A strategy to define the role of the primary care physician in occupational and environmental medicine

Although occupational medicine has its own unique knowledge, skills, and organizational base, it exists in a cultural, social, and organizational environment that is common to other institutions in our culture. ²⁴ It is therefore possible that the task of introducing the practice of occupational medicine into primary care can be made easier by examining the experience of those who have already attempted to introduce preventive cardiology activities into primary care. The Preventive Cardiology Academic Award provides a potential paradigm for enlisting a cadre of 10 to 25 innovative primary care physicians who would begin to develop actual practice models and disseminate their findings about the implementation of occupational medicine in primary care. Introducing preventive cardiology into primary care has required that multiple barriers be overcome; it is not unreasonable to expect that occupational medicine will face many of the same barriers. However, if these barriers can be successfully overcome at the experimental sites, the result will be a group of primary care practices that can be used as models for the expansion of occupational medicine to primary care in general.