EBM Insights podcast series is a deep dive into current issues surrounding insurance and risk management in today’s ever-changing world.
Introduction:
Complete Corporate Health
In this podcast we talk with Dr Richard Kain, Medical Director at Complete Corporate Health, an occupational health service provider.
For more information on Complete Corporate Health please visit www.completecorporatehealth.com.
A transcript of this podcast is below. The complete EBM Insights podcast series is available here.
00:00:06 Speaker 1 – Disclaimer
In this podcast, we have provided general advice only and not personal advice. In giving this advice, we have not considered your personal circumstances.
00:00:19 Speaker 2 – Sandy Cattley (Senior Marketing Specialist, EBM Insurance & Risk)
Welcome everyone to this podcast. I’m your host, Sandy Cattley from EBM Insurance & Risk.
On one of our previous EBM Insight episodes, we discussed how to support an employee during an injury claim and how to reduce the duration of a claim.
For that episode we were joined by Dr Richard Kain from Complete Corporate Health, an occupational health service provider.
Today, we’re very fortunate to have Richard join us again for what is his second appearance, so welcome back, Richard.
We’re also joined by Julian Lane, EBM’s National Manager of Injury Management, and Clancy Carter, EBM’s Return to Work Specialist. Clancy is a Physiotherapist by profession and leads EBM’s new Early Intervention Return to Work Service.
Thanks to all of you for joining us today.
So last time Richard joined us, we discussed how to support employees during an injury claim. Today, we will discuss the importance of return to work services to help employees do just that, get back to work after injury.
Julian, EBM recently launched the Early Intervention Return to Work Service. Can you tell us a bit about that please?
00:01:45 Speaker 3 – Julian Lane (National Manager – Injury Management, EBM Insurance & Risk)
Absolutely, Sandy. So, the EBM Injury Management department had seen the impact that a really strong best practice approach from the employer can have on their claim experience. But we also recognise that not every business can justify employing someone with the relevant skills and expertise.
We felt that there was an opportunity to offer a service that allows clients to have this resource available to them on an as needed basis and having worked with Clancy previously, I was over the moon when the opportunity came to get her on board to drive this service that we’ve built to align with the It Pay’s to Care research paper, which is ultimately aimed at helping our clients minimise the impact of any workplace injuries through helping get their workers back to work safely and efficiently.
Richard, I might ask you to give a bit of an overview of some of those key findings from the It Pays to Care research paper.
00:02:36 Speaker 4 – Dr Richard Kain (Medical Director – Complete Corporate Health)
Thank you. Dr Mary Wyatt’s white paper, I think was 2022, is a very comprehensive piece of work which encompasses both research and an opinion piece about how the sphere of occupational medicine ………..improve terrible outcomes that we see inside this space of injury management.
It is a really comprehensive document, and I do implore anyone who’s not read it to at least find an abridged version online and read and digest that.
I’d just like to make a few points just to paint a picture about why it is so difficult to work in this challenging sphere of injury management and occupational space.
The first point I’ll make is despite the increased focus and effort, the compensable claim numbers continued to rise right across Australia and Safe Work Australia has suggested that the last year was about a 6% increase. Of those claims, significant mental health claims make up 10%, so 1 in 10. Hence there’s a staggering 64% increase in those claims over that period. So, we have increasing claims and in particular, increasing mental health claims.
The next point I’d make, which is posed as a question of whether workers are happy in their role, and to answer that is a resounding no. As information we get from the Gallup Workplace Satisfaction data, which showed that 17% of workers were actively disengaged within their work, with only 31% been satisfied with the role that they occupied.
Across the board, the numbers of dissatisfied workers reach as far as 60%, so two and three workers in the workforce are not particularly happy. So, in effect, we have increasing numbers of dissatisfied and stressed workers who, when they become injured or ill within the workplace, are forced into an insurance driven compensable healthcare system of which they have little control. So, when you factor that in you can see why we have some really poor outcomes.
If we then go on and look at the imperative to return injured workers to the role of the workplace as quickly as possible, and the reason we do that, if all we remember is that after three weeks of being absent from work, 30% of people never return, and after 10 weeks 65% of people never return to work if they’ve been absent.
So, we’ve got this imperative: that return to work being vital to avoid the catastrophic event of long term loss of work. Long term loss of work is associated with halving of your life expectancy.
I’ll repeat that – if you don’t go back to work, well if you never go back to work, you halve as long as you’re going to live.
So, with this background you can start to get a feel of why such poor health outcomes and negative changes to a workers’ life has such a huge impact.
So that’s where Dr Mary Wyatt comes in and with a pivotal discussion paper and research surrounding understanding why injury management within the occupational sphere produces such poor outcomes.
