Proficiency in Occupational Medicine Practice of Occupational Physicians in Thailand: A Qualitative Study (In-Depth Interview).

Background: Occupational physicians (OPs) can lead to substantial economic costs due to work-related injuries and diseases, including early retirement, skill loss, and increased medical and insurance expenses. These have led the American College of Occupational and Environmental Medicine (ACOEM) established competencies for OPs. Objective: To investigate the occupational medicine practices among physicians in Thailand according to residency training in preventive medicine, or occupational medicine, course in various settings including medical residency training institute, tertiary hospital, and company or factory. Materials and Methods: The present study was a qualitative design research by structural in-depth interviews. The study sample consisted of 15 OPs, selected through criterion sampling. The research tools included a structured interview form with two parts, 1) personal information, 2) competency of OPs in practice according to the World Federation of Medical Education (WFME) Standard. Results: Twelve out of 15 OPs (80%) participated in the present study. The findings revealed that the predominant workplace was in tertiary hospitals at 58.33%. These physicians mainly conducted fitness for work and return to work assessments for 75%, which requires compliance with legal mandates. Medical emergencies in workplaces were less often addressed, with 66.67% of physicians reporting infrequent handling. They attributed this to the limited regulations. Notably, adherence to the Occupational Safety and Health Administration (OSHA) medical surveillance standards was low, showing a preference for the Thai over global regulations. Fit for work assessments were common, averaging 48 cases per month, while disease investigation was minimal, at less than one case per month. Confidence levels mode was five points across most of the competencies, with lower confidence in conducting occupational disease investigations due to low volume of cases. Conclusion: Fitness for work assessment was the most proficient and frequently used practice among Thai OPs. The practice of OPs should adhere to the clear laws and guidelines to ensure the expertise of OPs in performing their duty effectively. [ABSTRACT FROM AUTHOR]