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An examination of occupational medicine practices.

The traditional occupational health on-site utilization of physicians as part of an overall occupational health program has been in decline in recent times. The on-site practitioner is increasingly being replaced by physicians who practice at an off-site location. The effects of this change on the health care delivered to the work force are largely unknown. By utilizing data from the 4490 facilities surveyed during the National Occupational Exposure Survey, it was possible to perform analyses of the association between the on- and off-site practice of medicine and several industrial facility characteristics and services usually associated with occupational medicine. Examination of the data indicated that, in comparison with on-site activity, the off-site practice of occupational medicine appears to result in diminished provision of the screening tests and medical examinations for which data were available.