enough The schedule of Documents is inaccurate and the ACC also appeared to have forgotten to include several other medical reports.
I have of course asked the learned Medical Professional to clarify his statement.
1 . Would Dr .... agree that an assessing physician requires a complete patient history including all medical reports as well as specialist reports i.e. physiotherapy, occupational therapy, psychological and psychiatric reports to be supplied to the assessing physician before reviewing a patients case and making any diagnosis or recommendations on the basis of reasonable medical certainty.
2. Is it now accepted practice that medical assessors accept as adequate and appropriate a compendium of reports from the ACC and do not require a complete documented medical history?
I am of course waiting with anticipation for the learned Medical Specialists answers…
I do know of one instance when a learned medical specialist referred a patient for enhanced radiological examination. Unfortunately an ACC case manager had deliberately omitted the patient’s medical history, which included a severe allergy to Iodine. Can you imagine that patients agonising death as the Iodine dye blistered and boiled away the patients entire venous system. *
Of course I already have a third unasked question. Basically what qualifications would be appropriate to enable an ACC case Manager to reliably bowdlerize a claimant’s file? – Logically that answer is a medical degree.
Which led to this strange flight of Fancy! Well it is raining outside, the TV died on friday night & some stupid bastard cut my SKIL Saw lead in half so I can’t play downstairs either .
One of the failings of the present ACC system is that Injury and rehabilitation Cases are managed by “qualified” and occasionally well meaning clerks. It is readily apparent that the present case management system is unwieldy and open to mistake and abuse.
Obviously case managers are always going to be making mistakes when interpreting medical information and the legal requirements of the ACC Act. One just has to look at the unwieldy systems that the Minister & ACC has put in place in an attempt to rectify the sad situation i.e.
- 1. The review process. And the detrimental effect that this has on Injury Sufferers. For example patients are continually being denied rehabilitation and treatment for injuries and that by the time a “case managers” decision has been reviewed and appealed years have sometimes been lost before rehabilitation can begin.
- 2. The ACC approved provider scheme; which appears to have been introduced to provide patients with a choice of qualified service and treatment providers.
As I see it one of ACC’s jobs is to provide treatment and rehabilitation in order to return a patient to “work” as quickly and as economically as possible. Obviously it is costing the ACC & the patient considerably (both financially & physically) when delays in treatment or rehabilitation caused by faulty case management practices are experienced.
I also see that is the job of both the Minister & the Management of ACC’s responsibility to oversee the system and as part of that oversight to identify problems and flaws in the system in order to be as fiscally responsible as is possible.
Which brings me back to this!
Logically the most qualified person managing a claimants case and rehabilitation on a day-to-day, basis is the patients own Doctor. So I would suggest that the Patient’s primary ACC case manager should be the patient’s own GP.
It is obvious that the GP is working in a relatively efficient and proven system already, i.e. the medical system.
For example a Doctor when faced with a problem or requirement outside of his particular area of expertise is capable of identifying the patients needs & will refer a patient to the appropriate service or specialist e.g physiotherapy, oncology, orthopaedic’s, obstetrics.
By removing the need for a third unqualified party to second guess every decision, recommendation and referral made by the GP; the delays, inefficiencies and mistakes of the present faulty and inadequate case management system would be negated allowing for a much speedier recovery and less costly resolution for both ACC and the patient.
Obviously the present review system would then be redundant resulting in immediate and considerable savings to both the ACC and patient.
Not as obvious but I would suggest that there would no longer be a need for ACC approved providers & assessors.
I would hate to suggest that an industry has grown over the last few years catering solely to the ACC's base requirements. It is however, apparent that some ACC approved providers will only provide the minimum of a service required which although not detrimental to a patient’s rehabilitation and recovery are often less efficient & effective.
Simply removing the compliance costs of being an ACC approved provider and using the established medical and rehabilitation systems already in place would result in savings for the provider and consequently in savings to the ACC.
Simple patient choice would then see the less effective and efficient providers disappear from the market place.
It is an acknowledged fact by ACC that the present case management system is overworked and understaffed and that existing case managers have too heavy a caseload. Obviously the case managers are extremely stressed and consequently more prone to making mistakes.
By returning Primary case management to a patient’s GP, ACC would effectively remove the possibility of mistakes and inherent injustices in an overworked, inefficient and fault ridden system resulting again in huge savings, for both the ACC and the patient.
Such savings I suggest would be substantial and should over time result in both cheaper employer and earner levies.
I can only see the above suggestions as a Win Win situation for the entire ACC system, patient, taxpayer and the country in general.
Of course there would be loud squeals of discontent from those glutting themselves at the ACC trough and some job losses. I am however sure that some of the more suitably qualified profesionals & case managers could go on to develop meaningful careers in telephone sanitization or canine excrement collection.
* FYI. The patient didn’t die. Although severely brain damaged the patient adamantly refused too allow the procedure and became hysterical about it. Carefully and sympathetic questioning by the staff eventually revealed the patients knowledge of an allergy to iodine, which was tested with a simple skin swab! The radiographer immediately cancelled the enhanced radiological exam. As for the assertion that ACC deliberately withheld the medical records. There used to be a post about ACC double stamping files… Well the patients medical history noting iodine allergies had been double stamped and withheld from the consulting specialists.
makes proper inquiry if the need for inquiry is indicated. 
Whoa ...love the pictures and concept freefallnz ... mmmmm do we have to kiss the toad so it will turn into a princess ooops sorry in this case a horse.
