One of the more common career paths for occupational medicine physicians is in medical center occupational health. Working in a Medical Center Occupational Health setting you will oversee employee health for a hospital or even a health system. This is “bread and butter” occupational medicine which consists of pre-placement exams, management of injuries including bloodborne pathogen exposures, oversight of pre-employment and for-cause drug testing and even management of FMLA. Injury prevention efforts will focus on the use of sharps to prevent bloodborne pathogen exposures, respiratory protection and reducing the hazards associated with patient handling.
A typical medical center employee health department could range from one to several physicians and may involve the oversight of mid-level providers depending on state regulations. In the role you will interface with employees, managers, HR, risk management or legal, infection prevention staff and many other departments. Pursuing quality care and timely access for employees is key to success. Partnering across silos within the organizational matrix is important to resolving questions around potential pathogen exposures and enhancing the safe use of hazardous drugs.
Some medical centers leverage the excess capacity in their employee health clinics to provide occupational medicine services to other local employers that are generally too small to employ their own occupational medicine staff. This line of business can be valuable to hospital systems as it serves for as a community engagement gateway for individuals to enter the system. Occupational health services covers a broad range from wellness, injury prevent and management of injuries which can also generate downstream laboratory and consult referrals for other departments. Occupational medicine requires a different mindset where prevention is the goal of intervention. Similarly, remuneration if occupational medicine is focused on loss prevention. Reimbursement for occupational services is generally paid by employers based on contracts and comes without the risk of insurance denial providing for reliable revenue cycle management.
The demand for occupational health services often exceeds the supply of residency trained physicians meaning there are multiple different care settings. The hybrid occupational medicine service that provides services to outside clients competes with urgent cares that provide occupational medicine services. There are networks of service providers and often worker’s compensation insurers or third part administrators for self-insured entities will coordinate care. Many very large manufacturing companies still have in-house occupational medicine services provided by site and regional medical directors, however there have been cyclical trends in business thinking regarding outsourcing of occupational medicine services.
In the next article we’ll discuss the role of a corporate medical director.