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Stay up to date with important information that impacts the profession and your practice. Doctors of BC provides a range of newsletters that target areas of interest to you.
To streamline access to important information coming from WorkSafeBC and ICBC, Doctors of BC has compiled the latest updates into quarterly newsletters. These newsletters aim to provide doctors with a more accessible and organized source for staying informed.
Blood and body fluid exposures in the workplace: Scenarios you may encounter in your clinic
April 2024
Blood and body fluid exposures can occur in a variety of health care workplace settings. As a physician, you have different roles and responsibilities in different situations, particularly if you manage your own clinic. Below are three scenarios you might encounter in your clinic as an employer, worker, and primary care provider.
In this column, we often address physicians as providers: professionals who ensure workers across BC get the care they need to recover from work-related injuries. This month, we address you as workers yourselves: people who face unique physical and psychological risks at work.
At WorkSafeBC, we have seen that violence and other threats to safety are top of mind for many. In 2022, half the physicians surveyed by Doctors of BC said they had been involved in or impacted by a physical or psychological safety incident in the last year, with psychological safety incidents being more common.
New legislation to shift the needle on prolonged disability
January/February 2024
Unemployment and worklessness are critical social determinants of health and economic stability. Losing their livelihood can put workers at greater risk of morbidity, mortality, and social harms. For employers, losing experienced workers can cause them hardship, affecting overall productivity, staff morale, and their workers’ compensation costs.[1,2]
A recent amendment to the Workers Compensation Act aims to reduce the risk of prolonged worklessness after a work-related injury by introducing new duties for employers and workers as of 1 January 2024.[3] The goal of the legislation is to encourage connection and collaboration between employers and workers by setting out formal responsibilities in the event a worker sustains a work-related physical or psychological injury or occupational disease.
Perspectives on the value of the clinical exam for your patients with work-related medical conditions
December 2023
When I started my medical training in 1984, the general understanding was that clinical history contributed about 70% to establishing a diagnosis, with physical examination and investigations contributing about 20% and 10%, respectively. Since then, remarkable advancements in medical imaging (MRI became widely available only in the early 1990s), other rapidly advancing technologies, practice pressures, and virtual care have all influenced the role of the physical exam.
Performing a return-to-work consultation for patients with a workplace injury or illness
November 2023
Primary care physicians play an important role in the recovery, return to work, and disability management of patients who have a workplace injury or illness. Evidence shows that having conversations early and maintaining connections and communication with the workplace can facilitate a positive return-to-work journey for patients. Having conversations and encouraging your patient to stay in touch with their workplace is helpful in protecting their livelihood.
For physicians interested in helping with return-to-work coordination by reaching out to your patient’s workplace, there is a fee code (19950) to support this. We recommend that you use this code in the first few weeks of the claims process. With your patient’s consent, you can contact their employer or supervisor to develop a return-to-work plan. This can be done during the first or a subsequent office visit, on a phone call, or using whatever method of communication you and your patient decide on. Larger employers may be more likely to have alternative duties for your patient.
The origins of WorkSafeBC: What it means for you and your patients
October 2023
Modern workers’ compensation systems are complex, and physicians who treat injured workers often have questions on how to best help their patients. Being familiar with the history and mandate of WorkSafeBC, British Columbia’s workers’ compensation board, may further physicians’ ability to help their patients with work-related injuries, diseases, and illnesses.
Abilities-focused language: Seeing the possibilities
September 2023
Word choice and usage can have a powerful impact on someone’s thoughts and perception of their situation, particularly in clinical settings.[1] Given this effect, WorkSafeBC has shifted to abilities-focused language when we discuss recovery, return to work, and return to function, both orally and in writing. This language is meant to help injured workers identify possibilities at home and at work and to be seen for what they can do, not what they can’t. Employers, in turn, have a much easier time finding a place for an injured employee when provided with a list of functional tasks the worker can perform.
