Quality management of occupational health services: the necessity of a powerful medical profession.

Over the past few years there has been a growing interest in quality management in occupational health services. In this article the central role of the medical profession in this area is highlighted from a personal point of view. It is argued that a powerful and active profession is needed as a countervailing power in the field of tension between employees and the company, and for balancing the interests of these two main clients. Therefore, the medical profession should develop a policy on quality and apply quality management on national and local levels to reach a high professional level. In this way the profession can maintain the clinical autonomy that is necessary to be a countervailing power. Elements of such quality management are national guidelines, local peer review and intercolleagual visitation. These activities must be incorporated in the quality management of the occupational health services unit.