Studies from Australia, Spain, and the United States have shown that patients who attend a specially run occupational clinic have better outcomes. Claim costs were less, days off reduced and in some studies patients were happier.

Sounds positive, so why aren’t we all doing it?

Well, there are pros and cons. On the pro side, occ docs (doctors experienced in occupational health problems) tend to be more familiar with treating musculoskeletal problems- the most common workplace injury. Occ docs are often more experienced in streamlining management, confident in informing patients of appropriate work duties, have a better handle on investigation results and are used to dealing with employers and claims managers.

Good occ docs develop sound relationships with the employee and recognise the importance of the patient’s trust in their management. They tread a fine line between serving the needs of the employee and working with the employer, ensuring the patient sees their best interests as being foremost. Good occ docs recognise that what is good for the employee will generally be good for the employer.

So, what’s the downside?

If the occ docs are seen as representing the company’s interests, trust will be diminished and can be quickly destroyed. Employees will be reluctant to attend the clinic, the employer will be seen as disregarding the needs and rights of the employees and relations will deteriorate.

The occ doc needs to provide a level of care equal to that of any regular GP.

A family general practitioner who has known the person for some time is aware of their background, medical conditions and personality, and can often be better placed to manage the person. There is a relationship that stems back time, and the patient and doctor are used to each others’ communication needs and styles.

What’s the verdict, Doc?

The difficulty with the studies undertaken is that patients were not randomly assigned to the occ doc. In other words, they had no choice which doctor they saw.

If patients do have a choice of doctor, those who are more likely to be compliant with return to work are more likely to attend the company doctor. Those frustrated with their employer are more likely to wish to attend their own personal doctor. There is a strong relationship between the employee attending the company occ doc and then complying with return to work. So, though the studies give us some strong insights into the value of an occ doc, they are not yet definitive research findings.

What can a company do to maximise the effectiveness of an occ doc?

• Choose a good one. If employees are unhappy with the doctor, they aren’t going to go. Employees need to have trust in the Dr, particularly their return to work recommendations.
• Ensure the doctor’s recommendations are supported. If the employees feel that the doctor has no influence over the situation, doctor credibility and trust goes down.
• Never use the same doctor for two purposes. If the doctor is treating patients, don’t ask them to assess liability issues. They are there to help the person, not be seen as acting on behalf of the company.
• Set up regular communication channels. Get to know the practice manager, ensure the doctor has a full list of workplace numbers to keep in touch with, and invite the doctor regularly to the workplace to help them understand duties and meet key people.
• Involve Employees and unions in the setting up of a local occ clinic. If you have their buy-in, they are more likely to support the system and you are less likely to meet with resistance.
• If problems arise, deal with them early. Ensure employees, unions, and management are comfortable with the Resolution of any issues.

Where to from here?

The research, as it stands, suggests that occ docs can make a valuable contribution to getting both sides cooperating in return to work. They can improve patient recovery time and wellbeing, minimise claim complications and optimise workplace efficiency.

Occ docs can do it better - just be sure to get the right ones and set them up so it works.