Referring your WorkSafeBC patients to a specialist, and notes for specialists
July/August 2023
Physicians and nurse practitioners can refer patients with a WorkSafeBC claim to a specialist and have it billed to WorkSafeBC. No prior WorkSafeBC authorization is required by the referring clinician or the receiving specialist as long as the referral is for the injury, mental health condition, or occupational disease accepted on the claim (even if the decision on whether the claim can be accepted is still pending). Check the status of a claim at https://pvc.online.worksafebc.com.
There is a growing demand for time away from work due to stress, burnout, and compassion fatigue. When a patient asks for a note to begin a stress leave, physicians and nurse practitioners may be conflicted or unsure of where to begin. They are also increasingly aware of the social determinants of health, including the harms of worklessness,[1-3] and want to provide the best care and advice to patients who are requesting a medical absence from work.
Sick note or fit note? A simple approach to restrictions and limitations
May 2023
The health benefits of a timely and safe return to work after an injury or illness are well known.[1,2] Community family physicians are in a unique position to facilitate their patients’ recovery, and one way to do this is to use a fit note instead of a sick note.
A sick note usually states: “My patient is not able to work.” Unfortunately, a broad statement of inability to work can be discouraging and may become a barrier to recovery. In contrast, describing retained abilities in a fit note is recovery focused and useful for considering modified duties. It helps the physician speak to medical concepts and allows those with return-to-work expertise to do the rest.
Hand-arm vibration syndrome (HAVS) is a condition caused by exposure to hand-arm vibration, primarily from the use of vibrating tools. Exposure occurs most commonly in a workplace setting.
Prolonged contact with a vibrating tool or surface can result in exposure to vibration over a broad frequency range. The exposure action value is the daily amount of vibration exposure above which employers are required to act to control exposure. For hand-arm vibration, the exposure action value is a daily exposure of 2.5 m/s2A(8).
From a workers’ compensation standpoint, assessing tinnitus poses challenges. The subjective nature of tinnitus makes measurement difficult, and the medical literature related to tinnitus and disability does not lend itself to meta-analysis. However, a systematic review of the literature allows us to address several relevant questions:
How do we evaluate tinnitus causality?
How do we fairly represent the evidence for impairment and disability due to tinnitus?
What is the evidence that tinnitus, by itself, causes measurable disability?
FAQs about expedited surgeries and billing the expedited surgery premium
January/February 2023
What is an expedited surgery?
A surgery is considered “expedited” if it is performed within 40 business days from the date a surgeon receives written approval for surgery from a WorkSafeBC board officer.
It is important for surgeons to mark this date in Teleplan by invoicing for fee code 19326 and using the approval date as the service date.
WorkSafeBC and your patients with workplace injuries: Frequently asked questions
December 2022
Q: How do I initiate a WorkSafeBC claim for a patient with an injury or disease I think might be related to the workplace?
A: Your initial examination and treatment start injured workers on the path to recovery. As the patient’s physician, you are an important partner in that process. When your patient comes to you for initial treatment of a work-related injury or disease, fill out a Form 8. Please complete and submit the form as soon as possible after treating an injured worker for the first time; the sooner the claim is registered, the sooner your patient can receive applicable health care and wage loss benefits.
Evidence-Based Practice Group answers clinical questions
October 2022
A critical component behind WorkSafeBC’s mission to provide workers with appropriate medical treatment and rehabilitation on their road to recovery and return to work is assessing the breadth of medical and health technology information available. Within the greater Policy, Regulation, and Research Department, a dedicated team specializes in just such medically relevant topics.
The Evidence-Based Practice Group, headed by Dr Craig Martin, was established in 2002 and is mandated to address the many medical and policy issues that WorkSafeBC officers and clients—such as surgeons, medical specialists, and rehabilitation providers—deal with on a regular basis.
Are you covered? Physicians and WorkSafeBC insurance
September 2022
WorkSafeBC, also known as the Workers’ Compensation Board of British Columbia, is a provincial agency dedicated to promoting safe and healthy workplaces across BC. WorkSafeBC partners with workers and employers to prevent work-related injury, disease, disability, and death. Its services include education, prevention, compensation, and support for injured workers, and no-fault insurance to protect employers and workers.
