Buijs P, van Amstel R, van Dijk F
TNO Arbeid, AS Hoofddorp, The Netherlands.
Occup Environ Med. 1999 Oct;56(10):709-13. doi: 10.1136/oem.56.10.709.
To investigate cooperation between occupational physicians (OPs) and general practitioners (GPs).
Literature review; structured interviews; questionnaires sent to randomised samples of OPs (n = 232) and GPs (n = 243).
Actual cooperation is poor. However, more than 80% of both groups responded that they want to improve their cooperation, aiming at better quality of care. Obstacles identified by OPs include insufficient knowledge among GPs about occupational health services (OHSs) (57%) and their patients' working conditions (52%). OPs also consider that GPs suspect them of serving employers more than employees (44%) and of verifying reasons of absence, with information from GPs (34%). Responses from GPs confirm these two suspicions (48%, response 58%), adding obstacles like commercialisation of OHS, lack of financial incentives, etc. Both groups are unanimous about prerequisites for improvement, especially guaranteeing the professional autonomy of OPs (OPs 86%, GPs 76%).
As a first step to overcome obstacles to cooperation, OPs must clarify their position to GP colleagues. Initiatives have been taken after presenting this study.
调查职业医师（OPs）与全科医生（GPs）之间的合作情况。
文献综述；结构化访谈；向职业医师（n = 232）和全科医生（n = 243）的随机样本发放问卷。
实际合作情况不佳。然而，两组中超过80%的受访者表示他们希望改善合作，目标是提高医疗服务质量。职业医师指出的障碍包括全科医生对职业健康服务（OHSs）了解不足（57%）以及对患者工作条件了解不足（52%）。职业医师还认为全科医生怀疑他们更多地为雇主而非员工服务（44%），以及利用全科医生提供的信息核实缺勤原因（34%）。全科医生的回答证实了这两点怀疑（48%，回答率58%），并补充了诸如职业健康服务商业化、缺乏经济激励等障碍。两组在改善合作的前提条件上达成一致，特别是要保证职业医师的职业自主权（职业医师86%，全科医生76%）。
作为克服合作障碍的第一步，职业医师必须向全科医生同事阐明自己的立场。在提交本研究后已采取了相关举措。
