The occupational physicians have they deserted in full ” war ” against the coronavirus ? This is what suggest the 158 deputies of the majority in a column published on 15th may by the Sunday newspaper. “Companies have found themselves alone and feeling helpless for several days, which, in a climate of anxiety, has contributed to penalize the maintenance of economic activity in certain sectors “, judge elected, reviving the discussion around a “major reform of the health at work “ expected in 2021.
→ TO READ. The reform of the medicine and the work revived by the crisis of the sars coronavirus
A critical harm experienced by the profession, on the contrary very active during the crisis, according to Thibaut Fleury, the director-general Efficiency health at work, an occupational health service, located in the Île-de-France. “In this period unprecedented, we are suited to assist companies on a daily basis : we have called our clients to offer them solutions adapted to their activity, organized webinars and tele-consultation, set up a toll-free number… “ lists there.
“A service that is costly to the leaders “
“This kind of attacks against the profession is chronic. Who wants to drown his dog accuses him of rage “, reacts to his side Jean-Michel Sterdyniak, the secretary-general of the national Union of health professionals at work. The doctors would they be at this point disliked ?
According to Marc Sanchez, secretary general of the Union of freelancers, they are often poorly perceived by business managers, particularly smaller ones. “This is a service that is costly to the leaders, between 80 and 110 € per year per employee, but they don’t see the benefits “summarizes-t-he severely.
A situation of numerical disadvantage
“The problem comes in large part from their situation digital “says Jorge Munoz, a lecturer in sociology of work at the university of western Brittany. In France, there are about 5,000 doctors work for more than 18 million employees.
Difficult, in this context, to ensure a close monitoring, especially as the expectations have changed. “Since the asbestos crisis, we ask them especially to manage the psychosocial risks, a mission is commendable, but to which they have very low “, says the sociologist. Especially as the doctor’s work has mainly an advisory role and does not have the right to prescribe (1).
A relationship of trust difficult to establish
On the side of the employees, the medical examination, which is mandatory, has often been a constraint. “Establish a relationship of trust is not easy when one is taxed to the employee “notes Roman Da Rocha, president of the national Association of internal medicine of the work.
“Drawn and quartered “ between a hierarchy to which he must report and accounts of the employees for whom it must ensure the well-being, the doctor of work is by nature “in an ethical position precarious “raises Roman Da Rocha. Because what is good for the health of the employee is not necessarily that of the company, and vice versa.
Of what to do with it “a business cannot “, according to dr. Jean-Louis Zylberberg, who shall exercise it yet since 1996, in the CONSTRUCTION industry. “We are in a balance of power social standing, relève-t-il. It is one of the reasons why students do not want to commit to it. “
The number of internal, if it is stable, is modest. “Today, the majority of recruitment takes place among doctors older that is to convert “reports Roman Da Rocha. In question, in particular, a lack of recognition. “This is part of the specialties traditionally considered” less noble “the tip Jorge Munoz.
The return of the thought hygienist ?
If this lack of attraction is not new, the evolution of management in the business confronts the doctors of the work of new difficulties. “We told the employees how to eat, sleep, relax. With the idea that if there is a problem, this is not because of the organization of the work, but because they did not follow our advice “laments Roman Da Rocha, who fears “a return of the thought of the hygienist, in order to optimize the performance of companies. ”
A drift which “it puts the responsibility on the shoulders of the physicians of the work, so that it is specific to the system “, writes Jorge Munoz, for whom the stakes of the reform is to first examine the meaning of prevention, in the heart of the mission of these doctors is not quite like the other.
A role exclusively preventive
Occupational medicine was born with the law of 11 October 1946, that requires employers
to arrange medical surveillance for their employees.
Placed under the control of the ministry of labour, this specialty exclusively preventive for the preservation of the health of workers.
Since 2002, we no longer speak officially of occupational medicine, but health in the workplace. The medical doctors may practice in occupational health services-employer, common to several societies ; or in self-help services for large enterprises.
Since 2011, the follow-up of employees is based on a multidisciplinary team, involving doctors nurses and stakeholders in prevention of occupational risks.