When I tell people, even other doctors, that I am an occupational medicine specialist, I usually get a blank look and the immediate reply “what’s that?” I wish that more doctors, health professionals, and the general public were aware of this important specialty – so let me tell you more about it!
What do occupational medicine doctors do?
As an occupational medicine specialist (or “occ doc”), I treat work-related injuries and illnesses and provide the physical exams that employees need for work. These exams include DOT exams for truck and bus drivers, pre-placement physical exams for newly hired workers, and respirator clearance exams. (For the rest of my life, I will be able to tell people that I clear people to wear N95 masks and they will understand what I’m talking about!) The way I approach all patients is through the lens of safety. I want to make sure that injured workers can go back with restrictions that reflect what they are able to do. A primary care doctor will do a physical exam to look for medical conditions and treat them. As an occ doc, I do a physical exam to make sure that those conditions have been treated appropriately so the employee is safe to work. I want to make sure that the bus driver with a load of kids or an over-the-road semi-truck driver with a load of explosive materials doesn’t have a preventable accident because of their uncontrolled diabetes or sleep apnea. I want to make sure that the firefighter is fit enough to rush into a burning building and come out alive.
We are the doctors who ask the detailed questions about a person’s occupation. Sometimes I feel like I’m at a cocktail party and I’m breaking the ice by asking “so, what do you do for a living?” I don’t stop with just the job title. Occ docs are interested in the details of what you do for work because we want to understand the environment that you spend a third of your day (or more) in. I’ve been on tours of steel mills, factories, warehouses, bakeries, and dairies. I get to take that knowledge of how things are done and apply it to the treatment of my patients.
What kinds of injuries and illnesses do we treat?
I’ve seen everything from the basic sprains and strains, repetitive use injuries like elbow and wrist tendonitis, broken bones, and cuts to contact dermatitis, work-related asthma, needle stick injuries, severe burns, hernias, coal dust and asbestos exposures, head trauma, and PTSD. Each person has a story to tell about their injury, and sometimes they are harrowing. You never know what will walk through the door of the clinic, be it the park worker with the giant fishhook through the palm of his hand, the factory worker with a nail in his heel fired from a nail gun, the construction worker covered in a poison ivy rash, the nursing home aide with exposure to scabies, or the research lab tech punched in the face by a monkey (all true stories!). Then there are the patients who fell off a roof or were injured in a major car accident, crushed by equipment, sustained third degree burns in an explosion, or assaulted on the job. It’s my job to coordinate care with other specialists and to make sure that every injured worker can get back to work and do the job they are trained to do.
Occupational medicine is part of the broader specialty of preventive medicine. Many occupational medicine practices do medical surveillance work for employers by providing services at the worksite. My patients work in all types of jobs and industries. Each job has its own hazards, and some are more dangerous than others. Our job as occ docs is to not only treat these workers but also make sure that the hazards they face in the workplace are addressed. There will always be work related injuries; here in Minnesota we won’t be able to get rid of that ice in the winter that causes slips, trips, and falls. Our ultimate goal is to spend less time on treating injuries and more time on preventing them.
Not all occ docs do the same thing.
Some doctors are specialists in environmental toxicology and treat patients for toxic exposures at work or at home. Some work in the corporate setting to ensure that the employees are safe to work and that their work-related health needs are met. Others work in the military providing treatment and surveillance for our troops. Occ docs can become specialists in the evaluation of work-related impairment and disability or work for insurance companies to make sure that medical care meets acceptable standards.
So, if you’re a medical student or a doctor, or you know one, please tell them about our field. Our specialty has the highest rate of job satisfaction and the lowest rate of burnout of any medical specialty. I have never had to work nights or weekends or take call, and I don’t know too many other doctors who can say that.
If you’re injured at work, seek out care from your friendly local occ doc. We are happy to help!