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Are occupational pulmonary problems evaluated by low patient volume occupational medicine subspecialists?

Authors
Wu-S; Harber-PI; Bontemps-J
Source
Am J Respir Crit Care Med 2012 May; 185(Meeting Abstracts): :A2305
NIOSHTIC No.
20044852
Abstract
INTRODUCTION: Understanding the distribution of pulmonary cases among groups of occupational medicine practitioners can guide health service organization and training. Some posit that occupational lung disease (OLD) patients are primarily seen by my intensity, low-volume practitioners. METHODS: The OMP representative national survey of occupational medicine (OM) physicians included 252 who regularly saw patients. Participating physicians completed 25 activity logs describing activity at specific times. Patient load for clinicians was categorized by quartile of patients / week, and proportion of OLD was dichotomized above or below the 4% mean. Mantel-Haenszel Chi-Square analyses were used. RESULTS: There was no statistical relationship between quartile of patient load per week and proportion of pulmonary patients in occupational medicine practices. Similar results were seen for all toxicology cases. In contrast, there were strong relationships between patient load and frequency of musculoskeletal or spinal problems, with high patient load clinicians seeing disproportionately more of these cases. 38% of all participating OM physicians had >= 1 OLD matter among the 25 activities sampled. Analysis by OM Board certification status showed a nonsignificant trend for certified physicians to have at least one OLD activity (43% versus 33%). Career stage did not affect the likelihood of having >= 1 OLD). CONCLUSIONS: An average of 4% of occupational medicine physicians' patients involved OLD. These patients are seen by all occupational physicians, not just low volume/high intensity subspecialists. Improved understanding of practitioners' necessary skills and competencies should inform reimbursement and educational criteria. These data show that OLD is an important component of many occupational medical practices rather than being an esoteric subspecialist problem.
Keywords
Medical-services; Training; Education; Physicians; Medical-personnel; Questionnaires; Health-care-personnel; Statistical-analysis
CODEN
AJCMED
Publication Date
20120501
Document Type
Abstract
Funding Type
Grant
Fiscal Year
2012
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008647
ISSN
1073-449X
Source Name
American Journal of Respiratory and Critical Care Medicine
State
AZ; CA
Performing Organization
University of California, Los Angeles
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