REPORT ON THE FUND SEPTEMBER 2001

This report speaks for itself. The Occupational Physicians Scholarship Fund has achieved its founding mission.

We have seeded the medical field with a cohort of leaders — over 100 physician-specialists expertly trained in occupational/environmental medicine (OEM) — who are prominently positioned, at this very moment, to improve worker health, business productivity and our precious environment.

From this point forward we are prepared to surpass our founding mission.

• Nine new scholars were named Year 2001 recipients of stipends for specialty training and are in academic or practicum programs at leading teaching institutions (see Nine Different Paths, page 5).



• A successful campaign to increase Fund equity conducted over the past several years will enable 240 cumulative scholarships through the year 2011...one and a half times the number initially envisioned! And, thanks to OPSF’s Finance Board, we are steering a skillful course, husbanding our Fund’s equity through a rocky stock market (see Fund Information, page 6).

Corporate donors, understanding our importance, have been the progenitors of OPSF. Our Board is committed, in the spirit of what our corporate partners have accomplished, to find new ways via planned giving and other ongoing programs to address the dire shortage of OEM specialists in our nation.

We’re grateful to our parent organization, the American College of Occupational and Environmental Medicine (ACOEM), for its financial and administrative support over the years. And we’re working closely with them to explore opportunities for a united funding approach to further the OPSF mission.

We also are supporting our mission in an unanticipated way - through our website [OPSF.ORG], which is now the leading repository in the nation on information about OEM residency programs. This has been achieved without diverting any Fund equity. To the contrary, establishment of the website has speeded applications, reduced information handling costs, and increased in applications of qualified candidates. Kudos to Brian Compney, OPSF Program Director.

The OPSF Board at upcoming meetings will consider ways to leverage the success of our website. These include the feasibility of a password protected bulletin board where practice-specific questions can be discretely discussed, enabling those in the field to learn from the experiences of others. And we are looking at a mentoring program that would allow OEM practitioners in private practice, academia and government to be linked with OPSF scholars for support in making the best academic and career decisions possible.

As we look to the future, we give special thanks to recently retired OPSF trustees Myron Harrison, MD, and Elias A. Shaptini, MD, whose vision and insight have helped enable our success. And we welcome new trustee Robert L. Goldberg, MD, University of California, San Francisco, the past president of ACOEM.

EXPANDING NETWORK OF LEADERSHIP

Nine physicians - chosen during a highly competitive review process at the beginning of the year – were awarded stipends of $30,000 - 40,000 each. This fall, they are using the money to pursue a year of specialty training in occupational and environmental medicine (OEM) at an outstanding teaching institution of their choice. (See story in this issue: Nine Different Paths, page 5) For these medical doctors, and nearly 100 others of their caliber selected over the past 13 years, support from the Occupational Physicians Scholarship Fund (OPSF) has been decisive. Without it, most would have had no choice but to pursue careers elsewhere. They would have faced a financial barrier that has kept too many bright young doctors out of the field. Occupational/environmental residencies focus on prevention, so they can’t tap 3rd party insurance reimbursements for patient services. Instead, they struggle for survival, squeezed by training costs and diminished government support, less able to compete with other specialties for qualified applicants.
This has shortchanged the nation.

An average 9,000 U.S. workers sustain disabling injuries on the job, 16 die from those injuries, and 137 die from work-related disease...every day, says a National Institute of Occupational Safety and Health study. Beyond pain and suffering is the burden of this daily onslaught on our national economy - $171 billion annually in direct and indirect costs...higher even than cancer, heart, or any other major disease category.

Despite the toll work-related illness and accident takes on the economy, a mere one-third the OEM-Board-certified specialists needed to ease the problem are available, reports the National Academy of Sciences. OPSF was established to address the gap. Its mission:
To foster a new generation of physician-leaders who, with expert training, acquire the multidisciplinary skills needed to:

• Translate workplace health and safety data into concise business language for effective communication with top management.



• Play a significant managerial role themselves in the implementation of workplace health policy.



• Assure a strong scientific and academic basis to bolster the field.

