With a flourishing wellness industry in tech, and many companies deciding to focus their efforts on the health and wellbeing of staff without accredited expertise to support their initiatives, I thought it important to write this particular article.
Not many people even know that there are doctors who specialise in health and wellbeing at work (even doctors themselves!), therefore it's unsurprising that there are few Occupational Health Doctors involved in organisational wellbeing initiatives .
Having spent the last 5 years researching and observing job descriptions for Occupational Health Doctors/Physicians (OHPs), and matching this with the actual job on the ground, it's clear to me that few employers really understand;
The breadth of the skills of OHPs and how to maximise ROI
How to objectively compare OHPs
Devise a proactive recruitment plan - avoiding the need for expensive recruiter fees.
Therefore this is a simple guide for those in the industry new and established, taking the FOM guidance (last updated in 2010!) an putting an experiential twist on it!
What skillset do you need?
Doctors have a wealth of skills - but in reality, many can be performed by other (health) professionals such as Occupational Health Nurse Advisors (OHNA) - most of whom are extremely experienced and autonomous.
I therefore advise you to only consider hiring a doctor in the first instance if you're after the following on a regular basis;
- Management or leadership of complex health cases
- Contract leadership
- A doctor who needs to be internationally recognised within the company
- Chief Medical Officer (CMO)
- Named doctor for a business / organisation (e.g. for branding or legal reasons)
- Employment Tribunals or Medico-Legal matters
- Medicals where it's mandatory to have a doctor (e.g. HAVS Tier 4, Drivers Medicals, HSE etc.)
If you don't require these on a regular basis, consider hiring a doctor on a retainer or on a sessional basis if you need support for these some of the time. This can save you a substantial amount of money considering an OHP can easily command a 6 figure salary. You can even employ a CMO part time or on a contract / advisor basis.
In practice, the role of a doctor and nurse considerably overlap; both see management referrals, do surveillance, audit and with the relevant skillset can run a business, however when it comes to complex clinical or organisational decisions; the buck usually ends with the doctor.
Some companies prefer to have doctors because it helps win contracts from a B2B perspective. If this is a good ROI for your business - go for it.
Take home:
Only consider hiring a doctor for roles requiring regular leadership tasks - otherwise consider more economical options first.
What qualifications should your doctor have?
This is a hugely contentious and political issue at the moment.
Currently there are fewer and fewer doctors who are specialists in this area (the recession resulted in companies getting rid of their training posts), and in a specialty where there is a top heavy middle aged demographic, this problem will only get worse in the future when they eventually retire. As a consequence, most companies are flexible for what they can actually get.
As it stands, theoretically, you could hire any doctor for your company who could claim to have health and wellbeing .or occupational health experience - without any specific Occupational Health qualifications.
They may still be an amazing doctor.
However in the industry, mainly for insurance and quality assurance purposes, most companies prefer to have doctors with an Occupational Health specific qualification. Here are the ones to look out and what they really mean;
DOccMed - Diploma in Occupational Medicine
Who? For doctors interested in Occupational Health (OH) - either starting out or on the side.
What did they do to get it? As a minimum they've completed a 2 week course (or a part time university module for a few months), a multiple choice question exam and provided a brief portfolio with an accompanying viva.
Expertise on the ground? This varies hugely. I know CMOs of national organisations with this qualification alone and doctors with diplomas who don't practice any Occupational Medicine at all. It's a wild card, hence why you need to dig deeper into their clinical experience to assess their expertise. The Diploma confers some basic knowledge, but in no way guarantees a certain level or quality of practice.
AFOM - Associate of the Faculty of Occupational Medicine
Who? For doctors working regularly in OH who do not want to commit to the full MFOM qualification (most put off by needing to complete a dissertation or research to get to the next level!)
What did they do to get it? 2 parts of written exams (second part quite gruelling), and a trip to Sheffield to do a practical test. They also have to demonstrate a few years' experience in OH.
Expertise on the ground? These are usually career doctors who specialise in Occupational Health however, like Diplomates, their practice can vary widely. You're generally guaranteed a higher minimum standard compared to the Diploma. However, like Diplomates, you will need to fully assess their practical experience in more detail to determine whether they're suited for the job. There are many AFOM doctors who are independent practitioners or are running a national company.
MFOM - Member of the Faculty of Occupational Medicine
Who? For doctors working regularly in OH who have either completed an approved 4 year training programme or successfully applied for recognition based on experiential evidence.
