Are You Your Own Client?

The Shortcomings 

Depending on the size of the facility, the employee health department often may not have a healthcare provider daily. Employees/patients can only be evaluated on days when a provider is scheduled in the clinic. For this reason, injury evaluations may not occur on the day of injury. Preplacement exams are also subject to provider availability. This does not take into consideration periods of time when a provider is out of the clinic for extended periods (vacations, illness, or continuing education). These situations often incur the additional cost of arranging alternate provider coverage (locums, part-time providers, etc). 

The department is subject to ebbs and flows. During slow periods, the staff may be content to complete routine clinic organization and review of charts. During peak periods (hiring, Board of Health inspections, etc.), the department scrambles to find additional assistance to maintain department functionality. Despite the need at peak times, the slow periods do not financially justify increased staffing. This creates alternating periods of “overstaffing” and “understaffing.” 

The emergency department (ED) is NOT a reasonable alternative to a provider familiar with occupational medicine. Institutions often rely on the ED to handle work injuries, exposures, and other services that require a provider. While the ED providers are more than capable of providing medical care, they may not be familiar with the nuances of occupational medicine (OSHA, GINA law, ADA, etc.). EDs are not equipped for continuity or follow-up care of work-related injuries and their associated record-keeping requirements. While ED care can meet the fundamental needs of medical care, it is not meant to take the place of a provider knowledgeable in occupational medicine. 

Additionally, employees may have reservations about being evaluated or treated by a provider solely employed by the same employer. The perception being that the provider is biased toward the needs of the employer and may not be in the best interests of the employee. As a separate entity, the occupational health department cares for the best interests of the employees while still meeting the specific needs of the employer. 

The Solution 

A solution to this dilemma is to utilize the occupational medicine department as the “employee health” of the institution. In this case, the occupational medicine department treats the institution as a “client company.” All necessary services can be provided (surveillance, medical treatment/examination, record keeping, etc.). To meet the needs of community clients, the department maintains a consistent staffing level (nursing and providers). This staffing level can absorb or redirect the fluctuations of employee health needs. While ultimately employed by the same employer, the providers approach evaluation and treatment of coworkers as “employees of a client company.” This reduces or eliminates the employee perception of a conflict of interest. Finally, occupational medicine professionals incorporate and adapt to the changing regulations and requirements of the workplace. This approach improves quality of care, timely reporting, and compliance with public health requirements of the healthcare workplace. This is something you may want to consider in order to streamline your process and save money. ←