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Low-Cost Annual Medical Exams, Part 2

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In my last column, I introduced ways to implement low-cost annual medical examinations for your employees, including physician exams and lab testing. To develop a comprehensive and effective program, consider the following tests and policies.

Other Tests

If your service provides advanced life support and you have 12-lead ECGs, you can have your paramedics obtain a 12-lead ECG reading on each employee. Your agency's contracted physician can interpret the readings and place them into the appropriate medical records. This screening serves two purposes: It provides you and your employees with current 12-lead ECG readings, and it gives the paramedics some patients on which to their practice 12-lead ECG skills.

You should also schedule an annual TB tine test (PPD). A medically trained employee within your organization can usually interpret the results and provide feedback to the physician's office for documentation in each employee s medical record. If you have employees that are allergic to the skin test, they'll need to have a chest X-ray performed.

In addition, you should determine if annual chest X-rays are needed for all employees. Most agencies conduct these on a semi-annual basis to check for spots on the lung or other indicators that could affect an employee's health. Again you should shop for the best price on where to have the X-rays performed.

Policies & Agreements

In regard to record keeping, it's generally a good idea to have the physician provide your agency with only a Fit for Duty letter, which indicates the employee's health status and lists any health problems that need to be addressed, as opposed to a detailed report with lab results. This letter would be kept in the employee s medical file at the agency, and the specifics of the lab results, ECG s and chest X-rays would remain at the physician's office. This helps prevent any accidental release or disclosure of an employee's medical history. Only the designated persons, such as a HIPPA or an infection control officer, would have access to these records.

When developing an overall health and wellness program for your organization, be sure to establish the necessary policies and procedures in the event an employee tests positive for an infectious or contagious disease. As an organization head, you need to be proactive and determine what happens, for example, if an employee tests positive for exposure to Hepatitis B or C. Working with the physician, determine the appropriate medical responses to all potential findings. Develop clear guidelines that indicate whether such an employee can continue to provide patient care, or if they will be re-assigned to another position. Your organization must address these questions prior to an employee presenting with a serious condition.

For those organizations that work under a collective bargaining agreement, how will this affect you? As I stated in part 1 of this article, employers can require their employees to participate in periodic medical examinations that are job-related. If negotiations are necessary, the approach should be viewed from the positive benefit to both sides. Input from your labor representatives into the testing procedures and policies can generate a more constructive outlook and support for the examination.

I've coordinated annual medical exams for employees for more than ten years, and I've seen first-hand the benefits of providing an annual medical examination for employees. In several cases, serious health risks were found during the exams. The problems were addressed early, and the employees were able to continue working. As your personnel ages, you should create a solid foundation of medical information to improve their overall health and wellness. If you don't provide annual medical examinations, it's time to get started. Consult with your department physician to determine the specifics of an annual medical examination that meets your organization's needs.

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