She looks to create a mind changing approach of caring for injured workers, with change to systems, processes, and policies, but mainly to focus on superior outcomes to avoid the catastrophic event of permanent damage to people, families, and community.
I’ll just leave it at that cause I could go on forever, but I would really implore you to try and get an abridged version, which is a lot more digestible and really make yourself familiar with that.
00:06:25 Speaker 2 – Sandy Cattley
Thanks, Richard. So, what does this research tell us about the financial and operational benefits of early intervention in workplace injuries?
00:06:35 Speaker 5 – Clancy Carter (Return to Work Specialist, EBM Insurance & Risk)
I think I can jump in there Sandy. I think a lot of what you just mentioned Richard, fits in with looking at the financial and non-financial costs of delaying that prevention in return to work for work related injuries. Obviously, you’ve got things like your increased costs for work related injuries and claims which then you know often will lead to increased premiums for employers.
You’ve then got your protracted return to work timeframes as well, which again is a financial cost you’re potentially pay wages for a longer period of time while someone gets better and gets back to work. Then you’ve also got things like your non-financial side of things like your increased potential for psychosocial hazards. When someone isn’t managed or isn’t assisted in a really good, supportive way that will significantly increase it and then there’s other things as well, such as your lost productivity for the employer. You know…the requirement to find people to do overtime, there are organisational challenges as well, we’re looking at hiring additional staff to cover the absence of those workers that are unable to get back to their primary role. And also, a big thing I think that’s important to consider is the decreased morale of the workplace. If the wider workforce feels that there’s poor management of work related injuries by the employer, it can really lead to a negative impact on workplace culture, which then affects the organisation in a larger extent.
00:08:10 Speaker 3 - Julian Lane
I think another way of looking at it as well is almost flipping that on its head and sort of talking about an opportunity to support your workers and the positive benefit that can have on your overall workplace. When you’ve helped a worker through that period of vulnerability back to a position of health, the positive impact that has on the workplace.
00:08:29 Speaker 4 - Dr Richard Kain
Just going on with that, I think it’s a huge opportunity for employers and particularly with the backing of insurers and brokers, it to be proactive to create a system that’s all about caring, that’s what Dr Wyatt is talking about is that put the person first and you’ll get the best outcomes to support them, whatever’s going on. Whatever private thoughts you might have about the case, put that aside and just focus on the outcome of getting them back to work.
Statistics show that 20% or 80% of people get back to work fine without a problem. Unfortunately, that 20% are huge and they take up a lot of resources and a lot of money.
If we focused on everyone, I think that would get smaller and smaller until such time that we would start to get some really meaningful results. But it’s about being proactive. It’s about thinking about what they need. We were talking about before that we need a multi- disciplinary team, you know, physios, exercise physiologists, good occupational doctors, psychologists, and other allied health professionals, but also a suite of tertiary specialists, you know, surgeons.
We need to get injured workers into the system and out of the system as quickly as possible. If we can keep them out of the system, all the better. That would be the best and when we come into really early interventions, through physiotherapists, exercise physiologists, monitoring systems at work, seeing where people are starting to say, look, I’m struggling here. I think when you have a holistic approach to looking after your workers, people are going to really start to do well.
00:10:12 Speaker 2 - Sandy Cattley
There’s definitely a business case for an early intervention service. So, what I’ll do is pose the next few questions to the Group.
How does early intervention reduce the duration and cost of workers compensation claims?
00:10:29 Speaker 5- Clancy Carter
There’s so much to talk about. We’ll pull out a couple of statistics from the It Pays to Care white paper. Which I think are really significant and worth noting.
So, the research shows that workers who consider that their employers response to their injuries is fair and constructive, have got significantly higher return to work rates. They’re looking at approximately 43% higher for physical claims and 52% for psychological claims which obviously is incredibly significant. In addition to that, when we’re looking at employers that have systems and approaches which prevent and lessen psychosocial factors similar to what you were just saying, Richard, it almost can reduce work disability and the costs associated with that by 25 to up to 50%, which again is you know is huge.
Look, I think in summary realistically the research is just showing that supportive early management paired with consistent positive communication from your employer leads to significantly reduced costs and duration of claims and happier workers that are happy to engage in the process and go back to work. They feel supported by their employer, and that leads to quick in and out of the system, the system plays its part, and we get good outcomes for everyone.
00:11:54 Speaker 2 - Sandy Cattley
And are there specific industries where proactive injury management is particularly crucial?
