April 14, 2015
In 1988, a committee of the American College of Emergency Physicians asked me to write a position paper for the college entitled “Report on the Role of the Emergency Physician in Occupational Medicine.” In the paper, I tried to make sense of the intersection of occupational medicine, which is a preventive medicine specialty, and emergency medicine, which focuses on treatment rather than prevention. I concluded that there was overlap between the two specialties and labeled the overlap “industrial medicine.” The position was adopted by the College but the name never stuck. It’s probably just as well.
I’m reminded of this experience whenever I get approached with the question about the appropriate name for a service that provides healthcare to employees. Are these called “occupational health services” or “employee health services”? My answer is always: “Pick the name you like. These labels are arbitrary and interchangeable.” Some purists, who I suspect have too much time on their hands, want to argue the point with me.
The argument is:
- “Employee Health” refers to healthcare issues related to a type of patient: employees. It may include multiple facets of medicine: occupational medicine, internal medicine, sports medicine,family medicine, etc. In this concept, the effort to improve occupational health is just one subset of employee health.
- “Occupational Health” refers to healthcare issues related to a type of activity: work. It focuses on the health effects of work primarily on the employee, but in certain circumstances (such as production of toxic chemicals) it can also address the health effects on others, like the product’s end user.
Board-certified specialists in this field are certified in “Occupational Medicine.” Consequently, they chose the terms “occupational medicine” and “occupational health” for what they do because it mirrors the term officially used by their specialty. Employers have leaned toward the term “employee health” because their interest in employees and healthcare cost control extends beyond the workplace into general health issues like obesity and hypertension.
Anyway, that’s the argument. Like my attempt to define “industrial medicine” to mean a specific type of healthcare, folks are free to define these terms in a way that has meaning for them. Whether we use the term “employee health services” or “occupational health services”, our mission is the same: protecting the health of people who work.