Magazine article Occupational Hazards

Chrysler Takes a New Look at In-Plant Medical Care

Magazine article Occupational Hazards

Chrysler Takes a New Look at In-Plant Medical Care

Article excerpt


The medical units at four of Chrysler Motors Corp.'s plants have undergone administrative changes recently: They're no longer staff-operated; instead, they are being run by outside, hospital-based groups.

"What we have gained is access to trained physicians in occupational medicine," explains Robert J. Brandt, M.D., Chrysler's director of occupational safety and health services. Brandt says that, over the years, recruiting specialists in occupational medicine has been difficult on a plant-by-plant basis. "First of all, we can't afford to," says Brandt. "Secondly, many specialists aren't interested in working in an individual plant. But, by contracting, we can get access to specialists who work in hospital-based clinics."

Brandt, named Chrysler's top medical official 3 years ago, believes his company is in step with a developing trend as more and more companies contract for services and more and more hospital-based groups form to provide these types of services.

Brandt notes that when Chrysler recently announced that it was going to contract out three of its in-plant medical units, seven contractors submitted bids for each plant. "This told us essentially that there are people out there that are interested in doing this type of work," he says.

Medical background

Chrysler's in-plant medical units are responsible for preemployment physical examinations, medical surveillance examinations (such as audiometric testing), injury care, and emergency medical care. The company has in-plant medical units in 28 of its largest American and Canadian plants, where employment levels range from 500 to 2,400 people. (Smaller plants have off-site, fee-for-service arrangements with local doctors or clinics.)

Traditionally, the in-plant medical units have been staffed by company doctors and nurses. A doctor and at least one nurse are on duty during the day shift, and a nurse is on duty during other shifts. Currently, 24 of Chrysler's medical units are staffed by company personnel. Four others have been contracted out.

Chrysler's move to outside contractors in some locations reflects the efforts of the corporate occupational safety and health services office to gain the expertise of the best-trained occupational physicians available. Says Brandt: "What we're concerned about in the field of occupational medicine is the rapid development of technology and skill levels required to practice occupational medicine. We also looked at the development of the field of occupational medicine, which is changing now into hospital-based clinics."

Brandt says most of the job requests he's seen for occupational physicians and nurses lately have been from hospital-based groups, which, he says, can offer an occupational physician the backup of all of the hospital's staff and resources, plus room for advancement. "There's a shortage of physicians with technical training to do occupational medicine in the broad sense," Brandt adds. "If we would try to get this expertise in all of our plants, we would run into an availability problem trying to recruit some 28 occupational physicians.

"The majority of them like to look at a broader picture, where they can participate in a larger group, with some ability to advance," Brandt says. "An in-plant job basically does not provide a lot of advancement potential. There's only one corporate job. So there would be essentially no movement for these people, and that makes recruiting them for plant jobs extremely difficult.

"We feel that within a hospital system, these people recognize that they can move into other areas of the hospital, or as their department grows, gain more status. They have at least the opportunity to move on and move upwards.

"We felt that Chrysler could gain a considerable amount of expertise by going into the contracting side. So we decided to try this out to see how it works. …

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