The occupational health physician: good occupational health takes courage, not time

Being an occupational health physician is a rewarding and highly relevant profession. We work with two things that genuinely matter to people: their health and their work. Yet we don't always make the most of the impact we could have. That needs to change – and it starts with creating room to do more than simply see employees in consultations.

From time to time, I attend careers fairs for medical students to talk about occupational health. It's fair to say that their image of the profession isn't particularly heroic. As occupational health physicians, we're not going to save a patient's life in an emergency. And that's true, of course. But we can still have an enormous impact – not just on an individual employee, but on their team or even an entire organisation. To do that, though, we need to have the courage to step forward and stand up for what our profession is really about.

A diary packed with consultations

Take the current debate around prevention. It's a fundamental part of our profession, yet in practice we probably spend no more than five per cent of our time on it. A common explanation is: “My employer and client don't give me the time or opportunity to do that.” I think that puts the responsibility on others too easily. Too many physicians allow someone else to dictate their entire diary. They spend all day seeing employees in consultations – and that's where their involvement ends.

We need to create support for prevention ourselves and make room for promoting and protecting health. In fact, organisations that already make time for this tend to be the ones where safe and healthy working practices are firmly embedded anyway. As physicians, we potentially have the greatest opportunity to improve health in organisations where these issues aren't yet receiving the attention they deserve.

When the company picks up the tab

It takes courage to put health firmly on the agenda. But when you do, it can be incredibly rewarding. Some time ago, I worked with a company whose technical employees regularly spent weeks abroad on assignments. With little to do outside working hours, they would drink heavily. They'd submit the receipts to their employer, who would reimburse them without question. Eventually, unsurprisingly, problems began to emerge. Employees developed a range of health issues and were no longer able to function properly at work. I told the management team: “You're enabling this. You need a policy that changes the situation, and you need to give your employees the support they need.” That's exactly what they did – and it resulted in a lasting solution to the problem. Of course, it doesn't always work. Sometimes an employer simply isn't willing to change. And when that happens, you have to ask yourself whether they're an organisation you want to continue working with.

Stepping forward

Standing up for your profession – and for prevention and health – isn't always easy. In many cases, it's simply not something we've been taught to do. Medical training still doesn't do enough to equip occupational health physicians with the skills they need to influence what happens beyond the consultation room. So we have to develop those skills in practice. That's precisely why we've changed our approach to training at De Nieuwe Arts and made this an explicit part of how we develop our physicians. Then it's a matter of putting it into practice. Looking beyond the immediate case. Being more visible and willing to step forward. And becoming a valuable partner to the other healthcare professionals involved in supporting an employee. That's how we, as occupational health physicians, can make a genuine difference to people's health and their enjoyment of work.