Occupational and environmental health play a critical role in the lives of workers and the public at large. In 2010, it was estimated that, in the United States alone, there were 60,000 deaths and 860,000 diseases due to occupational exposures (chemical, biological and radiological). In addition, about 5,147 workers died in the United States in 2017, due to traumatic injuries such as traffic accidents.
And yet, occupational medicine physicians have been suffering from a shortage since the early 1990s, unable to keep up with this increasing demand.
What Do Occupational Physicians Do?
Modern occupational medicine was founded in the early 20th century by Alice Hamilton, MD (1869-1970), the first female professor at Harvard in any field. Nicknamed the ‘Mother of Occupational Medicine’, Hamilton was a pioneer in chemical health and workplace safety. Predominantly working in rural America, descending into coal mines and inspecting reluctant factories, Hamilton was a socially-conscious reformer who exposed the conditions of immigrants and the poor, bringing to light industrial sicknesses, mortality and disease rates of workers in the United States. Three months after Hamilton died, Congress passed the Occupational Safety and Health Act, paving the way for occupational medicine physicians to enhance the lives and health of workers through preventive medicine, clinical care, disability management, research and education.
Inspired by Alice Hamilton’s investigative work, occupational physicians have many tasks, including visiting work sites to advise workers and management about potential chemical, biological, radiological, physical, pharmacological, psychological and social hazards. They perform hearing tests, lung function tests, and test patients’ blood and urine for chemical exposures. Occupational physicians help rehabilitate injured workers and help them return safely to work. They care for workers exposed to bodily fluids and help hospitals with infection control programs.
They give travel immunizations and conduct drug testing programs. They counsel workers and management about reducing workplace ergonomic risks and help treat workers with repetitive motion injuries, such as back problems and carpal tunnel syndrome. Occupational physicians provide Department of Transportation exams for truckers. They work closely with engineers, ergonomists, industrial hygienists, occupational therapists and infection control specialists to reduce workplace hazards and decrease healthcare costs.
By the Numbers
In spite of the obvious importance of environmental medicine and health, there is a severe shortage of trained occupational physicians. There are now only about 2,000 occupational medicine specialists in the United States for a working population of 129 million full-time workers.
In 1990, there were about 100 annual occupational medicine residency slots. Drs. Joseph Castorina and Linda Rosenstock suggested in 1990 that the number of occupational residency positions should be increased to 300 to 500 per year. (Linda Rosenstock MD, MPH was director of the National Institutes of Occupational Safety and Health during the Clinton years.) Instead of increasing occupational medicine residency slots from 100 to 300-500, occupational medicine residency programs were cut by half, as occupational medicine residency slots were reduced to about 35 by 2002. Making matters even worse, an average of 250 occupational physicians retire every year.
How Do Locums Fit In?
Typically filling in gaps during vacations, maternity and sabbatical leaves of absence, or covering shifts while a healthcare facility searches for a permanent hire, locum tenens occupational physicians help combat this increasing shortage. With limited residency slots and a great number of providers retiring every year, facility’s have more difficulty filling these positions with qualified candidates. Locums in this field ease the burden and are able to provide care to patients that might otherwise have gone unseen.
Locum tenens services — which are built around the idea of quick, efficient, short-term access to physician talent pools — will be the answer as the effects of the physician shortage progress. For companies that may repeatedly need a physician in short-term capacity, establishing a relationship with a third-party partner could reduce the time and expense of manually hunting (and possibly overpaying for) a decreasingly common skill set.
Since occupational medicine physicians are in high demand, there are many excellent opportunities and openings in all areas of this specialty, including primary care/prevention, research and administration. According to the American College of Occupational and Environmental Medicine (ACOEM) website, Occupational and Environmental Medicine is the medical specialty ranked among the highest in satisfaction and lowest in professional burnout!
