Archives of Environmental Health: An International Journal

ISSN: 0003-9896 (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/vzeh20

Preceptorships in Occupational Health E. R. Plunkett MD To cite this article: E. R. Plunkett MD (1975) Preceptorships in Occupational Health, Archives of Environmental Health: An International Journal, 30:1, 56-57, DOI: 10.1080/00039896.1975.10666639 To link to this article: http://dx.doi.org/10.1080/00039896.1975.10666639

Published online: 02 May 2013.

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Date: 10 June 2016, At: 16:10

Letters to the Editor

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Misquote

To the Editor.-I note with great consternation and embarrassment that I have misquoted Hilscher et al in my paper HIs Short-Fibered Asbestos Dust a Biological Hazard" (ARCHIVES 29:115-117, 1974). The asbestos fibers that caused no or negligible changes when injected intra-abdominally by the above authors were ground, but not ~'with a microtome"; and they were less than III in length rather than less than 31l. On page 117 the third word from the end should be '~pressure" not "presence." I apologize to Hilscher et al for this gaffe. PAUL GROSS, MD Charleston, SC Health and Medicine

To the Editor.-I was interested in your recent ARCHIvES editorial, HHealth and Medicine" (28:356-357, 1974). About 15 years ago, I worked for Dr. Halbert Dunn, director of the (then) National Office of Vital Statistics. He was fond of lecturing about "high level wellness," or vibrant, energetic, optimistic well-being, and the need to know more about how to achieve it. Perhaps you give the medical professional people less credit than they should have. While most physicians may have very little time left, after treating diseases and other pathologies, for teaching and conditioning to high level wellness, it seems to me that any movement to apply science to achieving more of this will have to draw on many research methods and treatment methods that elicit patient cooperation that are now in use in medical research and therapy. Why should not various combinations of test findings and specific behavior symptoms yield increasingly more valid estimates of degrees to 56

Arch Environ Health/Vol 30, Jan 1975

which individuals approach high level wellness? One may find that some of these factors act independently, hence that there is more than one road to high-level wellness. If there are such options, then persons in different styles of living (eg, sedentary vs active) may achieve it by different routes. I think that the demand forperiods sional (ie, reliable) advice on achieving high-level wellness may be quite widespread, that is, not restricted to "food faddists, the health nuts, the exercise enthusiasts, and the bodybuilders." Perhaps this is an important reason for "getting into condition" for sports? When an executive is commended for showing ~\grace under pressure," is there not a connotation of high-level wellness? Might it be that patients who complain primarily about just feeling lo.usy, tired all the time, and so on, are often translating into pathology language desires for high-level wellness? Thank you for writing the editorial. May we expect some follow-through on how various sciences are basic to research on high-level wellness and hew research might lead to clinical procedures? ' The views are those of the author and do not necessarily express policies or attitudes of his organization.

E. ORTMEYER, PhD Public Health Service Morgantown, WVa

",",,,",,1",,,.,, of where to. begin an examination of the problem of I\wellness." For the lack of any better point of departure, I should suppose the study of a group who. had reached 75 years of with minimal physical and menperiods incapacity would be as good a periods place as any. Such a group has demonstrated at least one aspect of wellness-durability of tissues. Of course, usual approaches with an automated multiple analysis system (SMA-12), electrocardiography, and all the other studies of I'executivetype check-ups" are pretty sure to be meaningless, since a group of this type would be "normal" to all such tests. One would have to. develop far more subtle forms of study. Perhaps such an approach might consist of measuremen t of homeostasis under varying stresses and challenges. Attention might concentrate on response to stimulus, rebound, and rate of return to static condition. One can only guess, but possibly methods that involve time-rated challenge, response, and recovery-with respect to immunology and cellular response as well as biochemistry and physiologymay disclose some of the characteristics of wellness and perhaps something of the nature of aging. JOHN S. CHAPMAN, MD Dallas, Tex