GOING WHERE TOO FEW HAVE GONE BEFORE

Enabled by stipends from the Fund, scores of OPSF scholars have completed specialty training and moved into positions of leadership in government, academia, industry and clinical practice, where they are poised to have a profound affect on the health of American workers and the profitability of employers. “We are the “doctors of last resort,” says Brian Schwartz, MD, MS, Director of Occupational and Environmental Health at Johns Hopkins School of Hygiene & Public Health. “Other doctors don’t look at the effect of occupation or environment, so after they exhaust all of their resources, they turn to us for answers because we may think of things that they have never considered.”

Dr. Eddie Runde concurs. -Not many doctors do OEM and many don’t have a full understanding of the scope of our specialty,” he says. “A common perception is that we treat only strains and sprains, but we’re like cardiologists – we can take care of the more complicated aspects of an injured or ill worker.”

Dr. Runde is the OEM specialist for many of the towns in mid-Missouri, serving the fire brick and pharmaceutical industries, nursing homes, insurance carriers, Wal-Mart stores, and the City of Columbia, where his practice is based. He has treated respiratory ailments and recommended protections from asbestos and silica endemic to the fire brick field. He has surveyed Wal-Mart facilities and made recommendations for employees who suffer from back problems. He also reviews requests for special procedures, like MRIs and physical therapy.

EXPANDING NETWORK OF LEADERSHIP (continued from page 2)

A unique function of his OEM specialty is to facilitate communication between employers, employees and other health care providers. “Everyone is comparing notes and other doctors really rely on us,” Dr. Runde says. It was the Navy (a three-month training stint in aerospace medicine assuring pilots were healthy to fly) that gave Dr. Runde his first look at how organization and command structure impact the safety of the workplace. As a civilian, he wanted to continue in this field, moving beyond treating injuries and illnesses to studying the work environment that causes them.

In fact, what distinguishes OEM physicians is the impact they can make on preventing diseases and increasing worker productivity. In the field of research, leaders like Dr. Schwartz and Lynn Pinkerton, MD, a Medical Officer at the National Institute of Occupational Safety and Health, compile the hard data needed to make changes in the workplace to help prevent injuries or health conditions before they reach critical stages. Dr. Schwartz is currently researching the effects of non-occupational factors, like lead, mercury and asbestos on the incidence of headaches, which, the data suggest, have a huge impact on work activity.

Dr. Pinkerton at NIOSH is looking at occupational health issues involving latex allergies, breast cancer and uranium. Her work could have a significant impact on flight attendants. They are exposed to elevated effects of cosmic radiation that can increase chances of breast cancer. Dr. Pinkerton’s analysis of workers exposed to uranium could improve their quality of life. The Department of Justice compensates miners exposed to radon. But once uranium is above ground, millers who crush the ore are not compensated, even though their exposure and risk may be as great.

Dr. Pinkerton didn’t plan a career in OEM. In fact, she and her husband graduated with a degree in chemical engineering from Kansas State University. Their friends found work in the petrochemical industry. But Pinkerton, in medical school, was struck by the effects of the industry, particularly on reproductive health. It was her preceptor who convinced her to specialize in OEM. “He was great,” she said. “We met daily and he even took me to the workplace, which had a major impact!” Dr. Pinkerton enjoys studying population groups and trends, but also supervises OEM residents at the University of Cincinnati. “There are many different opportunities in this field,” she says, “as a clinician evaluating individuals in their actual workplace conditions, in the corporate world to establish workplace programs, in education to train others and in research. I saw a need for physicians to become more attuned to the workplace, and in OEM, we can really make a difference.”

Dr. Rosa Coppalecchia, DO, is the Assistant Medical Director of Employee Services at Schering-Plough, one of the largest pharmaceutical firms in the U.S. She serves a population of 7,000 workers. On a typical day, she sees 20 to 30 people, conducts annual exams and pre-placement physicals for new hires, and makes disability evaluations and follow-ups to assure workers receive needed care. She and her staff provide acute care onsite so employees don’t waste time away from work at lengthy doctor visits off site. A long-term goal: to help implement a plan to install defibrillators in every Schering-Plough facility and to train employees to perform this life-saving intervention, with the guidance of the American Heart Association. “I like my work because it’s not just me alone; it’s a team effort,” she says. “I get to know my co-workers as a doctor, a colleague and as a friend.”

