ABSTRACT
This chapter explores the changing role of occupational and environmental medicine (OEM) in the workplace, describing trends in occupational medicine practice and the reasons for the changing nature of OEM practice, including the context of rising health care costs, and the decreasing economic viability of the practice of occupational medicine. It suggests that some possible directions that might re-focus the field toward primary prevention and a greater role in encouraging healthier work environments. OEM specialists also face impediments to prevention-oriented practice. OEM doctors manage workers' compensation cases as well as fitness for duty and return to work assessments. OEM physicians assist patients, employers, primary care physicians and cardiologists in the secondary and tertiary prevention of cardiac disease, as well as the accommodation of workers with cardiac concerns. OEM doctors could provide leadership in the development of prevention-oriented clinics, even if only working there part-time.
