WHAT IS OCCUPATIONAL MEDICINE?
Would I recommend GPs take up an interest in Occupational Medicine (OM)? Absolutely. There are already around 1,500 GPs practising in the specialty, with over 1,000 achieving the Faculty of Occupational Medicine’s Diploma in Occupational Medicine. At least half of the Specialist (Consultant) Occupational Physicians I’ve met started out as a GP. The attraction of the field is easily illustrated: in my 13 years with a part time practice in OM I’ve known many full-time specialists who ‘used to be a GP’, but I’m still to meet a GP who used to be a specialist occupational physician! It is clearly an attractive, and sometimes lucrative, field of work.
My interest to occupational health (OH) was down to a chance introduction in my first practice. We were close to a new warehouse and distribution park in the East Midlands, and the first companies setting up there needed pre-employment medicals, particularly for their LGV drivers. As time went on more and more HR managers came to us to carry out statutory medicals and sickness absence assessments, and within a year or two around 10% of the practice income was from this line of work.
What is Occupational Medicine?
Occupational Medicine covers the relationship between health and work. The focus is to ensure that workplaces and work practices are safe and not detrimental to employees’ health, and that employees are fit for the job they are doing. If there are problems the occupational physician’s role is to advise on workplace adjustments and to give appropriate advice and support.
The traditional model of OH has an important role to rehabilitate people back into work after sickness or injuries. However the improving safety culture in the UK, together with an increasingly aging and ‘stressed’ workforce, means that our role is increasingly to help people with long term conditions or mental health problems to stay at work and manage their symptoms within the context of employment.
What are the attractions?
The pace of work is a welcome relief compared to the 10 minute appointments and rushed visits in primary care. A typical appointment would be for 30-45 minutes and allows time to explore a case in detail. There is certainly the feeling that your opinion is important and holds great value for the person you see and the company they work for. I enjoy the close working relationship with an HR manager that develops and the opportunity to understand a whole new culture in the world of businesses. The importance of work to an individual’s health and wellbeing is well understood, so the ability to really make a difference to keep someone in work can be very rewarding.
What are the challenges?
The switch from an advocacy role to one of impartiality is probably the main challenge for GPs. Also, while there are no statutory requirements, I would agree with most in the field that formal training should be a requirement to ensure good practice towards the guiding principles of OH. The Diploma in Occupational Medicine is awarded by the Faculty of Occupational Medicine, and this provides GPs with the extra competencies to understand the effects of work on health, assessment of fitness for work, health surveillance, rehabilitation, workplace visits, ethics and the law.
Setting up a client base can be difficult. Like me, many GPs find a demand for work from local organisations almost by accident. Word of mouth and local contacts have been the main source of new work for many of us. Some GPs also work with local NHS OH departments, or one of the number of number of national OH ‘agencies’, who are always on the lookout for GPs with the Diploma.
I’d urge any GP to diversify into OM. It has been a rewarding and challenging experience for me, and one which I would recommend to anyone.
Dr Rob Hampton, MB ChB, MRCGP, DRCOG, DOccMed