« Competency 5

• Competency 5 – Relationships with patients: Legal and ethical issues
• Competency 5 – Relationships with patients:Recognise the potential for conflicts of interest
• Competency 5 – Relationships with patients:Understand how occupational health is organised
• Competency 5 – Relationships with patients: Identify potential areas of conflict between interested parties
• Competency 5 – Relationships with patients:Recognise the potential pitfalls of inappropriate occupational health practice

Competency 5 – Relationships with patients: Identify potential areas of conflict between interested parties

Objective: to have the knowledge, skills and attitudes to cope with ethical and legal issues in the management of patients with occupational problems

SKILLS

IDENTIFY POTENTIAL AREAS OF CONFLICT BETWEEN INTERESTED PARTIES

See relationship with patients: maintaining trust: professional behaviour (Competency 4)

Clarification of the role and independent nature of the occupational health provider is important in managing the expectations of both the employer and employee. This can be illustrated by the activity outlined below.

Student activity

Consider the following scenario:

An occupational health physician has been asked by management to review an employee who is currently absent from work with depression.

Question1

What information do you feel would be helpful to the occupational health physician from the employer at this stage?

Answer

1. More background information relating to the employee.
2. Roles and responsibilities of the employee.
3. Length of employee absence.
4. Information regarding any employer contact with the employee.
5. Information from the employers regarding their views on the employee returning to work on a rehabilitation programme.

Question2

Why would such information be important?

Answer

1. To ensure clarity with respect to the expectations of the employer regarding the role of the occupational health physician.
2. To recognise any conflicts of interest, for instance the employer may express the opinion that they have lost patience with the employee due to the length of absence and if he cannot return to work on his full role, he would be dismissed.

Question3

On consulting with the employee what do you feel the occupational health physician can do to identify any conflicts of interest?

Answer

1. Set the scene; structuring the consultation by stating the purpose of the consultation, the role of occupational health and reiterating that the information is confidential.
2. Ask the employee about their expectations with regard to the occupational health input.
3. Be honest and clear on the information that will be given to management with an explanation as to how that decision was made.

SOURCE INFORMATION ON ETHICS AND LAW IN OCCUPATIONAL HEALTH PRACTICE

• HSE info line 0845 345 0055
• HSE Books 01787 881165
• Incident Contact centre (info on RIDDOR reportable conditions) 0845 300 9923
• HSE web page www.hse.gov.uk for information searches, free leaflets
• www.nrpg.org – general information on radiation
• www.hmso.gov.uk for statutory instruments
• Ethics Guidance for Occupational Health Practice published by the Faculty of Occupational Medicine.
• Faculty of Occupational Medicine http://www.fom.ac.uk