Occupational physicians mainly focus on supporting employees during sickness absence, leaving less room for preventive tasks such as open consultation hours or workplace visits. Although almost every occupational physician sees prevention as part of their role, only 57 percent expect to be able to carry out preventive tasks. This is one of the conclusions of Suzanne Orhan Pees’s PhD thesis, defended on 22 September at Vrije Universiteit Amsterdam.
The support occupational physicians perceive for the performance of preventive tasks plays an important role in whether they actually perform these tasks, and explains why a large proportion of them do not manage to do so. Most occupational physicians (84 percent) feel supported by colleagues, 62 percent by their own occupational health service, but only 43 percent perceive support from the employers they work for.
Preventive tasks in practice
Although preventive tasks are outlined in the Dutch Working Conditions Act (Arbowet), occupational physicians often struggle to make time for those tasks in practice. To support them, an intervention was developed. As part of the intervention, existing peer-review groups held three meetings on carrying out preventive tasks. The occupational physicians drew up personal action plans to take on more of these tasks.
More time spent on preventive advice during sickness-absence management
The intervention increased awareness of the importance of prevention among participating occupational physicians. Many were also able to set goals to engage more in preventive activities. After one year, the participating physicians spent an average of five additional hours per month giving preventive advice during sickness‑absence management. One explanation is that, for this particular task, occupational physicians are not dependent on extra time, money, or approval from employers or their own occupational health service. Tee total time spent on prevention did however not differ between the intervention group and the control group.
Recommendations
Many of the obstacles to performing preventive tasks are linked to how the system in the Netherlands is organised. To improve implementation, Orhan Pees recommends establishing a stronger focus on prevention. This requires agreements and resources from all involved parties, including employers and occupational health services. Because the study showed that employers play an essential role, it is important to explore how they can be encouraged to invest in prevention.
This study was carried out jointly by the National Institute for Public Health and the Environment (RIVM) and Amsterdam UMC and commissioned by the Ministry of Social Affairs and Employment (SZW).