On-line site becoming major source for OH professional networking
Duke University offers free way to share knowledge
Occupational health professionals are embracing the Internet as much as anyone else these days, and a Web site hosted by Duke University in Durham, NC, is proving to be a hot spot for professionals seeking guidance on a wide range of issues. If you want to ask a colleague about a thorny problem in your practice, the Duke University occupational health forum is the place to go. (Access the site at: http://152.3.65.120/oem.)
A popular aspect of the forum is that it is totally free. All the user has to do is register and then he or she can participate in all the discussions, as well as post questions for people to help out with. The forum is the "Occ-Env-Med-L Electronic Forum & Mail-list," a Web site hosted by the Duke University’s department of occupational and environmental medicine. By joining, occupational medicine professionals automatically will receive daily reports from the site with messages posted by other members. Members are then free to post replies to those messages, either individually to the single person posting the original message or to the entire list of users.
The forum is managed by Gary Greenberg, MD, MPH, division chief for the Duke division of occupational and environmental medicine. He tells Occupational Health Management that the site is growing in popularity.
"It’s proving to be a useful way for occupational health professionals to stay in touch with each other and get quick feedback on problems within their practices," he says. "People thrive on information they know they can trust, and this is information from others in the occupational health community."
Site growing with more participants
The site has registered more than 2,600 readers from 52 different countries. Greenberg describes the site as a way for clinicians and public health professionals to instantly send information to thousands of readers all over the world, and to receive near-instantaneous information from colleagues elsewhere.
Greenberg says a recent survey of the list members indicated that 43% were physicians and 14.8% were nurses. The others were educators, researchers, industrial hygienists, and a number of other professionals.
The Duke site is tremendously helpful to occupational health professionals, says William Patterson, MD, FACOEM, MPH, chair of the medical policy board at Occupational Health + Rehabilitation in Wilmington, MA. Patterson is an avid user of the site and says it is one of the best ways to network with other professionals.
"It covers a lot of material and has many interesting discussions about a wide range of topics," he says. "I use it to stay on top of things."
For instance, Patterson says he recently learned about false positive purified protein derivative (PPD) tests with alpersol that turn out to be negative when retested with tubersol.
"We had a case like that in our office which would have been incorrectly labeled as a positive PPD if I had not read about it on the board," he says.
Get help with problems, debate issues
Messages posted on the Duke site run the gamut of issues of interest to occupational medicine professionals, from difficult clinical issues to regulatory interpretations and practice management issues. Here are a few examples recently posted on the site:
• "Here’s one for aerospace/neurosurgeons: I have a patient who recently had a CT scan performed after a minor motor vehicle accident. His only complaint is of neck stiffness (long term, pre-existing the MVA). He has no neurologic complaints, nor findings. His neck CT shows a small focus of air within the left foramen transversarium at the C5 level. He wishes to fly commercially in two weeks. Is it safe for him to fly? "
• "Except for direct trauma, can anyone identify a work-related cause of epididymitis? I see it regularly on folks who are lifting and feel the pain. I believe that the lifting does not cause the problem, rather they finally notice it. Comments? Thanks."
• "Our Security Department is instituting a policy to have new and current Security Officers complete annual physical ability testing. This pursuit course requires officers to crawl, jump, run, vault, balance on a beam, and scale a wall. In addition, they will be tested for flexibility, ability to carry the weight of a person, and ability to climb stairs. (Whew!) I am thinking that all security officer candidates for hire should not be allowed to complete this physical agility testing course until they pass a physical exam. I am also thinking that currently employed security officers should have to have a physical exam before completing the annual physical ability test. Is anyone else dealing with a similar policy? If so, what are your health requirements and procedures?"
That last item prompted this response from another list member:
• "Before you embark on this plan, make sure that the physical ability testing you do is consistent with the essential functions of the job. Also the testing cannot be constructed to exclude classes of individuals such as women. The [Equal Employment Opportunity Commission] EEOC would have a field day with this. Make sure that you speak with corporate counsel about the advisability of this with regard to the possibility of discrimination issues. There is another possible snag in requiring current employees to undergo performance standards that were not in force under their conditions of original hire. We do not require our security personnel to undergo such rigorous testing. We are not hiring the police department. However, for police and firefighters there are physical agility tests which you might use as a guide. And when in doubt, you can always call up your local EEOC for guidance."
Messages delivered to you daily
There are different ways to subscribe to the Duke list, depending on how much information the user wants to receive every day. The regular subscription yields up to 10 messages daily, with individual subject lines indicating what each message is about. The messages are distinguished from other mail by inclusion of the OEM: subject prefix. Messages are received immediately, but are mixed into recipient’s individually addressed e-mail. Messages arrive the hour they are posted, allowing more dynamic interaction with other members.
Another option is Digest OEM-L, which delivers one message daily (at midnight U.S. Eastern Time), representing the combined message traffic on the mail list for that day. This delivery is more easily ignored, or read when time becomes available. A still leaner option is the OEM-Announce, which delivers fewer than 10 messages each week. These messages are not part of the members’ discussion of issues, but are simple declarative announcements, including new Web sites, upcoming conferences, release of educational materials, job openings, and regulatory changes.
Some restrictions are imposed
The hosts do impose a few restrictions on participants, in the interest of keeping the site useful. In addition to prohibiting unprofessional comments and mean-spirited bickering, Duke asks participants not to post "easy, fundamental queries." A warning at the site states, "Our community at OEM-L is not a free reference tool that can replace your own reading and research. Questions should only arrive within our forum after the questioner has looked into the usual resources, such as reference books and other electronic sites."
The only exception to that rule is for queries from developing countries, where the member may not have access to the same resources.
The site also prohibits charitable pleas. "Despite the temptation that might be there to reach thousands of sympathetic and well-paid colleagues, do not solicit donations to your favorite and even urgent worthy cause," the warning says. "There are countless needy situations which solicit support for victims of unimaginable tragedies on a daily basis. Most responsible professionals do make an effort to contribute their time and dollars to such efforts, but apart from their participation in this public health assembly. No exceptions, please."
Anonymous messages also are forbidden. And with any clinical issue, the site forbids the inclusion of any confidential information.
"Posting cases or real-life tales to the OEM-List is a good idea, but there’s usually no advantage to include identifiers of the patient, the employer, or the other clinicians involved in the specific situation," Greenberg says.
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