Occupational Medicine Recognized Specialty Since 1949 Combines Clinical Skills With Toxicology, Epidemiology, Safety, Rehabilitation, and Business Operations “Tightrope Walker” Responsible to Patients as well as Business.

Occupational Health Services Evaluation and Treatment for Medical Conditions Emergency Medical Response Medical Surveillance Disease Management Fitness and Wellness Work-Life Management Disability Management and Accommodation Employee Assistance and Advocacy Absence Management Workers’ Compensation Training Records Management Information Privacy

Why a Special Practice Model? Occupational Diseases are Hard to Distinguish From Ones Unrelated to the Workplace Economic Implications of Maintaining a Healthy Workforce are Large Source: USA Today

Building the Occupational Health Program The Goal is to Enable Employees to Safely Attend Work and Successfully Perform Their Tasks Without Interference from Health Based Issues. Consideration Must be Given to Work Processes and How They Impact Employees, Their Contacts, and The Environment. If an Employee is Absent, Facilitate the Receipt of Effective and Efficient Interventions by Employees. Set a Goal of Return to Work as Soon as Practicable.

How Do We Know What to Address? Remain Vigilant For Activity or Incident Trends, Changes in People, Worksites, or Regulatory Requirements. Situational Evaluation Should Occur Early. –Involves Management, Safety, Human Resources, Industrial Hygiene, Engineering, and OH Personnel –Decisions Must Balance the Individual’s Rights and Needs With The Rights and Needs of the Employer

Employee Evaluations Entrance (Baseline) Examinations –Can They Physically do the Job? –Do They Have Medical Conditions Impacted by the Job’s Requirements? –Do They Need Accommodation? Periodic Voluntary Screening Fitness for Duty (Specific Cause) Examinations for Specific Exposures Evaluations in Conjunction With Accommodation or for Disputed Documentation

Emergency Medical Response Activity is More Complex Than People Think –Why Don’t You Buy an Ambulance and Cut Down on the Waiting Time? EMS Agency –Strict Certification Requirements –Specified Equipment and Treatment Protocols –Required Continuing Education –Physician Oversight of Operations Volunteers from Employee Population Tangible and Intangible Benefits

What About Absences? Work Within Company Policies, Any Regulatory Requirements, and Privacy Program Use Competent and Objective Personnel For Evaluation and Management Obtain Optimum Intervention for Individual and Coordinate With Others in Worksite Closely Manage Return to Work Monitor Outcomes and Prevention Efforts Both During Intervention and After Full Return To Work (Disease Management)

Can We Really Assist Employees? An Important OH Service is Provision of Employee Assistance and WorkLife Enhancement Programs A Broad Array of Services Should be Provided to Employees and Members of Their Households Utilization Rates Should be Tracked Against the National Average for Similar Industries It is Not Enough to Offer Services. Due to Human Inertia, Assistance Programs Must be Marketed Assistance Also Includes Advocacy With Non-Work Related Health Issues

Advocacy Services Clinical Health Matters Administrative and Benefit Issues Information and Access to Healthcare Resources Help Locate Doctors, Hospitals, DME, Other Services Interface With Member’s Health Plan Health Coaching; Health Information Data Base; Locate Centers of Excellence & Treatment Sites Resolve Claims Questions Arrange 2nd Opinions Help Arrange Appointments With Specialists Explain Benefits and Coverage Policies Assist With Senior Care Issues Coordinate Medical Services, Transfer Medical Records Resolve Billing Errors Identify Community Resources