Behavior changes result in award-winning program
A good understanding of human behavior can make a big difference in a wellness program, says an occupational health physician with a program that just won an award for its outstanding service to employees of the Indianapolis and Marion County Sheriff’s Department.
So many wellness goals depend on behavior changes by the employee that occupational health professionals must understand what motivates those changes, says Steven Moffatt, MD, medical director for the city of Indianapolis. Otherwise, you may end up spending a lot of money on the effort and see little in the way of results. "We focus on behavior changes, people accepting their individual lifestyle goals. That’s a very important piece of what we do," Moffatt explains.
"People don’t just automatically quit smoking. They go through several processes in quitting smoking, and it’s the same with weight loss, exercise, and other goals. In the past, employers just spent money on people no matter how ready they were to quit," he says.
That approach is one of the reasons the Ameri-can College of Occupational and Environmental Medicine (ACOEM) in Arlington Heights, IL, has named the City of Indianapolis and Marion County Sheriff’s Department one of four national winners in its 1999 Corporate Health Achievement Award (CHAA) competition.
A team of occupational medicine physicians, led by John Rodway, MD, studied extensive documentation on the city’s health and safety programs, then completed the final examination and review process during an on-site visit to Indianapolis. In their written report, CHAA examiners explained that the city was selected as a winner because of its "outstanding programs, outstanding facilities, and exceptionally highly qualified people." The quality of the working relationships at Indianapolis also won approval.
"We were very impressed with the positive interaction between the unions, management, and providers," the report said. "All parties heaped praise on each other, and the synergism was contagious."
OH works closely with benefit provide
Moffatt also points to the close connection between his occupational health services and the city’s provider of health benefits. The occupational health team makes immediate referrals to the health provider when necessary, and their close relationship means that the referral gets quick attention, he says. That sort of relationship can make a difference in some situations, such as when the worker has indicated a desire to quit smoking.
"We can refer quickly back to the plan to get the appropriate medications and the resources to get them into the smoking cessation program," he says. "Because of our close association with the benefit provider, we can get them into the program quickly rather than the employees doing it on their own."
That close relationship also plays a role in the remarkably high success rate for rehabilitation after injury, he says. Ninety-three percent of injured employees achieve their rehabilitation goals, a success rate that Moffatt attributes to a highly integrated partner approach with Methodist Occupational Health Centers throughout the community. Moffatt coordinates a large network of multiple providers that handle injuries, while he is directly responsible for preplacement examinations, wellness programs, and physical fitness.
"Because we work with a municipality, we have a very strong emphasis on partnership," he says. "So there’s a fairness between who’s providing what service, with no monopoly on who’s providing the health services. In a municipal environment, those things have to be bid upon and the competition is high, so you have to be able work out a good partnership between different entities."
Every visit an opportunity for needed exams
The occupational health program also tries to take advantage of every opportunity to provide needed services to individual employees without incurring additional expenses and inconvenience. Because the city and county employees include a wide range of people working in law enforcement, firefighting, maintenance, and other professions involving some degree of risk, there are a lot of physical examinations that must be performed on a regular basis.
If the employee visits the clinic for an unrelated reason, the staff will check the records and see if that person is due for any mandated exam. If so, the occupational health staff will try to perform that exam at the same time as the other treatment. The idea also works in reverse.
"If they are here for a mandated exam, we will try to be efficient and add some confidential components for lifestyle changes," Moffatt says. "If someone comes in for a respirator exam, we might do some other examinations as well that may have an impact on their lifestyle in general. We might check them for cholesterol, cancer, or do a cardiac assessment."
The only information released to the employer, in that example, is whether the subject can safely wear a respirator. Moffatt says the employer does not mind the added services because city and county leaders are convinced of the value of preventive medicine.
The occupational health team is taking advantage of the money already spent on the visit, he says. The majority of the expense for the visit is already required for that respirator exam, and based on the volume of tests, the program gets the other testing at reduced costs, he says. (See story on how program saves money, p. 127.)
Sources
For more information, contact:
• Steven Moffatt, Medical Director, City of Indianapolis, 303 N. Alabama, Suite 110, Indianapolis, IN 46204. Telephone: (317) 972-1180. E-mail: Stevenmoffatt@publicsafetymed. com.
• American College of Occupational and Environmental Medicine, 1114 N. Arlington Heights Road, Arlington Heights, IL 60004. Telephone: (847) 818-1800. Fax: (847) 818-9266.
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