How can your Occupational Medicine Doctor Improve Your Company?

The health and safety of employees often becomes an issue only after an incident. It is at that time that meetings are called, investigations are done, reports are written, plans are formulated and action is taken. It is also the time that the company personnel first learn the name of their occupational medicine doctor. This scenario represents a missed opportunity. The opportunity to engage and interact with the physician should have been taken before the incident. Not only may it have prevented or mitigated the severity of the incident, but it will have made the resolution of the problem more successful for everyone. The choice of an occupational medicine physician should be treated as equal to the choice of one’s attorney. He is a vital part in the day in and day out activities of your employees. Furthermore, in a world of increasing regulation and liability the need for a good working relationship is mandatory.

What does occupational medicine entail?

Occupational medicine involves a wide range of services. This begins with a pre-employment physical examination. This examination should not be a cursory wave of the hand. It is the opportunity for the employer to have vital information relevant to the job description that he is not allowed to ask. As a prospective employer you are restrictive in types of questions that you may ask of a prospective employee. The physician is not bound by any such rules. A proper physician’s examination will elicit information of health history, types of medications used while at work, and potential concerning conditions. It is incumbent upon the physician to be through in the examination process. This should include a complete history of previous issues, assessments of current medications and conditions, and reasonable judgment as to the impact on the individual’s safety and ability to perform the job adequately. Included in the previous sentence is the subject of medications. Many individuals are taking a wide array of prescription medications. These medications may cause sedation, impair coordination and affect judgment. These affects are magnified when this occurs during working hours, on a vessel, at heights, or while operating a vessel. The employee will likely require specific testing mandated by OSHA. These results should be reviewed and preserved for future comparison or in the event of a claim. An important component of the exam is the doctor’s knowledge of the actual type of duty and environment in which the individual will be placed. Each company should take the time to sit down and review the workplace conditions with their physician. It provides an opportunity to establish a rapport and begin a working relationship with the physician. This helps the physician feel comfortable with returning the employees to work, possibly assisting in a transitional position, and minimizing lost time and recordable incidents. It also provides the physician with knowledge that will benefit the employee’s health and safety. All of these factors will minimize liability claims and improve the efficiency of the workforce. When an injury occurs, the physician is more than just a required stop. It is important to have the employee seen in a reasonable time period by a physician that once again is familiar to your organization. This opportunity may be the only one you have to get a real and honest assessment of the mechanism, event, actual injury and complaint. The occupational medicine physician is often the only physician that is going to provide you with the components that helps maximize outcome and minimize problems. These components include a specific history of events, a mechanism of injury, an honest and comprehensive evaluation of all complaints resulting from the incident, a plan for future care and follow-up and guided referrals to specialists that are familiar with your concerns. The physician can further aid you be properly managing the entirety of the event. This means providing proper and attentive treatment, education, rehabilitation if needed and early return to normal activities. This approach lessens the anxiety and suspicion of the employee. They are more likely to return to full duty, avoid liability claims and feel loyal to the employer.

What about the drug screen?

An opportunity is often missed during a pre-employment examination. The pre-employment drug screen is often thought of as a check box. The DOT mandated 5 panel (marijuana, PCP, amphetamine, morphine, cocaine) test tells only part of the story. The use of a 10 panel test identifies the most often used and abused prescription drugs, namely opiates, benzodiazepines, methadone, etc. The application of a non DOT drug screen during the pre-employment process is inexpensive and can be done in conjunction with the DOT process. In addition to the above situation, implementing a random and a return to work drug screening policy further limits risks associated with dangerous drugs. It also of great benefit to have your MRO medical records officer, review all drug test. Having a reported negative drug test does not mean the employee is drug free. It only means that they may be a prescription involved. If you have a concern knowledgeable MRO, it is more likely that you will be notified based on a safety concern. By having a far removed or third party MRO this potentially vital interaction is often missed. In effect, by performing an expanded panel drug screen at different times you are able to identify dangerous prescription medications, potentially current medical problems, injuries, and undisclosed risks.

Return to Work Exams and Interval Exams

The additional benefit of an occupational medicine physician can be included in the two above titles. Any time an employee has been off work or is idle for an extended period of time, it behooves the employer to get an assessment of that individual’s condition. It is not uncommon or a work related injury or illness to have extended consequences. Without an assessment by your occupational medicine physician this non work related problem now becomes a work related problem. Remember, an employee’s personal physician has little to no knowledge of the work conditions or liability issues surrounding his return to duty. Just because an individual is released from care it does not mean that that individual is either completely recovered or is able to perform at the same level of his pre-injury. This exam can include a drug screen, review of medications, and examination of the specific concern and its impact on the job performance. This is also an opportunity to include a physical performance test if applicable. Secondly, the topic of interval or annual examinations should be discussed. Employees are valuable assets of any business. Investments are made in the form of training, equipment, and expertise. The annual examination allows for surveillance and insurance of the investment. It will prevent unrecognized issues from progressing unchecked. It will also minimize the effect on missed work days and poor job performance.

A Built in Consultant

Inevitably, situations will arise where crew members have concerns regarding exposures to chemical, other crew members, or simply rumors. These situations can often easily be handled with a phone call. Your occupational medicine physician is the expert on these issues. With the aid of a knowledgeable and proactive physician you may avert a complicated situation and avoid the rampant spread of misinformation. This is also the individual that is able to “make sense” of confusing and mysterious injuries that may have not been reported at the time of the occurrence. The occupational medicine physician can help your staff assess the realism of the compliant, the need for requested treatment, the ability to return to duty, and the time to full recovery.