What did they do to get it? Same as for AFOM but they've also submitted research/dissertation - minimum of 4 years' OH experience. They will also be listed as a specialist on the GMC register - unlike the other qualifications. This confers more of an international recognition. Considering the main difference between the AFOM and MFOM is the research component (which has for several years been contested as an outdated requirement), one could argue that the difference between the two when assessing clinical potential, could be quite small.
Expertise on the ground? These are fully specialised career doctors in Occupational Health. They tend to be popular amongst companies who are after a Lead OHP, CMO or equivalent. Although theoretically you would expect a higher minimum standard compared to the AFOM, this is not always the case - and again you would have to fully assess their practical experience in more detail to determine whether they're suited for the job.
Watch out for:
FFOM - this is a Fellow which is given to a doctor with an MFOM who has contributed significantly towards Occupational Health in some way or as some have reported - after about 5 years of being an MFOM. Be careful as some FFOMs are honorary and are not actual doctors!
MFOMI - this is a Member of the Faculty of Occupational Medicine in Ireland. Its a (quicker) route to get an equivalent MFOM status, and marketed internationally as such. However, achieving MFOMI status will not automatically lead to GMC registration as a specialist. This still has to be done via training or CESR. Quality of the doctor is very much dependent on their experience.
There are many companies that may only wish to hire MFOMs or FFOMs for various reasons however in practice, this may not always be required.
General Practitioners (GPs)
Many GPs practice Occupational Health - in fact many OHPs used to be GPs. However I'd advise against employing a GP for Occupational Health work unless they have (or working towards) a Diploma as a minimum.
Take home:
Ensure your doctor has a minimum of a Diploma in Occupational Health. After this, experience is one of the strongest indicators of whether they have the right skillset for your company.
Finding an Occupational Health Doctor
Unless you're in the OH circle, they can be difficult to find as individuals because they generally work remotely (therefore barely see each other) - even if working within a large OH organisation.
To access a pool of OH doctors, it's best done through one of the doctor-led OH providers (companies who hold contracts with multiple companies.) Some examples include BHSF, Medigold and Duradiamond.
A substantial number of OH doctors are independent and work directly with companies on a contractual or adhoc basis. They're best found through word of mouth, recommendation or by scouring LinkedIn carefully.
Even better, it's recommended you attend one of the conferences for OHPs run by ALAMA, FOM or SOM. The latter will definitely be able to help you in identifying one in your area.
Alternatively there are recruiters, however a substantial fee will be incurred.
Recruitment Planning
If you're an OH company or OH provider, you likely know that this is key to your staffing solutions moving forward. However from my experience most companies have a poorly thought out plan / no plan or a reactive recruiter-led model costing them over 6 figures or more per annum.
For a successful recruitment strategy, it needs to be working constantly with ongoing review - where doctors are coming to you through word of mouth referrals and you pro-actively develop a healthy pipeline of candidates for the future.
Below are some of my favourite low cost yet heavily under-utilised ways of attracting the best OHPs;
Providing free hosted or sponsored educational days or webinars for OHPs
Referral programme for OHPs (great happy people will attract and introduce great happy people)
Advertise shadowing opportunities or programmes - invite prospects to see what you do
Advertising training programmes for new OHPs
Invest in online social media activities - maintain an active presence and encourage your employees to do so too.
Ask current employees on how to improve their experience - focusing on retention
Exit interviews - explore why people leave. Is this an organisational factor?
Become a SOM Corporate Supporter
Host a kick-ass local or national event in your premises
Get involved with supporting or training medical students and junior doctors
Encourage candidates to express their interest via your website or LinkedIn even when there are no 'jobs' available. Most importantly - make sure you keep in touch with time
Allocate a dedicated person to manage the relationship with prospective candidates (this is not the same as an internal recruiter)
Whatever strategy you decide - make sure you continually audit and re-evaluate your efforts to maximise outcome.
Summary
It takes a bit of understanding to really determine whether you need a doctor and if so, at what level.
The best indicator of a doctor's suitability for your role is sector expertise and ideally a minimum of a Diploma qualification.
Finding (and keeping) the best doctors require networking in the right places using an innovative recruitment strategy which further leverages your USP as an organisation.
I advise companies on doctor recruitment and other OH matters. If you have any further questions, please send me a line.