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last updated:24/01/2012 @ 4:29 pm

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Competency 4 – Maintaining relationship with patients:Be aware of potential difficulties in the relationship

Objective: to ensure the appreciation of the professional position of the OH advisor, employer and employees



The relationship between members of an occupational health team, employers and employees can be complex, each member having their own views of the others’ objectives and needs. So, clarity is essential to minimise any misunderstandings and difficult situations. This can be illustrated by the discussion below

Question 1

What might an employer expect from their Occupational health doctor or nurse (OHP/OHN)?


  • At an organisational level; they may need advice on the development of policies – absence management, drug and alcohol policies. (It is an acceptable role for an occupational health service to provide advice to an organisation)
  • They may expect the service to manage their sickness absence policy. ( This is not an acceptable role for a service)
  • At a clinical level ; they may expect the OHP/OHN to act like a GP and provide treatment ( This is incorrect – the service can provide advice but in most cases is not a treatment service)
  • Statutory (required by law) and non – statutory health checks called health surveillance (This is an occupational health service role)
  • Pre-employment medicals (This is an occupational health service role)
  • They may expect full access to medical records and to be provided with all information on the health of their employees. (This is not acceptable. All records and information are confidential)

It is important to be aware that not all employers have an understanding of the independent and confidential nature of occupational health. There are often misconceptions about the role of an OHA, which can lead to conflict.

Question 2

Can you give an example of a situation in which there may be difficulties between a manager and an OHP/OHN?


This can be discussed in terms of a discussion around;

Providing advice to managers in terms of limitations to duties of an employee, without divulging the clinical condition.

Here, the employer might press the occupational health advisor for justification for the limited duties. This information can only be passed onto management with the informed consent of the employee. Divulging clinical information may result in better understanding from an employer regarding any limited duties, but, this information can only be given to the employer if the employee gives consent. If the employee refuses consent; the OHA can not divulge the information.

It is therefore important for any occupational health provider to be clear on what a service is able to deliver and what it is not able to deliver.