CARL

Reply

I agree that "high level wellness" is the desirable state but how does one define it, except ethologically? Some individuals seem to have it while others do not. One observes similar varieties of I'wellness" or Ilresistance" or Iltoughness" in colonies of animals. Is it genetic or a matter of psychological adjustment or do these two questions really differ? Dr. Ortmeyer correctly raises the

Preceptorships in Occupational Health

To the Editor.-Early in 1974, the author became acquainted with details of the Medical Student Preceptorship Program of the American Society of Anesthesiologists (ASA). Their program has been in operation for eight years and currently sponsors approximately 345 students per year in an eight-week program in which they are matched with ASA members in different parts of the country. They receive approximately Letters to the Editor

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500 to 600 applications from students at nearly every medical school in the United States and consider the venture to be a success. Inasmuch as there seems to be a need for stimulating interest in occupational medicine among physicians and in view of similarities between the fields of anesthesiology and occupational medicine, the following letter in a much longer version was mailed to 110 corporate medical directors: Dear Doctor There appears to be a need for more occupational physicians at the present as well as for the future. The present methods of attraction and recruitment may not be as productive as they should be. Some consideration must also be given to what appears to be two types of occupational physicians: those who are full time and who devote themselves to corporate administrative responsibilities, and those who are doing the bulk of occupational medical care in conjunction with other phases of medical practice, but who assume this role incidentally and with no didactic or practical background. It is my belief that a pilot program of summer clinical preceptorships in occupational medicine has merit, and this letter is intended as a preliminary sampling of opinions from a number of larger corporate medical directors.

Under the direction of a Committee on Training and Recruitment a program could be designed as an educational work experience for preclinical medical students in the following areas: First hand experience in the clinical practice of occupational medicinethere are many paramedical procedures which students could perform. Observation and participation in the Arch Environ HealthlVol 30, Jan 1975

areas of industrial hygiene, safety, compensation and health benefit programs, and hopefully to the broader problems of work epidemiology. Exposure to new concepts and skills which would not otherwise be known. Appreciation for the clinical and team concept of the physician in occupational medicine. Enhancement of interest in occupational medicine and a better image of the physician in this field. The scientific and educational achievement levels of these students would permit their direct contribution in many productive areas. Your response is solicited. Along with comments on the basic concept, please enlarge on what you conceive to be strong and weak points, whether your company would sponsor such a student in a summer work program in any of your locations, what you would expect of the student, what teaching goals you set for the student and anything else which you consider ,pertinent.

Twenty-one (19%) responses were obtained. Eighteen of the medical directors believed such. proj ect would be worthwhile, and 12 of these thought the matter should be pursued. In five instances the proposal was similar to an existing operating relation with a local medical school. Those who admitted prior experience with medical students in this capacity were almost evenly divided in their opinion that their program was beneficial: poor (5:4). Some of the pertinent comments in the responses are as follows:

a

This brief experience with one student makes me optimistic that the program might actually attract some physicians to

the field of occupational medicine. In not one single instance (of summer employment) was the student influenced to pursue the specialty of occupational medicine. The students' responses have not been an enthusiastic acceptance of occupational medicine as a career, but rather an understanding of what goes on that was very interest to him. They are extremely limited in what they can do in the occupational setting and it requires an extensive effort on the part of our professional staff to acquaint them with our particular requirements. I do believe that such training would require the full-time services of the medical director. It would be better to attempt the program with clinical students.

The comment made by one respondent might well explain good vs bad experiences: "We must distinguish between providing summer work for medical students ... versus educating them in the overall concept of occupational health." It would seem that there is some genuine interest in such a program among a small nucleus of corporate medical directors. In my opinion, this would justify exposing the matter for editorial and general comments. If the interest generated is a sustained one, perhaps the implementation of a pilot project on a formal basis could be referred to the House of Delegates for consideration as a project of the American Occupational Medical Association. E. R. PLUNKETT, MD Occupational Health Services Inc Barberton, Ohio Letters to the Editor

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Letter: Preceptorships in occupational health.

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