Company physician

Interim reviews of the data are an essential requirement to minimise risk during dose-escalation studies. After each study day, or certainly after a predefined number of volim-teers have received the next dose increment, the investigator, nurses, study physician and preferably one or two other experienced physicians who are not intimately involved with the study should meet to review the data. When the study is being conducted in a CRO, a sponsor company physician and a limited number of other personnel should participate by tele- or video-conference if not in person. A decision to stop, modify or continue dose escalation should be made jointly between the Principal Investigator at the CRO and the sponsor s physician. Such reviews should be conducted with maintenance of the double-blind and steps should be taken to avoid inadvertent unblinding, such as by coding of subject numbers. The data that should be reviewed are listed in Box 4.12. 

Finally, since some of the questions posed to information services departments are of medicolegal importance, for example, prescribing advice or adverse event reporting and/or management and liability, information scientists will normally seek the support or advice of the company physician or pharmacist and even the legal department, in providing a response. The company physician or pharmacist should always be prepared to respond personally to the health service professional who is making... 

Additional fit tests must be conducted whenever the employee reports, or the company, physician, supervisor, or program administrator makes visual observations of, changes in an employee s physical condition that could affect respirator fit. Such conditions include, but are not limited to, facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight. 

The Multidisciplinary Approach. At one time, the company physician and occupational health nurse bore the primary responsibility for the health and safety of workers in their workplace. Although that physician-nurse team has expanded to include other disciplines, clinical services are stiU an important part of occupational health and safety programs. Some of the services provided by health care professionals include preemployment physicals, health assessments, and health surveillance through intermittent medical examinations and basic laboratory testing. Health education and counsehng usually falls to occupational health professionals, as do treatment, rehabilitation, and referral. 

In self-medication, the application of Echinacea preparations is very often started when patients experience the very first symptoms of a common cold. The objective of this early treatment is either to prevent that the common cold symptoms fully develop (some form of prevention) or to decrease the duration and the severity of the illness (in the sense of a typical treatment). In this early stage patients rarely consult a physician consequently, it is not easy to study this type of use. Only recently a first study investigating this early treatment has been published [20]. The employees of a Swedish industrial plant were informed of the study and asked to consult the company physician in the case of the very first symptoms of a common cold. A total of 120 employees presenting during the recruitment period were then randomized to receive, in a double-blind manner, the pressed juice of Echinacea... 

Q. An employee has a work-related occupational injury and is examined by the company physician. The employee can be returned to work, full duty however, the employee is given a 20-pound lifting restriction, or a do not use left hand restriction for 3 weeks. 

Before allowing the injured worker back into the workforce, the FLS should ensure that this team member has been released for duty by the company physician, medical department or personnel, or human resource department. Using the company physician or company department authorization is an important point. Team members have been known to perform a variety of interesting antics both to avoid work and to get back to work. 

On one particular remote worksite in the Midwest, one new hire showed up for work without obtaining a medical authorization through the company-approved physician. The FLS turned him away, restating that he would have to have medical clearance before being allowed to start to work. As it turned out, the potential new hire had gone for his physical exam, but the company physician wanted to have a variety of other tests successfully completed before the company physician would deem the potential new hire fit for duty. 

The tests that the company physician was requiring were not part of what the company was authorized to perform and pay for during the physical examination therefore, the team member was told to see his personal physician. The potential new hire s physician would perform the tests (keep in mind that the potential new hire was expected to have these tests performed at his own expense, insurance or otherwise) and then have his personal physician call the company physician. The company physician and personal physician would then consult. 

A situation similar to this example repeats itself many times daily in the normal course of business. We have a worker who wants to work, but who is not deemed fit for duty by a company physician. Further testing may result in the clearance for duty, or it may not. One situation we want to avoid is allowing someone to perform work without proper authorization. In the previous example, the team member was very unhappy about being asked to leave the worksite because of a lack of medical clearance. In this team member s logic, he had already proven that he was fit to perform the job. After all, he had been performing it successfully until his less than acceptable fitness for duty was discovered. He expressed with vehemence that there was absolutely no reason not to allow him to continue. 

An equipment operator was struck in the head by a flywheel that shattered from a neighboring machine. It was believed that the operator was okay, but after urging from the FLS, the operator was sent for a medical evaluation. The company physician prescribed some medication and told the operator to take the rest of the day off and come back the next morning before the shift change for another look and potential full release. The operator, knowing that his shift was understaffed, went back to work. He told the FLS that he was okay and wanted to get his work completed. The operator went back to the company physician the next day and was released. 

These actions cast aspersions on the company physician, medical treatment, and judgment of the company doctor. The order was to go home for the day and be reevaluated tomorrow. The worker chose not to obey the doctor s orders. The FLS needs to ensure that the doctor s orders are being adhered to. The FLS probably committed an error by allowing the team member to return to work without first viewing the retum-to-work slip. 

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