Role of the Primary Care Physician in Occupational and Environmental Medicine (1988) / Chapter Skim
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Appendix A: Abstracts of Commissioned Papers
Appendix A: Abstracts of Commissioned Papers
Pages 78-90
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From page 78... ...
The duties imposed on a primary care physician acting as an individual's personal physician may be different from duties that arise when the medical practice is related to an individual's employment, (i.e., preemployment physical examinaiior~s, periodic physical examinations, or examinations undertaken for the purposes of medical removal, workers' compensation, or a third party lawsuit in tort)
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From page 79... ...
Unfortunately, in the minds of many public health professionals, surveillance systems are viewed as passive, imprecise, and ponderous systems designed to collect information of uncertain Utili~. To achieve a broader involvement of occupational health professionals in the surveillance of occupational disorders, systems must be developed that are intrinsically active and precise and that allow for a rapid response to the emerging trends of illness and injury.
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From page 80... ...
that will utilize targeted sources of sentinel providers to recognize and report selected occupational disorders to a state su~veilance center in the state health department. INCENTIVES TO DIAGNOSE, TREAT, AND REPORT OCCUPATIONALAND ENVIRONME:NTAL DISEASE Leslie I
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From page 81... ...
The basis for this emphasis on content is the recognition that large societal and medical economic forces will, in and of themselves, increase the attention paid to OEM. There are five discernible forces pushing in this direction: patient demands for OEM services are growing, and consumer power is at an all-time high in a competitive health market; regulatory and legal pressures are leacling employers to provide more OEM service; business is cutting back on in-house medical departments; health care financing dictates that hospitals more aggressively market service to insured, healthy workers rather than the poor, sick, and elderly on whom residents have historically trained; and expanded prepaid health delivery provides a new incentive for recognition of (cost assignable)
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From page 82... ...
for discovering the influence of occupation or environment on the patient. This paper discusses the benefits of and barriers to incorporating occupational history information into routine patient care and suggests ways to change family practice residency curricula to include more occupational medicine content.
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From page 83... ...
CURRENT STATUS AND TRENDS IN REIMBURSEMENT OF OCCUPATIONAL HEALTH SERVICES FOR WORMERS Frank Gokismith Primary care physicians continue to be a major ingredient in the delivery of health care. The ever present diagnostic issue persists.
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From page 84... ...
Some of the earliest attempts to upgrade the medical skills of general practitioners were not successful because they were largely based in county hospitals and there were no family practice role models present in medical schools nor was this a significant part of the medical school curriculum. It only became successful when an academic movement in family medicine was established and role models were placed on medical schools, strong departments created, and medical students were positively affected and influencer]
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From page 85... ...
PREVEN rIoN AND DETECTION OF OCCUPATIONALLY RELATED DISEASES BY PRIMARY CARE PHYSICIANS: DEVELOPING THE PARADIGM Thomas E Kot~ke Occupational hazards are a significant burden for American workers, and primary care physicians are a potential resource for prevention and early detection of occupationally related diseases.
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From page 86... ...
The success of the award is documented by the recent announcement of a Preventive Pulmonary Academic Award and a Transfusion Medicine Academic Award by the same agency. It is suggested that a similar paradigm development program be considered for occupational medicine by primary care physicians.
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From page 87... ...
In order to improve medical school education in occupational health, three areas, in the author's opinion, should be focused upon: taking and interpreting an occupational history; identifying and instituting preventive measures for both the patient as well as other workers who may face similar risks; and appreciating the context of work and actual working conditions of individual patients. Training in these three areas should begin in medical school and be continued in more depth in residency and continuing education programs.
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From page 88... ...
These technologies include increasingly powerful and inexpensive personal computers, mass information storage devices such as magnetic and optical disks, and affordable digital telecommunications for online access to biomedical data base systems. There are currently three types of electronic information resources that are useful in clinical problem solving: bibliographic search systems, factual data bases, and artificial intelligence or expert systems.
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From page 89... ...
. Rules for diagnosing occupational and environmental illness exist in most of the current general purpose expert systems developed for medical diagnosis, and the ability of such systems to methodically and rapidly evaluate hundreds or thousands of candidate diagnoses based on clinical findings offers a new tool for improving the consistency and accuracy of clinical diagnoses.
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From page 90... ...
expertise in only two functions: critical diagnostic (physiologic abnormality identification) decisions and critical therapeutic (medical interventions decisions.
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