Krahl Pamela L, Thomas Richard J, Gaydos Joel C, Mallon Timothy M
Department of Preventive Medicine and Biostatistics, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland.
J Occup Environ Med. 2022 Feb 1;64(2):166-172. doi: 10.1097/JOM.0000000000002384.
Transfer of military medical facilities to the Defense Health Agency is transforming the Military Health System. Our objective is to inform this transformation with respect to optimum application of occupational and environmental medicine (OEM) expertise.
We defined and analyzed the external influences on military OEM practice using a structured framework to identify key drivers.
Key drivers are political and economic factors. These may change the size or military/civilian ratio of the specialty. Limited career development pathways should prompt consideration of making OEM a second or combined residency, and military-funded training of civilian physicians may be required. OEM specialist utilization should be reassessed.
OEM is a highly adaptable specialty defined by the needs of its stakeholders. Comprehensive analysis of external influences can ensure that OEM practice remains in step with changing needs.
军事医疗设施向国防卫生局的移交正在改变军事卫生系统。我们的目标是就职业与环境医学（OEM）专业知识的最佳应用为这一转变提供信息。
我们使用结构化框架定义并分析了对军事OEM实践的外部影响，以确定关键驱动因素。
关键驱动因素是政治和经济因素。这些因素可能会改变该专业的规模或军事/文职比例。有限的职业发展途径应促使考虑将OEM设为第二专业或联合住院医师专业，可能需要军方资助对文职医生进行培训。应重新评估OEM专家的利用情况。
OEM是一个高度适应性强的专业，由其利益相关者的需求所定义。对外部影响进行全面分析可确保OEM实践与不断变化的需求保持同步。
