Occupational Medicine Advance Access originally published online on February 23, 2006
Occupational Medicine 2006 56(3):191-198; doi:10.1093/occmed/kqj030
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Occupational physicians: what are their questions in daily practice? An observation study
1 Academic Medical Center, University of Amsterdam-Coronel Institute for Occupational and Environmental Health, PO Box 22700, Amsterdam 1100 DE, The Netherlands
2 Royal Netherlands Navy Occupational Health Service, PO Box 10.000, 1780 CA DenHelder, The Netherlands
3 ING Occupational Health and Safety Services, PO Box 1800, 1000 BV Amsterdam, The Netherlands
Background To enable occupational physicians (OPs) to make use of scientific information in the decision-making process, evidence-based occupational health practice is stimulated.
Aims To study the questions which arise in daily practice of OPs, and to evaluate the possible contribution of evidence-based medicine (EBM) strategies to answer these questions.
Methods Observation of 20 OPs during two consecutive half-day periods, followed by an interview to explore the topics that arose during the preceding period. The conscious or manifest and unconscious or latent questions by OPs were analysed, and the number of questions suitable for performing a search in scientific medical literature databases was assessed.
Results After 40 half-day periods, the OPs had asked 26 manifest questions and 348 latent questions; the latter were voiced during the interview. Of all the questions, 40% were clinical in nature and considered suitable for a literature search. The emphasis of these questions was on prognosis, susceptibility and diagnosis following individual consultations. A lack of time or ‘no necessity to look for an answer’ were the most important reasons for leaving the questions unanswered.
Conclusions OPs spontaneously formulated less than one question per working day. However, after an observation of their daily practice followed by an interview, many latent questions were formulated. A substantial number of these questions could be answered by EBM strategies. If OPs were encouraged more to improve the quality of their decision making, they might formulate more answerable questions and feel more inclined to search for answers.
Keywords Evidence-based medicine; information demand; information need; occupational medicine; occupational physicians
Correspondence to: Frederieke Schaafsma, Academic Medical Center, University of Amsterdam-Coronel Institute for Occupational and Environmental Health, PO Box 22700, Amsterdam 1100 DE, The Netherlands. e-mail: f.g.schaafsma{at}amc.uva.nl