American Association for Physician Leadership

Strategy and Innovation

Why Occupational Health Matters

Corey M. Cronrath, DO, MPH, MBA, CPE

April 18, 2024


Abstract:

Corey Conrath is service line medical director for Marshfield Clinic Health System in Eau Claire, Wisconsin. The health system supports several hospitals to help manage workers’ compensation cases and the treatment of injured patients and attends to the employee health side. He describes here the importance of occupational health.




Who is the patient to an occupational health (OH) provider?

In occupational health, the provider’s “patient” encompasses three distinct individuals who must be advocated for during each visit.

First and foremost, the employee seeking care is one of the patients. Their health and wellbeing are essential as they are the ones performing their job responsibilities.

Second, the OH provider must consider the person who relies on the employee to perform their duties effectively. This could be the coworkers who depend on them to contribute to the team’s success or the customers and clients who expect quality service.

Finally, the employer is also considered a patient to the OH provider. The employer plays a vital role in bringing everyone together to advance society by providing job opportunities and contributing to the workforce.

This responsibility becomes especially challenging when conducting medical examinations for bus drivers or commercial vehicle drivers. The OH provider must carefully assess the risks associated with certain health conditions, like diabetes or atrial fibrillation, which could lead to sudden incapacitation while driving. The provider’s decisions can have far-reaching consequences, affecting the safety of passengers, pedestrians, and other motorists on the road.

Similarly, when evaluating a firefighter candidate, the OH provider must carefully assess the risk of sudden incapacitation in high-stress and physically demanding situations. Consider, for example, a 25-year-old firefighter candidate with asthma utilizing maintenance therapy and a rescue inhaler four times a year with strenuous activity — the pulmonologist and National Asthma Education and Prevention Program would consider this “well controlled.”

However, the OH provider must carefully assess the specific demands of the firefighting environment, which involves extreme heat, high psychological and physical stress, increased end tidal CO2 with self-contained breathing apparatus use, and the added weight of the protective gear. The provider must consider whether the candidate’s asthma is adequately controlled to handle these challenging conditions without risking sudden incapacitation or impaired performance that could jeopardize the firefighter’s safety and the safety of others.

OH providers carry a heavy burden, as they must consider the wellbeing of employees, their dependents, and employers alike. Their duty is not limited to the individual but extends to the broader impact on society and public safety. Making well-informed risk/benefit assessments is crucial to ensure the safety and health of everyone involved in the work environment.

How does occupational health serve the community?

OH serves the community in several meaningful ways. With a significant portion of the American population being employed, OH plays a crucial role in safeguarding the health and wellbeing of workers and their communities.

OH providers, who are often board certified in occupational medicine and hold a master’s in public health, have a unique perspective that allows them to address the social determinants of health. They not only focus on individual patient care but also consider the broader factors that influence health outcomes, such as workplace conditions, environmental hazards, and community health trends.

One essential aspect of OH is its emphasis on preventive measures. OH providers encourage and support employees in adopting healthy lifestyles and making positive health choices. Since recommendations for maintaining good health are often tied to a worker’s ability to continue employment in certain fields, employees are motivated to follow advice on smoking cessation, weight reduction, CPAP use (for sleep apnea), and regular visits to primary care providers.

Through these efforts, OH providers actively contribute to increasing the overall health of the community members they serve. By promoting healthy habits and providing necessary medical interventions, they help prevent the development and progression of chronic conditions, ultimately reducing the burden on the healthcare system.

Moreover, OH providers are instrumental in protecting workers from hazardous workplace exposures. By assessing and mitigating occupational risks, they create safer work environments that benefit not only employees, but also their families and the surrounding community.

How does occupational health benefit the integrated healthcare system?

Occupational health brings multiple benefits to the integrated healthcare system in clear and measurable ways and in more subtle ways.

One significant advantage of occupational health is that it can improve provider satisfaction. By handling administrative paperwork specific to this field, such as completing forms required by government regulations (e.g., WKC-16 in Wisconsin), occupational health providers allow non-OH providers to focus on specialty care and relieves them of perceived unnecessary administrative burdens. This streamlined process benefits patients by ensuring that the required forms are accurately completed, increasing their chances of receiving benefits when eligible under state criteria.

Moreover, OH providers are well-equipped to serve as employee health medical directors within the healthcare system. They have expertise in evaluating the safety requirements for employees operating in various environments, such as those with laser, radiation, noise, hazardous drugs, infectious disease exposures, and worker’s compensation claims. Their familiarity with relevant regulations from multiple governing agencies enables them to ensure compliance and promote a safe work environment for healthcare employees.

From a financial perspective, OH services can bring in substantial downstream revenue for healthcare systems. In states where worker’s compensation fee schedules are set above Medicare reimbursement values, the potential for reasonable profit margins on these services is high. Additionally, investing in an OH service line can lead to a significant increase in worker’s compensation charges, as demonstrated by one system that experienced a rise from 5 million to over 27 million annually in just three years.

Finally, OH can significantly improve business development relationships with local employers. Employers often have their initial interaction with healthcare systems through OH services like respirator fit tests, audiograms, and drug screening.

