Role of the Primary Care Physician in Occupational and Environmental Medicine (1988) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-10
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The physicians of particular concern to the committee include general internists, family physicians, osteopathic primary care physicians, emergency room physicians, and pediatricians. To the extent that other specialists, for example, cardiologists, gynecologists, and surgeons, provide general as well as specialty-specific health care, they, too, are part of the study's target audience.
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From page 2... ...
In short, the committee's use ofthe term environmental medicine includes caring for individuals exposed to toxic substances in their homes and neighborhoods through such media as contaminated soil, water, and air. As a clinical specialty separate from occupational medicine, environmental medicine is in its infancy.
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environmental medicine as well as in the related disciplines of epidemiology and toxicology, most primary care physicians are hard-pressed to keep up with developments in the field. Indeed, the general medical literature contains relatively little about occupational and environmental medicine.
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The overall barriers to the implementation of preventive seduces in the clinical setting also have an impact on the ability and willingness of the physician to deliver occupational and environmental health services. There are numerous constraints to the active participation by the primary care physicians: · Infrequent occurrence of occupational and environmental illnesses and .
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Recommendations to Foster the Role of Primary Care Physicians in Presently Patient Care Activities Disease and impairment problems attributable to environmental or occupational exposures present unusual complexities in clinical medicine because the necessary expertise to assist the practitioner in documenting etiology as well as determining appropriate preventive activity is fragmented and often unknown to the primary care practitioner.
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There are only about 1,000 active board-certif~ed specialists in occupational medicine in the United States, and the process of certification is difficult for candidates with a predominantly clinical background. Today, these few board-certifiecl specialists in occupational medicine are for the most part employed by industry or academia and are not available to primary care physicians as clinical consultants.
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The CDC, through the Center for Environmental Health, should convene a similar panel to identify alternative means to deliver such services to those affected by hazards in the general environment. Due to the paucity of information about the practice patterns and activities of primary care physicians in today's changing medical scene with respect to occupational and environmental medicine, a broad and systematic survey of the needs and concerns of such physicians is recommended.
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From page 8... ...
The appropriate federal agencies in association with the appropriate professional medical societies, local and state medical societies, and malpractice insurance carriers should develop resources that will provide primary care providers with basic information on their legal obligations. Steps should be taken to explore the ethical situation of physicians who deal with workers with occupational problems or those who work for businesses and industries.
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From page 9... ...
In an effort to achieve a greater recognition of the important academic and clinical role of occupational and environmental medicine, steps should be taken to encourage greater representation of these areas in national and state board examinations required for certification and licensure. Occupational medicine is an established and recognized medical specialty.
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Over and above the evil effects of a sedentary life, the affliction irz store for such workmen as a result of their craft is myopia, a well-known Affliction of the eyes which obliges orte to Ding objects closer and closer to the eyes in order to see them clearly; hence we may see nearly all such workers using spectacles when tthey are elaborating the details of their handiwork.
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