1199 How do occupational health physicians in a belgian occupational health service perceive their current and future role in re-integration?

Abstract

Introduction Recently a new legislation on re-integration of employees on long-term sick leave was introduced in Belgium. The purpose is to facilitate return to work of disabled employees with adapted or other work. The more prominent social importance and government demand could change the role of the occupational health physician (OHP). The question could be asked how OHP’s perceive their changing role in the re-integration process? Methods 61 OHP’s (93.8% response) working in a Belgian occupational health service participated in a survey. Five function roles were defined: ‘healthcare provider’: helping the employee (trust relationship); ‘coach’: coaching and motivating the employee; ‘service provider’: focus on employer’s situation; ‘expert’: focus on evidence based medical evaluation; ‘controller’: employees who are able to work, obligate to do so. The frequency of each role was asked for three different situations: occupational medical examination (OME), current attitude in re-integration examination (CARE), best possible attitude to assume in re-integration examination (BARE). Mean scores (0–10) were calculated per function role, a higher score was concordant with a higher frequency. Results In all 3 situations the roles of healthcare (7.3–7.7) and service provider (5.8–6.2) scored similarly. The coach role was highest in the BARE (8.2), followed by the OME (7.7) and the CARE (7.0). The expert role was predominantly in the BARE (8.2) compared to the OME (6.7) and the CARE (6.6). The score for controller increased gradually from 2.9 (OME), over 3.5 (CARE) to 4.8 (BARE). Discussion The OHP is a healthcare and service provider in all circumstances. In the BARE the most important roles were those of expert and coach, followed by healthcare and service provider. Although the role of controller had the highest score in this situation, it still remained the less important of the five roles.