The Need for Occupational Rehabilitation : A decade of experiences in Australia

Introduction
In Australia, as in most countries, Occupational Medicine and Rehabilitation Medicine are two separate disciplines. Trainees are taught separately, after which they tend to practise without much rapport with practitioners in the other discipline. This often leads to suboptimal results in the rehabilitation of injured or diseased workers. This paper draws upon the experiences of a special programme which combines the skills and experiences of Occupational Medicine and Rehabilitation Medicine in providing education for trainees in either discipline in a special programme from 1988 - 2010.

Methods
Cases are referred from within the hospital itself, such as back injuries from heavy lifting, occupational overuse syndrome from repetitive movements and occupational dermatitis from detergent handling. Cases are also referred by outside general practitioners and specialists, including those under Workers' Compensation and toxic exposures from pesticides, organic solvents and heavy metals. All cases are seen by myself as the consultant in charge, and also by a trainee or registrar. Periodic discussions of problem cases involve physiotherapists, psychologists, rehabilitation specialists and personnel officers. When necessary, visits are made to workplaces and discussions held with managers, supervisors and welfare officers. Whenever possible, the rehabilitation programmes are conducted in cooperation with the referring doctor.

Results
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Discussion
Several examples of successful outcomes are given. Outstanding examples are those which are accompanied with visits to workplaces and where full rapport is established with the patient, the referring doctor, the supervisor and management.