00:12:03 Speaker 4 - Dr Richard Kain
It’s an interesting question, Sandy, I’ve been racking my brains about that and for me, I think people outside the metro area, particularly with fly and fly out, who come and go through Perth airport and then they could be anywhere from Bali to Collie or to the east coast of Australia for me they are vital that we get to them early and you know the point I’ve made there is that with the advent of telehealth we can, as a doctor, we can get there very quickly. Physios can too. Sometimes we have physios on site, exercise physiologists and they need to be literally corralled to have a consultation, to make sure to gauge the risk. Is this a serious injury, or is it not? How are they doing from a psychological aspect, they’re, you know, they’re really starting to hate work and don’t want to fly in and fly out. And, really, they’re looking to leave not just the system that they’re in, but actually their role as well. Just going back to what Clancy said about the psychosocial stresses and that’s the huge part of Dr Wyatt’s research is that unaddressed psychosocial risks are the biggest driver for very poor outcomes. But if we can get them early or a physio that can gauge where they’re at, how serious is this operation? One, they feel that someone cares. We can then do a risk assessment. We can talk about a management plan or if we can work out what the diagnosis is or at least we can troubleshoot it if they’re flying to Sydney, we say, ‘Who’s your GP? Let me e-mail them. Let me talk to them about it.’ It’s the people that fall between the cracks and the next thing you know, you’ve got three months later, you’ve got a first medical certificate with three months that’s it from work, just ends in disaster. So hugely important to get to people early and to make sure that they know they’re cared for.
00:14:00 Speaker 5- Clancy Carter
I might add to that. I think obviously, all industries are important. We’re not picking and choosing here, but I think you touched on it then, Richard, it’s perhaps those industries where there is more of a potential risk from a psychosocial hazards perspective. So, you mentioned your FIFO, your mining. I also think healthcare where there’s significant pressures from a work demands perspective, perhaps there’s not a huge amount of support. I guess it’s just not necessarily high risk, but there’s that potential if there’s not really good systems and structures in place from an employer perspective.
00:14:36 Speaker 2 - Sandy Cattley
What are some best practises that employers can adopt to improve injury prevention and early intervention?
00:14:43 Speaker 5 - Clancy Carter
This is where Julian and I are so excited about this new service. I think in terms of the practices that employers can put in place, we’ve already talked about it – it’s early and ongoing positive communication with their workforce. You know, it’s also engaging that worker in the return to work process and in their recovery journey versus instructing someone or dictating what they’re to do. And I think that’s really empowering for workers and, you know, has shown to lead to a much more positive outcome. And then I think, look, obviously engaging a service, if the employer doesn’t have the means to manage return to work or work related injuries or workers compensation claims, which again a lot of them don’t. As Julian mentioned, a lot of companies don’t have that financial means to employ someone who is a specialist. By all best intentions, the person managing is doing their best, but it could be done better. So, we’re building this service so that myself, can be that resource for an employer. We can get in there early to provide that really proactive approach, early identification of the psychosocial hazards, making sure that the worker is booked in with a GP, an appropriate treatment provider, as soon as possible, and even just checking in with them as well and seeing how overwhelmed they are by the process and what other supports they might need in place. I think it’s such a beneficial service for us to have.
00:16:26 Speaker 4 - Dr Richard Kain
I’ll add to that Clancy that I’m just talking about choosing your weapons really of who you’re going to use.
I’m about to talk to a group of 20 GP’s that are fully booked for days in advance and then if they get a workers compensation claim for one of their patients, they’re not going to see them same day. Everyone needs to be seen the same day of the day after – it’s imperative. If you’re not, the times ticking and you’re losing traction. So, I’m going to talk to them about, one, I’m going to educate them about the sphere that I work and breathe in and how important it is. And if they’re not interested in doing that, or don’t find they’ve got the capacity, then send the work to us or someone like us. It doesn’t have to be me, but it’s highly specialised and it’s fraught with danger if you get it wrong and for a GP to be the advocate and give their patient days and weeks off is really very detrimental to their health outcome.
00:17:32 Speaker 2 - Sandy Cattley
How can employers quantify the ROI of investing in an early intervention?
00:17:38 Speaker 3 – Julian Lane
I think we’ve sort of spoken to that early identification and management of psychosocial factors as being one of the biggest benefits of engaging the right person or right people, but again, there’s also efficiencies there in minimising lost time where you’ve got a suitable duties register drawn up, which is part of the service that Clancy provides. Making sure that you’re working with a GP with that occupational expertise that the information’s there really. It’s hopefully making their life pretty easy, and you can implement that return to work plan really effectively and efficiently. But it’s also that early access to relevant quality treatment to address that individual’s injury and help them on their recovery journey.
And no two injuries are the same. You’re going to find that the needs of that worker are going to vary from time to time, and we also find that with that proactive management approach, there will be some minor injuries that resolve even without the need for the insurer to pick up any costs.