Lydia Boyd-Campbell, MD, is the Physician Program Manager of IBM Corporation, where she has helped establish wellness programs and reviews issues of worker’s compensation. Her performance has decreased the cost per employee for annual worker’s compensation from $80 to $17, well below industry standards set by OSHA. Dr. Boyd-Campbell went through medical school thinking she would like to become a surgeon, but she also wanted to raise a family. So when she met an occupational physician at career day, she discovered a perfect way to combine her interest in epidemiology and biostatistics with clinical medicine. She started her career at General Motors as a plant medical director, where 75% of the cases she saw were related to back problems and carpal tunnel syndrome. She performed worksite inspections, and her evaluations helped to change the way the line was set up. “There is a lot of need for corporations to understand that healthy employees relate to the bottom line,” she says. No one knows about the effect of the environment on worker productivity more than

Sarah Royce, MD, Chief of the Tuberculosis Control Branch of the California Department of Health Services. From her first project studying lung function in pesticide workers to a fellowship in lead poisoning prevention at radiator repair shops, she has explored the effects of the environment and social conditions on health and worked on policy to make changes. Now as Tuberculosis Director for California, which has the most TB cases in the nation, Dr. Royce has broadened her goals to influence communities in the workplace and home environments. She has seen eight consecutive years of decline in the number of cases since its resurgence in her state. “My career has been focused on lead poisoning and TB, and they are both ancient scourges and totally preventable. That’s what I always liked about the field of occupational/environmental medicine – I knew that there was something I could really do to improve people’s lives.”

Nine Scholars - Nine different paths
2001-2002 OPSF SCHOLARS

Anthony J. Vita, M.D., of San Francisco, knew early in his medical career that he wanted to do research, but it was a serendipitous opportunity that steered him toward occupational medicine. After medical school, Vita worked with a health care consulting firm in San Francisco, where he gained a firm understanding of how HMOs choose and price the services they offer. While he initially chose EM as a specialty, he found it offered fewer opportunities to pursue a career based on research. Now Vita hopes to combine his interest in research and clinical medicine to pursue a career in OEM academics. Vita begins his academic year of specialty training at the Harvard School of Public Health.

Melissa Frisch, M.D., of Chevy Chase, Maryland, became interested in occupational medicine from her work as an internist in private practice, where she gained an understanding of the importance of preventing work-related injuries. She recognized that few practicing physicians have the training or are equipped to assist patients beyond treating them medically.

Dr. Frisch would like to pursue both the clinical practice of occupational medicine as well as epidemiologic research in the area of worker health and safety. Dr. Frisch begins her practicum year of specialty training at the Johns Hopkins School of Hygiene and Public Health.

Mark C. Taylor, M.D., of Iowa City, Iowa, developed an interest in working conditions stemming from a background that varied from a summer job at Winnebago Industries to nine years of employment at Baskin-Robbins. He strengthened his interest in OEM while in medical school at the University of Iowa College of Medicine. There, he took an elective course that allowed him to spend several days at the Occupational Medicine Clinic, where he met two patients that had an interesting constellation of symptoms thought to be secondary to a chemical exposure. Later, during his internal medicine training, he completed a month-long rotation in OEM and traveled to Maytag to see patients at the worksite. During this visit, he toured the plant and observed the company’s efforts to ensure a safe work environment. Taylor combines this curiosity about how jobs affect the personal lives of workers with a particular interest in tobacco abuse and the role of secondhand smoke in causing morbidity and mortality. Taylor completed his internal medicine training in June 2001 and begins his academic year of OEM training at the University of Iowa in Iowa City.

Brian A. Johns, M.D., of Pocatello, Idaho, attended medical school at the University of Utah and completed his internship in Muncie, Indiana. He was inspired to go into the field from his patient visits with OEM physicians, where he experienced first-hand how strongly they can influence people. He observed how OEM doctors balanced the needs of workers and employers, and how their skills contributed to the health of individuals and populations, as well as the productivity of businesses and industries. Johns enjoys the intersection of clinical medicine, public health, preventive medicine and business, and he envisions himself practicing clinical occupational medicine in a multi-client OEM clinic or in a plant and also practicing general preventive medicine. Johns begins his academic year of specialty training at the University of Iowa in Iowa City.

