This material is for training purposes only. Its purpose is to inform Oregon employers of best practices in occupational safety and health and general Oregon OSHA compliance requirements. This material is not a substitute for any provision of the Oregon Safety Employment Act or any standards issued by Oregon OSHA. For more information on this online course and other OR-OSHA online training, visit the Online Course Catalog.

MODULE 7: MEDICAL MANAGEMENT

INTRODUCTION

Company health care management strategies and policies and health care providers is an important part of the overall ergonomics program.

In general, medical management emphasizes the prevention of impairment and disability through early detection, prompt treatment, and timely recovery. Medical management responsibilities fall on employers, employees, and health care providers.

Employer responsibilities

The employer can create an environment that encourages early evaluation by a health care provider by:

Providing education and training to employees regarding the recognition of the symptoms and signs of MSDs and the employers procedures for reporting MSDs
Encouraging employees to report symptoms early so prompt evaluation by an appropriate health care provider can be provided
Giving health care providers the opportunity to become familiar with jobs and job tasks
Modifying jobs or accommodating employees who have functional limitations secondary to MSDs as determined by a health care provider
Ensuring, to the extent permitted by law, employee privacy and confidentiality regarding medical conditions identified during an assessment

Employee responsibilities

Employees should participate in the health care management process by:

following applicable workplace safety and health rules,
following work practice procedures related to their jobs, and
reporting early signs and symptoms of MSDs.

Employees may be faced with conflicting job demands or requirements. Safe work practices or rules may conflict with pressures or incentives to be more productive. If the message from management is that job security depends on working fast... employees will work fast... possibly choosing unsafe shortcuts in safe procedures. On the other hand, if management sends the message that job security depends on working safe... you can bet employees will not take those shortcuts.

Health Care Provider Responsibilities

The health care provider can support the employer's ergonomics program by:

Acquiring experience and training in the evaluation and treatment of MSDs
Seeking information and review materials regarding employee job activities
Ensuring employee privacy and confidentiality to the fullest extent permitted by law
Evaluating symptomatic employees including:
medical histories with a complete description of symptoms
descriptions of work activities as reported by the employees
physical examinations appropriate to the presenting symptoms and histories
initial assessments or diagnoses
opinions as to whether occupational risk factors caused, contributed to, or exacerbated the conditions
examinations to follow up symptomatic employees and document symptom improvements or resolutions

Job Familiarity and Job Placement Evaluations

Health care providers who evaluate employees, determine their functional capabilities, and prepare opinions regarding work relatedness should be familiar with employee jobs and job tasks. With specific knowledge of the physical demands involved in various jobs and the physical capabilities or limitations of employees, the health care provider can match the employees capabilities with appropriate jobs. Being familiar with employee jobs not only assists the health care provider in making informed case management decisions but also assists with the identification of ergonomic hazards and alternative job tasks.

One of the best ways for a health care provider to become familiar with jobs and job tasks is by periodic plant walk-throughs. Once familiar with plant operations and job tasks, the health care provider should periodically revisit the facility to remain knowledgeable about changing working conditions. Other approaches that may help the health care provider to become familiar with jobs and job tasks include reviewing job analysis reports, detailed job descriptions, job safety analyses, and photographs or videotapes that are accompanied by narrative or written descriptions of the jobs.

Early Reporting and Access to Health Care Providers

Employees reporting symptoms or signs of potential MSDs should have the opportunity for prompt evaluation by a health care provider. In general, the earlier that symptoms are identified and treatment is initiated, the less likely a more serious disorder will develop. Employers should not establish policies that discourage employees from reporting symptoms. For example, programs that link a manager s earnings to the number of employees reporting symptoms may discourage supervisors from allowing symptomatic employees to be evaluated by the health care provider. Employees should not fear discipline or discrimination on the basis of such reporting.

Treatment

Health care providers are responsible for determining the physical capabilities and work restrictions of the affected workers.
The employer is responsible for giving an employee a task consistent with these restrictions.
Until effective controls are installed, employee exposure to ergonomic stressors can be reduced through restricted duty and/or temporary job transfer.
Complete removal from the work environment should be avoided unless the employer is unable to accommodate the prescribed work restrictions.
Immobilization devices, such as splints or supports, can provide relief to the symptomatic area in some cases. These devices are especially effective off-the-job, particularly during sleep. They should not be used as prophylactic PPE to prevent the development of MSDs. Therefore, these devices should be dispensed to individuals with MSDs only by health care providers who have knowledge of the benefits and possible negatives of these devices.

Last words

Well, there it is: medical management in a nutshell. Coordinate with your health care provider to develop this component of the ergonomics program. When administered effectively, medical management can result in lowering costs, and it sends a very positive message to employees - a message that says "we care!"

Time to take the infamous review quiz, so let's get to it! Answer each question as best you can. Scroll up the page to review if you like.

Module Quiz

31. In general, medical management emphasizes the prevention of impairment and disability through all of the following, except:

a. Early return to work
b. Prompt treatment
c. Early detection
d. Timely recovery

32. Employers should provide training to employees regarding all of the following, except:

a. symptoms and signs of MSDs
b. methods of self-treating MSDs
c. procedures for reporting MSDs
d. All of the above

33. Which of the following important activities was not listed as a way employees can participate in the health care management process?

a. following safety and health rules
b. following procedures
c. suggesting ergonomic improvements
d. reporting signs and symptoms

34. According to the text, one of the best ways for a health care provider to become familiar with jobs and job tasks is by periodic ____________________.

a. communication
b. plant walk-throughs
c. medical exams
d. accident record reviews

35. Immobilization devices, such as splints or supports, should be dispensed only by health care providers who have knowledge of the benefits and possible negatives of these devices.

a. True
b. False

Good work on Module 7! Medical management is essential to an effective ergonomics program. Now, let's continue on to Module 8 to learn more about medical management of ergonomics injuries. If you have any questions or comments, just drop me an e-mail at monique.e.schmidt@state.or.us.

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