Good medical practice for occupational physicians.

A complaint has been lodged against an occupational physician, claiming pro-management bias and substandard care. How should he/she be judged for professional accountabil-ity? Indeed, what are the useful benchmarks to apply for performance appraisal? • A worker who is stressed at work exhibits early signs of depression. Should informing the managers and supervisors be a necessary part of the remedial plan, so that investigations can be made into work practices and procedures that may be the stressors? • A member of the occupational health team has a health related personal problem that is affecting the work performance of the whole team. As a physician and team leader, how should the occupational physician manage that person and the team? S ociety demands the highest standards of professional competence and ethical conduct from doctors. The working population expects no less, and insists on equally high standards of proficiency in care and conduct from occupational physicians. However, defining what exactly constitutes good medical practice and acceptable standards of professional competence and conduct is not so easily done. For example, how can the questions posed in the above scenarios be answered? Yet answers and guidance are needed, not only for the public, workers, and employers, but also for occupational physicians. The Faculty of Occupational Medicine (FOM) has prepared a publication, Good Medical Practice for Occupational Physicians, 1 which attempts to provide some answers to these questions, and act as a guide for occupational physicians. In essence, this publication offers a specialty specific interpretation of the UK General Medical Council (GMC) document entitled Good Medical Practice. 2 But why the need for a specialty specific interpretation? In occupational medical practice, patient consultations may often be in the form of routine medical examinations. These examinations are often conducted because of statutory requirements or at the request of the employer. In addition, besides his obligations to the patient, occupational physicians also have a duty to the community of fellow workers as a group, as well as to the employer of the patient. The obligations to these three parties—the patient, the fellow workers, and the employer—are linked to one another. For instance, the occupational physician who diagnoses and manages a work related illness will automatically assess and re-evaluate the risk for the community of other fellow workers who are similarly exposed and therefore may be potential cases waiting to happen. The employer and management have to be involved …