The Cooperation between the Clinician and the Industrial Physician and their Associated Problems(Symposium/The Latest Frontiers of Occupational Mental Health)

DOI Web Site 6 References
  • Ashihara Mutsumi
    Department of Psychosomatic Internal Medicine, Chubu Rosai Hospital:Mental Health Center, Chubu Rosai Hospital
  • Yamauchi Mariko
    Department of Psychosomatic Internal Medicine, Chubu Rosai Hospital:Mental Health Center, Chubu Rosai Hospital
  • Ohira Taiko
    Department of Psychosomatic Internal Medicine, Chubu Rosai Hospital:Mental Health Center, Chubu Rosai Hospital

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Other Title
  • 臨床医と産業医の連携 : その重要性と課題(シンポジウム:職場のメンタルヘルス最前線,2008年,第49回日本心身医学会総会(札幌))
  • 臨床医と産業医の連携--その重要性と課題
  • リンショウイ ト サンギョウイ ノ レンケイ ソノ ジュウヨウセイ ト カダイ

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Background: The author thinks that there are following seven stages in many processes of the mental health activity: 1) prevention, 2) early detection, 3) consultation, 4) diagnoses, 5) treatment, 6) reinstatement and 7) recurrence prevention. Generally the industrial physician participates in 1) prevention, 2) early detection, 3) consultation, 6) reinstatement. As for the clinician, duties of 4) diagnoses and 5) treatment are important. Not much is done about 7) recurrence prevention. The author performs duties every day in a situation where the industrial physician and the clinician are concerned with all processes mentioned above. Results and Conclusions: When the clinician and the industrial physician cooperate, it is important for each one to accomplish his own duties. However, this cooperation is not always attained in practice. With regard to reinstatement in particular, it is often the difference in opinion between the clinician and the industrial physician which needs to be. Generally the industrial physician follows the health of the employee, but considers the productivity of the business establishment. Reinstatement is accepted only for the employee who can offer work force more than 40 hours a week. An accurate, objective judgment is requested by the industrial physician. On the other hand, the clinician is "a defense lawyer" who protects a weak patient. Therefore even if illness does not improve good enough, the clinician consoles an invalid and tends to let him return to work. In addition, the clinician makes a diagnose of his patient and cures him. Therefore he thinks highly of himself when he lets his patient return to work. However, it is often the case that the self-confidence of the clinician is not always acceptable in his workplace. The purpose of this report is to clarify the differences in viewpoint between clinician and industrial physician, and to discuss the importance of their cooperation and its related problems. The author also introduced their opinions about reinstatement in particular.

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