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| Dr. Upfal. |
Occupational and environmental medicine encompasses many health care concerns: workplace safety, employee rehabilitation, pain management, ergonomics, air pollution, stress management and environmental hazards. The American College of Occupational and Environmental Medicine (ACOEM) has brought some order to this diverse list by establishing a competency inventory for physicians in the field.
Mark Upfal, MD, associate professor and director of occupational and environmental medicine (OEM) at Wayne State University and The Detroit Medical Center, chaired the ACOEM panel which established an inventory to define competencies in 12 categories and 14 subcategories of occupational medicine. "OEM physicians vary widely in the nature of their practices and specialties," said Dr. Upfal. "By defining competencies, there may finally be consensus in understanding what an OEM physician does or can do to improve and impact health."
Because no practitioner can have expertise in all areas, the panel established a comprehensive "menu of services" and recognized that each physician would have a unique spectrum of experience and competencies. "It is not practical to design one single set of core requirements for this field of medicine," said Dr. Upfal. "Instead, we listed the possibilities and noted whether each competency is characteristic of all OEM physicians, of the OEM specialist, or of those with specific additional training."
The fundamental competencies required of all OEM physicians include strong clinical, disability management and fitness for duty assessment skills. Residency trained and board certified OEM specialists have additional competencies which include public health, preventive medicine, epidemiology and industrial/environmental toxicology.
"We are part of a rapidly growing and rapidly changing field. This list of competencies helps clarify and define occupational and environmental medicine for physicians and patients, alike," said Dr. Upfal.