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Impact of an Occupational and Environmental Medicine Curriculum on Lost Workdays

Bernard, Matthew E. MD; Rohrer, James E. PhD; Swenson-Dravis, Dana M. MA; Justice, Michael W. MD

Journal of Occupational & Environmental Medicine: July 2007 - Volume 49 - Issue 7 - pp 771-775
doi: 10.1097/JOM.0b013e318074bb43
Original Articles

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Clinical Significance: 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.

From the Department of Family Medicine (Drs Bernard, Rohrer, and Justice) and the Alzheimer's Disease Research Center (Dr Swenson-Dravis), Mayo Clinic, Rochester, Minnesota.

Supported in part by Residency Training in Family Medicine Grant #D22HP00262 From the Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions.

Address reprint requests to: Matthew E. Bernard, MD, Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; E-mail: bernard.matthew@mayo.edu.

©2007The American College of Occupational and Environmental Medicine