Emergence of occupational medical services outside the workplace.

A new type of occupational medicine clinic has recently emerged in the United States. These clinics are multispecialty in staffing, are located in hospital outpatient departments, and are affiliated with academic medical centers. Their primary goal is to provide personal health and medical services including diagnosis, treatment, and follow-through of occupationally related diseases. Approximately 15 such clinics have been established in the last several years. A review of the medical, economic, and social forces that have historically shaped the content and scope of occupational medical and health services for workers explains in large part the reasons why many of these clinics have now come into being. Characteristics of eight of these clinics are reviewed in detail. These clinics provide a setting for interdisciplinary and interspecialty education of personnel and offer the medical community a demonstration of a means for better recognition and treatment of occupationally related illnesses.