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At the heart of general practice since 1960

Let's play the DoH at its own game over pay

phil peverley

Miss Whiplash

The woman in the cervical collar wants a sicknote ­ she's a right pain in the neck

Perhaps the most feared word in the GP lexicon.

'Whiplash,' according to the Oxford Clinical Mentor, 'is a cervical strain caused by sudden neck flexion followed by rebound hyperextension. It is a common injury, often in a rear-end collision car accident. Subsequent protective muscle spasm causes pain and stiffness, which may be severe.'

So far so good. What the Oxford Clinical Mentor fails to mention, and this is where we as GPs come in, is that whiplash is a minefield, and the most fertile of all areas of the compensation culture.

I had the misfortune to be involved in a car accident myself recently. I was a passenger in a car that hit a sports utility vehicle that had no business to be crossing the road in front of us. We hit it at about 30mph. I suffered a mild whiplash injury, and unthinkingly, I mentioned it on the insurance claim form.

It was no big deal. My neck was sore for a few days, but I found some out-of-date Feldene in my bag, and by the end of the week I was back to normal. But I was surprised by the reaction of the insurance company.

'We would be pleased to offer you £600 in compensation for your whiplash injury,' they said, even though I had asked for nothing at all. All I had to do was to sign a form that exempted the insurance company from any further claims. They wanted out. They considered that six-hundred quid was a bargain to get out of a whiplash scenario. And I can understand why.

My next patient would like another sicknote. She is wearing a cervical soft collar, her own investment, even though I have advised her previously that it will make matters worse. Her solicitors have referred her to Professor Bachsachencrach, a local orthopaedic specialist in whiplash injuries. He appears to specialise in nothing else. It seems he does not need to.

'How long do you think this pain might go on, doctor?' she asks, sighing like a martyr.

'It's hard to say,' I reply. 'How long do you think it will be until your compensation claim is settled?'

She looks at me, obviously nettled. 'Professor Bachsachencrach says my pain might go on for years. He says it might never get better. He says I have to have tablets and physiotherapy and acupuncture and a TENS machine and traction and maybe hypnotherapy.'

'Is that right?' I ask, and she nods, without any apparent discomfort at all. Reluctantly, I write her another Med3 form, turn to the computer, and type in the Read code for 'Pain In The Neck'.

Dr Phil Peverley is a GP in Sunderland

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