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Services Provided by Family Physicians for Patients With Occupational Injuries and Illnesses

¹ Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
² Occupational Health Program, Harvard University School of Public Health, Boston, Mass
³ Department of Family Medicine and Community Health, Center for Health Policy and Research, University of Massachusetts Medical School, Worcester, Mass

CORRESPONDING AUTHOR: Allard E. Dembe, ScD, Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Ave, Higgins Bldg, Shrewsbury, MA 01545, Allard.Dembe{at}umassmed.edu

PURPOSE Many family doctors provide care to patients with occupational injuries and illnesses, but little is known about the type of medical services provided, or how they compare with services provided by other types of physicians. This study used national data to develop a statistical profile of office-based medical care delivered by family physicians to patients with work-related disorders.

METHODS Using data from 4 years (1997–2000) of the National Ambulatory Medical Care Survey, we classified visits for patients with work-related conditions according to patient and physician characteristics, services provided, and other visit characteristics. For comparison, we also compiled profiles for visits to other types of physicians for treatment of work-related disorders, and for visits to family physicians for treatment of nonoccupational conditions.

RESULTS Analyses were based on 96,183 office visits made to 4,947 physicians. A majority of visits made to family physicians for occupational conditions involved patients seeing their regular primary care doctor. Possibly for this reason, patients at these visits were more likely to have their blood pressure taken, receive diagnostic and screening services, and have prescription drugs prescribed or administered, compared with patients seeing other types of physicians. Only 73.3% of visits to family physicians for work-related disorders were expected to be paid for by workers’ compensation insurance.

CONCLUSIONS Our findings suggest that the distinctive types of care provided by family physicians to injured workers may be related to their role as the patients’ regular physician. This finding is relevant to the proposals being considered by many states to expand employers’ and insurers’ ability to choose the treating physician in workers’ compensation cases.

Key Words: Family practice • occupational health • occupational diseases • work • employment • workers’ compensation • National Ambulatory Medical Care Survey

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