Doctors’ attitudes to patient occupation information in four hospital specialties

Abstract

Background Although we do not know how often doctors enquire about their patients’ work, evidence suggests that occupation is often not recorded in clinical notes. There is a lack of research into doctors’ views on the importance of patient occupation or their educational needs in this area. Aims To assess doctors’ attitudes to using patient occupation information for care-planning and to determine doctors’ need for specific training in occupational health. Methods We undertook a cross-sectional survey of doctors in cardiology, obstetrics and gynaecology, oncology and orthopaedics. Our questionnaire explored attitudes of the doctors to asking patients about their occupational status, their training and competency to do so, and their training needs in occupational health. Results The response rate was 42/46 (91%). Obstetrics and gynaecology 6/9 (67%) and oncology doctors 3/6 (50%) reported enquiring about the nature of patients’ occupations’ ‘most of the time’/‘always’ and that it rarely influenced clinical decisions. This contrasted with orthopaedic doctors 12/12 (100%) and cardiology doctors 14/15 (93%). Although 19/42 (45%) participants felt it was important to ask patients their occupation, only 10/42 (24%) ‘always’ asked patients about their work. The majority of participants 29/41 (71%) reported receiving no training in occupational health, but 37/42 (88%) considered that some training would be useful. Conclusions Training on the importance of occupation and its’ role as a clinical outcome in care-planning, might help doctors feel more competent in discussing the impact of health on work with patients.

Attitudes and practices of ophthalmology doctors in London (UK) on the importance of discussing work as a clinical outcome with patients during consultations: A cross sectional survey

“…In addition we had a good response rate across all medical staffing groups within the specialty. Furthermore, our findings reflect those found from previous work in other specialties such as obstetrics and gynaecology [ 11 ]. This suggests that our collective insights may be generalisable to other surgical specialties who provide care to the working age population.…”

“…An earlier study also identified a lack of, and desire for, OH training among doctors working in other specialties (namely, cardiology, gynaecology and obstetrics, oncology and orthopedics) which was also associated with feeling less competent and skilled discussing work outcomes with patients. Moreover, they found a similar discrepancy between the number of doctors from other specialties who consider it important to enquire about occupation and doing so in clinical practice [ 11 ]. Collectively these results suggest that non-OH doctors have a perference for focusing on their own specialty area during patient consultations rather than take into consideration broader factors such as the impact of health on work.…”

“…In light of the evolving evidence which has called for the enhanced provision of ‘work and health’- themed education and training for non-OH clinicians [ 11 , 17 , 19 ], we recommend implementing OH education during medical training for Ophthamologists to enhance clinical care.…”

“…Conversely, returning to work after sickness absence appears to have a positive effect on mental health [ 9 ]. Despite the protective benefits of work, limited research suggests that work-focused discussions do not routinely occur between patients and doctors in primary and secondary care [ 10 , 11 ]. Clinical practice reforms in the UK regarding sickness certification for workers highlights the prominent role that doctors can play in advising what work activities patients are able to perform, particularly if reasonable work adjustments are made (e.g.…”

Physicians' Knowledge, Attitudes, and Practice of Occupational Diseases Diagnosis and Occupational History Taking

“…In addition, large percentages of different specialty physicians agreed only on the importance of taking an occupational history from patients, as in the current study. 18,27,28 However, a lower percentage agreed when it came to their opinion on their role in detecting occupational diseases or the importance of knowing if the patient's disease has an occupational origin. This may reflect their low general knowledge and interest in occupational health as medical students, as Bhardwaj et al 29 explained.…”