One of the most crucial aspects of consulting with industry is the plant walk-through.
When dealing with plants on a local or national level, it is imperative that this meeting be arranged early on in the relationship. Several things are accomplished when the physician personally views the employees at the job site. First, it gives an unquestionable authority of the specific job tasks that cannot be challenged by attorneys or other physicians. If you are the company physician treating or examining, and another physician is treating from a plaintiff stance, you will be in a much better position with regard to return to work, injury relation to job task, etc.
This holds true if you are treating someone and you take the time to look at the job site when the company physician did not take the time. You will be in a better position to help the employee patient and to offer company management some very pertinent observations that may open the door to a fruitful working relationship. Secondly, it gives the DC a first-hand look at what the working conditions are really like. This will help you to design specific stretching exercises for employees that takes into account their individual needs.
The initial walk-through should take no more than one hour. This is a get acquainted overview; you're looking for general problem areas that will be examined in more depth at another time. You can't expect to perceive the total ergonomic portrait of a company in a single viewing.
Another aspect of the walk-through is that this is a very visible sign from management that it is concerned about its employees. Let the management know that injuries have little to do with workers' compensation costs. What affects costs are management/employee relationship, physical demands, and medical control. Effectively change these factors and their workers' compensation costs will plummet. One plant I am working with dropped workers' compensation costs another 79 percent this year. It works.
The final aspect of the initial walk-through is to develop a bonding relationship with all parties concerned. The employees see the personnel director with you and it begins to reinforce the idea that someone cares. Also, just as important, you need to spend some time with your contact person to build a relationship of teamwork and trust. The company and DC should have an ideology and purpose that are aligned. This interaction must be smooth and effective to accomplish the overall purpose: to deal with workers' injuries (and the emotions they engender) in a cost effective manner to the company while enhancing the management/employee relationship. When a good working relationship is developed along these lines, it will do much to benefit the company and its employees. By the way, don't rush this interaction -- it takes time.
When viewing the actual job site, there are physical aspects as well as "intangibles" of which you must be aware. First, some general physical aspects to look for while on the floor. Watch to see if an individual employee is using what seems to be excessive effort or is having difficulty performing a task. This may indicate that the person is inexperienced at the job; training by someone who knows the "ropes" may be very helpful.
Are people displaying visible signs of hurting, such as wrist splints or braces? This creates an atmosphere, at least subconsciously, "that a lot of people are hurting." This also indicates a developing problem that the company will eventually feel the affects of in a very costly way. Splints are only short-term help. They do give some support but further weaken the muscles which actually accelerates the cumulative trauma. Look at the fingers of people and note if there is swelling around the rings and watch bands. This indicates again that the company will be affected in the long run. Look for obvious ergonomic changes that could easily be initiated.
If you see many of the signs of cumulative trauma and the company has a poor management/employee relationship, it's a virtual guarantee that attorneys and multiple doctors will soon be involved.
Good luck, and remember, the more walk-throughs you do, the better you will be.
Theodore Oslay, D.C.
DeKalb, Illinois
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