When these services are delivered with exceptional quality, employers are more inclined to buy more services or facilitate their employees’ access to the healthcare system. This connection is especially crucial for healthcare systems that also own health plans. Building strong relationships with employers through OH services fosters mutual benefits and better access to healthcare for employees.

Does occupational health collaborate with other fields of study?

Occupational health stands as a prime example of an inter-professional field, bridging a multitude of disciplines to safeguard workers’ health and wellbeing. Aligned under the American College of Occupational and Environmental Medicine, this college houses board certifications in aerospace medicine and preventive medicine, indicating its collaborative nature. Embracing both occupational and environmental aspects, occupational health thrives on diverse inter-professional partnerships.

This arena intersects with public health, blending legal, political, and scientific perspectives. From addressing worker’s compensation intricacies to navigating the health impacts of climate change-induced extreme temperatures, OH demands collaboration with professionals across legal, medical, and policymaking realms. Its canvas extends to the clean energy sector, assessing exposures to metals such as lithium, cobalt, copper, nickel, and manganese, emphasizing interdisciplinary cooperation.

The field’s gaze ranges from raw material extraction to product recycling, necessitating teamwork with engineers, scientists, and policymakers. Monitoring water contaminants like per- and polyfluoroalkyl substances connects OH with governmental policies and public safety, necessitating epidemiological and toxicological expertise.

Occupational health’s holistic approach embraces emerging concerns like microplastics, further widening its collaborative reach. This expansive territory, where health and various industries converge, underscores its inherent inter-professional character. By consistently intertwining medicine, law, engineering, policymaking, and more, OH stands as a testament to the power of interdisciplinary cooperation in enhancing workplace health and beyond.

What career opportunities are available for physician leaders in occupational health?

Leaders in occupational health are poised to embark on a diverse array of rewarding career paths that span healthcare leadership, government roles, corporate medicine, policymaking, and serving as subject matter experts within the legal realm. Their specialized knowledge and unique skill set position them at the forefront of safeguarding workers’ health and wellbeing while shaping the future of livable environments.

Healthcare Leadership: Occupational health leaders are well-equipped to take on influential roles within healthcare organizations. They can ascend to positions such as medical directors of occupational health departments, overseeing medical surveillance, workplace safety protocols, and employee health initiatives. They also play a vital role in integrating occupational health services into broader healthcare systems, ensuring seamless coordination of care for workers. This can expand into roles such as chief safety officer, chief medical officer, vice president of population health, and many other influential roles.

Governmental Assignments: Opportunities abound within government agencies responsible for setting environmental standards and regulations. Occupational health leaders can serve as medical officers in agencies like the Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, Environmental Protection Agency, Department of Defense, Department of Transportation, Department of Homeland Security, and state public health offices to name a few. They contribute to policy development, enforcement strategies, and research initiatives aimed at enhancing workplace safety and employee health.

Corporate Medicine: Organizations across various industries seek occupational health leaders to manage employee health and safety programs. These leaders collaborate with human resources, management, and employees to implement health promotion, injury prevention, and wellness initiatives. They ensure compliance with regulations, reduce workplace hazards, and create environments that foster employee wellbeing and productivity. They hold titles such as senior director of corporate medical and chief medical executive director. They hold positions at facility, regional, and global levels.

Policy Making: Occupational health leaders can make a significant impact on public health by participating in policy-making processes. They engage with legislators and policy influencers to shape regulations that protect workers’ health and safety. Whether at local, national, or international levels, their expertise contributes to crafting effective policies that resonate across industries.

Legal Expertise: In the legal realm, occupational health leaders are valued as subject matter experts. They provide critical medical insights in cases involving worker health, injuries, and exposures. Their knowledge informs legal decisions, worker compensation claims, and litigation involving workplace hazards. This role highlights their indispensable contribution to ensuring justice and protection for workers.

Consulting and Research: Leaders in occupational health can establish themselves as consultants, providing expert guidance to businesses aiming to enhance workplace safety and employee health. They can contribute to research initiatives that advance the field, developing evidence-based strategies to mitigate workplace risks and improve worker outcomes.

Academic and Educational Roles: Many occupational health leaders find fulfillment in academia, educating the next generation of healthcare professionals. They can contribute to medical education programs, training physicians and other healthcare providers to address occupational health challenges effectively.

In conclusion, the world of occupational health offers a vast landscape of career opportunities for leaders with a background in healthcare, public health, and medicine. From healthcare leadership and governmental roles to corporate medicine, policymaking, legal expertise, and beyond, these professionals play a crucial role in shaping healthier, safer workplaces while influencing broader public health outcomes. The versatility of their expertise equips them to make a lasting impact across industries, making occupational health leadership a dynamic and fulfilling career path.

Corey M. Cronrath, DO, MPH, MBA, CPE

Corey M. Cronrath, DO, MPH, MBA, CPE, is service line medical director for Marshfield Clinic Health System in Eau Claire, Wisconsin.

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Topics

Systems Awareness

Environmental Influences

Adaptability


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