The Institute of Medicine (IOM) states that there is a critical shortage of specialty-trained occupational and environmental physicians in communities, in academic medical centers, and in public health and related agencies. Moreover, the IOM reports a severe shortage of frontline primary care physicians who are willing and able to care for patients with occupational and environmental illnesses. The IOM concludes that data from the Bureau of Labor Statistics (BLS) are significant underestimates of occupational diseases, which emphasizes the need for more and better diagnoses of occupational diseases by primary care practitioners. The IOM recommends that “all primary care physicians be able to identify possible occupationally or environmentally induced conditions and make appropriate referrals for follow-up.”

Since passage of the OSHAct, US employment has more than doubled, from 56 million workers at 3.5 million work sites to 130 million workers at nearly 8 million work sites. Most of the labor force expansion during this period was in service sector companies with fewer than 500 employees. Although these companies are not likely to employ occupational physicians, they do add to the demand for injury and illness care as well as for health and safety consulting. Employers expect to hire almost 500 occupational physicians over the next 5 years and are looking for residency-trained specialists. Skills in evidence-based clinical evaluation and treatment, determining fitness for work, and worker and management communications are the most important technical skills needed by employers. The estimated number of occupational physicians that employers expect to hire over the next 5 years is substantially higher than the number estimated to be produced from current training programs. Opportunities in occupational medicine, and in the increasingly important specialty of environmental medicine, vary by region. There are many industrial areas with an established medical community serving their needs, yet in other areas there are growing industrial corridors very much in need of occupational physicians.

Source: CURRENT Occupational and Environmental Medicine 5/E