Likewise, I mean insurers like working with employers who are proactive in that risk space, and we see this as another opportunity to demonstrate that to them. And I guess some of those slightly less tangible benefits that we’ve touched on include that sort of happier, more engaged workforce where that positive experience of being supported back to health also helps with that ongoing relationship between employer and their workers. And there’s also just that relief from your end as a business owner in knowing that those work related injuries and claims will be managed by a specialist who’s able to help navigate that often challenging multi-stakeholder scheme and advocate for you to help achieve that best outcome for both the worker and the employer. So yes, one less stressor for them.
00:19:47 Speaker 2 - Sandy Cattley
How important is collaboration between employers, insurers, and healthcare providers in ensuring faster recovery and return to work outcomes?
00:19:56 Speaker 5 - Clancy Carter
Look, I think as we’ve all discussed throughout this podcast, it’s, you know, it’s incredibly important. I think from not only the research in the It Pays to Care report, but just day-to-day, myself and Richard and Julian have seen what happens if we don’t collaborate and everything goes downhill basically. Some of the issues that were raised in the It Pays to Care report was the idea of fairness from a workers perspective. What is their diagnosis? Is the treatment provided or recommended? Is that fair or do they feel that they should have something else to support their recovery. Delays were also a huge, huge thing and again that relates back to that collaboration because if we’re not collaborating with the stakeholders involved, we’re looking at potentially reductions or delays in the worker getting their weekly payments. So, at a financial disadvantage potentially if there’s not that collaboration with the insurer. Again, they might not actually have funding for the treatment that they need early enough and then again, we’re just getting them offside from the get-go.
It’s very easily avoided, and the interesting thing is everything we’ve talked about today – it’s not rocket science. We’re looking at proactive management, really clear communication that involves that worker and makes them feel that they’re in control of their recovery and return to work journey.
But for whatever reason, we haven’t quite got it yet and I think that what we’re really hoping this service will really assist the worker and employers and just doing a better job of managing it and just keeping people happy and healthy and getting them back to work.
00:21:51 Speaker 4 - Dr Richard Kain
I think Clancy the bit that was missed, I mean the systems process has always been fantastic. Big money we’re talking about across Australia, but what Dr Wyatt really emphasises is the care factor. Care for the injured worker, care for the outcomes.
Before, we were so focused on the outcomes that we forgot about supporting the person and some of the things I listed at the beginning, we’ve got unhappy people, stressed people, disenfranchised people. They’re going to go their own way, and they’re allowed to go there and with the new Act, they can see anyone they want. But I think that the key to that is if an employer can get them in to see a doctor on the same day or soon after, or even the physiotherapist, to really start the process rolling, they’re going to feel very cared for. They can go to their own GP. We can see in 3-4 days a week. That’s not going to get us anywhere far. So, I think that injured workers can see anyone at the end of the day they very quickly realise what sort of service they get through professional organisations.
00:23:05 Speaker 2 - Sandy Cattley
So, for you, Richard, if employers and insurers take away just one key lesson from this discussion, what should it be?
00:23:13 Speaker 4 - Dr Richard Kain
Yeah, I touched on that earlier and that’s any injured workers should be embraced by their employer and shown and introduced to some quality providers of healthcare. And I think if you go into a clinic that’s designed for occupation – they can see a lot of high-vis and other injured workers there and they feel comfortable and, sorry this sounds bad, but it’s not screaming kids, and you know and fights in the waiting room. It’s quiet, it’s relaxed and they’re seen on time for their first consultation. They’re given half an hour, there’s lots of details gone into. The person’s hopefully inviting maybe the injury management coordinator in afterwards to talk about it because, you know always it’s what’s the diagnosis and from that, what’s the management plan and the prognosis, it’s always the gold standard. If that’s conveyed and well-articulated, they feel that there’s collaboration between your employer, the injury management coordinator, the Doctor, the physio, the clinical psychologist.
And really you need organisations that have a holistic approach and easy, quick access to a whole range of clinicians, because as we all know, if you want to see a clinical psyche, you might be waiting for three months at the moment. But adjustment disorders, counselling we find, you know, psychosocial. This is vital. We know if we get that early and they get help that all just evaporates, and they move through the system very easily.
00:24:59 Speaker 2 – Sandy Cattley
I would like to mention that Dr Kaine and Complete Corporate Health are part of EBM’s Risk Solutions Network. This network has been set up to help our clients gain access to key resources and support to assist them to identify, understand and manage their risks.
More information about the Risk Solutions Network and our new service, the Early Intervention Return to Work Service, which is led by Clancy, has information about it on ebm.com.au so please go there and take a look or chat to your EBM Account Manager for more information.
I would like to thank Julian and Clancy for their time today and finally a big thank you to Dr Kain for joining us again for this podcast. If f you would like to learn more about Complete Corporate Health, please visit their website at completecorporatehealth.com.
Once again, thank you for sharing your expertise today.
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