If you’re a physician in BC, you may be required to register with WorkSafeBC. You are required to register if:
You employ workers (e.g., medical office assistants or clinic staff).
You operate through an incorporated company. The incorporated company is generally considered to be the employer, and you, the physician, are considered the worker.
Tips for billing Initial Expedited Comprehensive Consultations (19911)
July/August 2022
Some physicians report significant delays or denial of payment for their Initial Expedited Comprehensive Consultations (19911). According to recent data from WorkSafeBC, a top reason for this is missing or illegible consult reports.
When your 19911 is submitted to WorkSafeBC, the system automatically searches for proof of a consult report. If the system is unable to find such a report, the 19911 is reviewed manually by WorkSafeBC, which may result in payment delays. If WorkSafeBC is unable to find the appropriate consult report, it may result in a payment rejection.
When a worker gets injured, their family doctor plays a key role in their recovery. Every year, WorkSafeBC offers a unique opportunity to 20 to 30 family medicine residents in their second year of residency at the University of British Columbia. The year-2 family medicine residents complete a 1- to 4-day rotation with WorkSafeBC that introduces them to the claims process and services, offers practical sessions with rehabilitation programs, and presents them with the basics of primary care occupational medicine. It is a just-in-time opportunity to reach family medicine residents before they graduate and start practising.
As an additional support for workers referred to post-COVID-19 recovery clinics in the community, the WorkSafeBC Visiting Specialist Clinic (VSC), in collaboration with Claims and Rehabilitation Services and Medical Services, has established a worker-centred post-acute-COVID-19 clinic to provide workers with the support they need more quickly.
Engaging community physicians on COVID-19 prevention in the workplace
March 2022
Throughout the COVID-19 pandemic, WorkSafeBC has continued to deliver its essential services across the province. Those include prevention services to help ensure workers remain safe.
Every year, we focus our prevention efforts on high-risk work activities in health care and community social services worksites under our high-risk strategy. With the pandemic, we’ve had to shift our focus to also include reducing the risk of workplace COVID-19 transmission.
Gathering your feedback: Are you interested in joining our WorkSafeBC Medical Advisor Seminar Series?
January/February 2022
The November 2021 article from WorkSafeBC (BCMJ 2021:63;392) included information about our just-in-time assistance and accredited outreach to physicians and their offices. We also have internal committees planning continuing professional development; WorkSafeBC Medical Services employs or contracts more than 90 family physicians and specialists, as well as a consultant dentist and chiropractor, known internally as medical advisors and medical specialists. As one element of our internal continuing professional development, we organize a monthly noontime seminar on a variety of topics related to workplace injury and disease. The seminars are accredited for Mainpro+ and MOC Section 1 credits. Our seminar series presenters include community and WorkSafeBC practitioners/consultants. Topics from the past 2 years are provided in the Box.
The Community Physician Health and Safety Program is a provincewide initiative funded by the Physician Master Agreement, through the Memorandum of Agreement on Physician Health and Safety (the PHS Agreement). It is being led and supported by the Safety, Wellbeing, Innovation, Training and Collaboration in Healthcare organization, otherwise known as SWITCH BC.
This program aims to support and enhance health and safety for physicians and support staff working in communities. It offers tools and resources to improve workplace safety such as psychological and physical health, violence prevention, injury prevention and more.
A Community Physician Health and Safety Guide developed by SWITCH BC allows community physicians and their staff to understand and comply with legislative standards and requirements. This guide includes laws, rights and responsibilities, information on the Health and Safety Program, managing risk and much more.
With these tools physicians and clinic staff will be empowered to develop a custom health and safety program, and help prevent work-related illnesses and injuries.
This initiative caters to physicians in community practice settings such as private offices, medical clinics, and after-hours walk-in clinics in BC.
For more information or if you are interested in developing a health and safety program for your clinic, please contact CPHS@switchbc.ca.