By Frank H. Leone
I had the privilege of speaking to several hundred occupational medicine physicians at the American Occupational Health Conference (AOHC) in May, a talk I titled “33 Lessons from 33 Years in Occupational Health.” It was the 33rd anniversary of my first presentation at that conference in Toronto in 1982.
Such occasions invite reflection. Many of the lessons were related to the adages I have tried to live by. “Think big,” for example, “one person can make a difference,” “empower others,” “hire happy people,” “nip problems in the bud,” and finally, the very simple, “have fun.”
Other lessons were occupational health-specific. A sampler:
1. Patience is a virtue: Back in 1982, (and certainly by 1985 when I established RYAN Associates) I often spoke about occupational health’s potential to be the next big thing, primarily because of its capacity to affect and manage large populations. I expected the population health concept to kick in by the next decade and surely by the turn of the millennium. I was right on the concept––markedly wrong on the time. I learned that we sometimes have to wait years or even decades for our vision to come to pass. Hang in there. Your day will come.
2. The Guard is changing, just like the world: The Occupational medicine crowd at that 1982 conference was starkly homogenous: older white men in gray suits based largely in industry. Now, 33 years later, the conference is splendidly heterogeneous, multi-cultural, international, and gender balanced. Many, perhaps most, of the participating physicians, were based outside the industry at “provider-based” programs, as consultants, in academics, or in government service. As for those gray suits…
3. Integrate, integrate, and integrate: Those who continue to view occupational health as a narrow discipline applied strictly to work-related conditions tend to miss the point (that it can be infinitely broad rather than painfully narrow). Such a narrow vision, if collectively held, would doom the field to a peripheral niche, and to a fraction of its potential.
Exceptional work in the Journal of Occupational and Environmental Medicine (JOEM) by Dr. Robert McClellen et. al. provides an excellent overview of how occupational health fits well with the emerging healthcare paradigm by integrating the workplace, home, and community to achieve optimal delivery. Read the article here: https://www.acoem.org/uploadedFiles/ Public_Affairs/Policies_And_Position_Statements/Optimizing%20Health%20Care%20Delivery%20Position%20Statement.pdf
4. Educate, educate, educate: Whether you are a physician, non-physician provider, program director, or sales professional, informing and educating others is critical. There are so many groups to educate, including patients, employers, fellow staff, specialists, senior administrators, and the community at large. Regardless of the circumstances, occupational health professionals must learn how to educate others and seek opportunities to do so.
5. Balance is the key: In a black-or-white “you’re either with us or against us” world, it is critical to consider both sides of every issue. Be nimble, and open-minded and seek a balanced middle ground. In occupational health, this includes the worker/employer balance, the work/life balance, the bottom line/ quality of care balance, the restorative/prevention balance, and a balance between authoritative and passive management styles.
6. Adapt to modern technologies: In 1982 I had just started using WordPerfect, printed pages on my ink jet printer, and hadn’t heard of cell phones, faxes, email, or the Internet. How did I get anything done? The pace of technological advance during the next ten years is likely to be equal to the total advances of the previous 33. All activity in our information-driven discipline will be propelled by yet-to-be-invented technologies. Stay on top of, if not ahead of, the curve.
7. Think and speak of value: The core principle in our macro-healthcare world is the strong movement from a volume-driven mindset to a value-based mindset. All key staff need to associate the “what we are doing” with the “why we are doing it” and command some understanding of the economic implications of our actions.
8. Learn the language: An overreliance on healthcare terminology when speaking to non-healthcare individuals has been a chronic failure. When speaking with employers, engage in “employer-speak” by parroting their buzz words; when dealing with patients, frame all of your comments in words and concepts they will understand.
9. Respect the profession: If you are in occupational health you are in a very good place. It is a niche in its infancy; it is continuously expanding and redefining itself and by the nature of its dual emphasis on direct patient care and environmental causation seems poised to have a bellwether role in the 21st century healthcare paradigm. Believe in and commit to what you are doing and share that commitment with others.
10. Be yourself: We all have but one life to lead; best that we commit to excellence. Think big and go for it. But be yourself. I learned long ago that I am not a clinician and that I should “stick to the knitting,” by confining my activities to what I do well.
