Work status issues in primary care and occupational medicine practice: result of a physician survey.
Pransky-G; Katz-JL; Benjamin-K; Himmelstein-J
Health Services Research: Shaping the Health System in the New Millenium, AHSRHP Annual Meeting, June 25-27, Los Angeles, California. Washington, DC: Academy for Health Services Research and Health Policy, 2000 Jun; :10
RESEARCH OBJECTIVE: Prior investigations of how primary care physicians (PCP's) address work status of their patients have focused on disability claims, and have not addressed the larger scope of work-related issues that arise in primary care practice. This study was conducted to evaluate the extent of these practices and opportunities for improvement. STUDY DESIGN: Mailed survey of 423 actively practicing PCP's and 40 occupational medicine physicians (OMDs) selected from the database of the Massachusetts Board of Registration in Medicine. Response rate was 43% for PCP's and 70% for OMP's. POPULATION STUDIED: Occupational and primary care physicians in Massachusetts. PRINCIPAL FINDINGS: On average, PCP's were asked to provide some information on work ability in 9% of all visits, primarily in non-work-related conditions. Decisions about work status were largely based on patient input and clinical observations. Direct communication with employers was rare, although this was a recognized need. Facilitating safe return to work and protecting patient confidentiality were endorsed by 93% and 82% of PCP's as important roles; only 6% stated that PCP's should not have a role in these issues. However, a quarter of PCP's believed that they had little influence over disability outcomes, a viewpoint not shared by OMP's. PCP's endorsed a number of patient-related, information and workplace barriers to effectively supporting return to work; OMP's also endorsed the workplace factors, but had significantly less concern about the patient-related and information factors. CONCLUSIONS: Results suggest that disability issues are common and appropriate aspects of primary care practice. Difference between PCP's and OMP's responses may reflect differences in patient mix, conditions, and employer affiliation, as well as training and experience. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Recommendations for improvement include PCP education, improved systems for communication with employers, and more access to alternative duty assignments.
Surveillance-programs; Health-care-personnel; Health-care; Epidemiology; Statistical-analysis
University of Massachusetts Medical School, Liberty Center for Disability Research, 71 Frankland Rd, Hopkinton, MA 01748
Conference/Symposia Proceedings; Abstract
Work Environment and Workforce: Special Populations
Health Services Research: Shaping the Health System in the New Millenium, Academy for Health Services Research and Health Policy Annual Meeting, June 25-27, Los Angeles, California
University of Massachusetts, Worchester, Massachusetts