A large part of the occupational (OH) service’s role is to make sure that employees are physically and psychologically fit for their job and that those working with them, are safe. Advice to managers about fitness for work and effectiveness and reliability are the two primary reasons for advice from an OH service. During any consultation, an OH clinician seeks confirmation from the person of their diagnosis and treatment and explores relevance to recovery and capability for their job. There are two ways of doing this, either face to face with the employee called into OH or via a telephone consultation.
Many employers believe that the OH Service makes medical diagnoses and gives treatment advice to employees. However, it is only the family doctor who provides this, unless there is a work-related health problem, where a family physician may have to refer to a specialist.
In this case, the occupational health service is the right expert.
What Happens at Occupational Health?
The management referral is assessed by the occupational health service when it arrives to see if it is suitable for a telephone consultation.
Occasionally the management referral paperwork does not give enough information to make a decision, so the manager has to give more details. In cases of doubt, occupational health can do a preliminary telephone call to the employee to gauge the appropriateness of the way forward; that is either a telephone consultation or a face-to-face appointment at occupational health.
Some cases are better discussed in person; such as, if Mr Harris and Mr Smith are both off sick with depression, their consultations do not necessarily have to be face-to-face. The first phone call from the OH clinician finds out the most appropriate method. Mr Smith’s case may be wholly right for a telephone assessment, but Mr Harris may need a face to face discussion, due to personal circumstances or due to the complexity of the situation. During an assessment if the OH clinician believes that a face-to-face consultation is more appropriate this is arranged; in both cases, management is advised.
Other Likely Issues:
- Work-related stress
- Mental health problems
- Ill-health retirement assessments
- Short-term repeated absences
- Those who have difficulty communicating on the telephone
- Any medical condition that requires an examination such as work-related upper limb disorders
Research shows that telephone consultations are as effective as a face-to-face consultation (see further reading below).
- Less time needed for both the employer and employee
- The referral actioned faster
- No clinical premises required
- The employee does not need to come into the office/workplace
- Less threatening for the employee
- Can be conducted anywhere the employee is, with their consent of course
- Perceived as being of less value by the employee
- Unable to physically check the person over the phone
- No feedback in the form of body language or visual clues on either side
- The employee may become distracted
The Process of a Telephone Consultation
The format of the phone consultation can vary. However, there are some basic steps which most assessments go through.
Occupational health sends a letter to the employee setting out:
- An introduction to occupational health, usually with a leaflet and contact details
- How occupational health works
- A suggested date and time of the appointment
- How long the interview usually lasts
- An explanation of confidentiality
- What happens after the consultation
If an employee has problems with the process or wants to change their appointment time or date, then OH contact details are available too.
On the day of the phone assessment, the employee receives the call from occupational health and after introductions, follows a process such as:
- Confirming the employee has the appointment letter
- The correct person is answering the call
- The reason for referral
- If they have any problems with talking to the OH practitioner
- Assessment of their health condition
- Receiving health information and relevant advice
- The next steps in the process
After the Telephone Consultation
The OH Clinician collects information from many sources before writing the report to management, calling for all their medical ability and knowledge of the particular job. During any consultation, it may be clear that the telephone approach is not working, in which case it is their responsibility to suggest a face to face appointment.
Occupational health clinicians use the same process for assessment for both a telephone and a face-face consultation. Moreover, many occupational health services use an assessment tool to gather the information, so that this process is systematic and objective, also most importantly, they do not miss any critical areas of enquiry. The OH professionals use their clinical skills to find out if the patient is fit for work and if a return to work plan is needed.
Health advice is readily given during telephone consultations, as in a face-to-face situation.
If more medical information is required to progress the case or if the information received from the employee does not agree with the OH clinician’s opinion, a written consent form needs to be signed by the employee, to get more information from their treating GP or specialist.
Why Use Occupational Health for a Telephone Consultation?
Some managers have questioned the usefulness of telephone consultations believing that they could do this themselves. I am not going to argue with you; managers can do this themselves, however,
- The employee is under no obligation to tell you the truth
- Occupational health services act in an objective way and have no personal interest or gains from the outcome, because Managers may have their own agenda’s, that is, pay and production issues.
- An employee cannot hoodwink a trained medical professional as easily as they can their manager
- Managers are busy people and do not have the time to deal with each employee or write-up notes afterwards.
- A Place for Telephone Consultations in Occupational Health
- Telephonic Support to Facilitate Return to Work: What Works
 ‘Assessment’ is the gathering of information to make an informed decision or give advice
Have you had any experience with a telephone consultation from occupational health? Share your experience here.