Karron LeGarie Power, M.D., of San Rafael, California, has been focused on occupational medicine and dermatology since the completion of medical school. Following her internship, she worked in a clinic focusing on occupational illnesses and injuries and with a corporate wellness company providing executive health services to corporations. She enjoys occupational/ environmental medicine because it demands that the health care provider look beyond the patient and the confines of the exam room. She feels that in many other fields of medicine the Biopsychosocial Model, taught in medical school, is forgotten. In OEM, it is the key to successful control and treatment of disease. Power would like to specialize in the field of occupational dermatology. She begins her practicum year of specialty training at The University of California, San Francisco.

Michelle T. Watters, M.D., PhD., of Chicago, has combined her knowledge of environmental engineering and medicine to provide insight into occupational diseases and exposures. Her industrial rotation at the University Health Service provided training in employee screening, medical surveillance, return-to-work evaluations and worker’s compensation claims. Her ambition in OEM leans toward health policy and research, and she plans for a career in either a government or corporate setting. Watters begins her practicum year of specialty training at the University of Illinois at Chicago.

Paul S. Darby, M.D., Ph.D., of Tacoma, WA, found his dream career in OEM because it allows him to integrate his interest in medicine with his passion for organic chemistry. After several years of monotonous primary care practice, Darby is also rediscovering his love of clinical medicine. He spends up to two hours with each patient, exhaustively probing the occupational and environmental history prior to performing a thorough physical exam. Darby is leaning in the direction of private or corporate practice but would like to maintain his affiliation with a teaching institution and actively recruit others into the OEM specialty. Darby begins his practicum year at the University of Washington in Seattle.

James D. McCluskey, M.D., of Tampa, received a new lease on life when he became a successful candidate for a kidney transplant and was free, after two years, from the grueling daily regimen of dialysis. He found an interest in OEM while pursuing his Masters in Health Administration at the University of South Florida (USF) College of Public Health. His job as Manager of Continuing Education and Outreach at USF, as well as his roles as student, researcher, manager, physician and teacher, led to his focus in OEM, particularly toxicology and risk assessment. Laboratory research on pesticides and adrenergic modulation have prepared him to present seminars on occupational toxicology and dermatology as well as to write articles for the Journal of the American Chemical Society. His goal is to emerge from training with a broad background that will allow him to understand and integrate the various specialties into his practice of occupational medicine and toxicology. McCluskey begins his practicum year at the University of South Florida, College of Medicine, in Tampa.

Iveta Dubravec, M.D. M.B.A., of Salt Lake City, Utah, completed her MPH in the Spring 2001.While completing her preceptorship for the MPH program with Utah OSHA, she performed walk-arounds through plants with inspectors and consultants. In the process, she learned about workplace-related issues that include safety, worker’s compensation, disability and legal proceedings that broadened her knowledge in occupational toxicology, safety, occupational and environmental diseases and public health sciences. Born in the Slovak Republic, Dr. Dubravec has a special interest in international occupational health issues, especially for employees when they travel, as well as the health aspects of progressive countries as they become more involved in the global economy. Dr. Dubravec, in her final year of clinical clerkships, continues her practicum in specialty training at the University of Utah.

Funded Residency Programs To Date
Columbia University
Duke University
Emory University
Harvard University
Johns Hopkins University
Mount Sinai School of Medicine
St. Louis University
UMDNJ - Robert Wood Johnson
    Medical School
University of Arizona
University of California, Berkeley
University of California, Davis
University of California, Irvine
University of California, San Francisco
University of Cincinnati
University of Colorado
University of Connecticut
University of Illinois
University of Iowa
University of Michigan
University of Oklahoma
University of Pittsburgh
University of South Florida
University of Southern California
University of Texas
University of Utah
University of Washington
West Virginia University
Yale University

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