Impact of an Occupational and Environmental Medicine Curriculum on Lost Workdays

Abstract

We established an occupational and environmental medicine (OEM) curriculum for our residents. We hypothesized that greater OEM knowledge would decrease the number of lost workdays for injured patients. We retrospectively compared return-to-work outcomes before and after implementation of the OEM curriculum. Study subjects were workers' compensation patients (18 years and older) seen between January 1, 2001, and December 31, 2002. In 2001, 253 injured workers were treated; in 2002, 204 were treated. The OEM curriculum was introduced in January 2002. The adjusted odds ratio for having lost workdays increased after implementation of the curriculum. Greater competence in assessment and treatment of occupational injuries may increase lost work time for injured patients. This surprising result was a cause for concern. However, by including only patients with injuries in the analysis, it is unlikely that this paradoxical result was attributable to increased recognition of occupational disease. Treatment by the employee's personal physician may have had an effect on the number of lost workdays. In an effort to reduce lost workdays for the injured employee, we implemented a formal OEM curriculum for family medicine residents at our clinic. The curriculum and results are presented in this article.