Anybody working in Occupational Rehab?

Hi there,

I am a physio and currently work in Australia. I am thinking of a little career change and was considering a job in Occupational Health/Rehab. Anybody here who has taken the step from clinical work to a more corporate/management role?
How do you like it? Do you find it interesting?
Any info would be greatly appreciated!

I moved into occupational rehab and occ. health quite early in my career. Since then I have moved on quite a long time ago and am now in education. so I am not completely up-to-date with what it involves nowadays.

However it was an incredibly rewarding experience and I thoroughly recommend it as a career option. I was never a particularly medical physio and so I really enjoyed working in the "real world", dealing with complex work systems, and communicating with people.

OTs and physios often have the same job description - so either profession works well in the area. I think what physios bring to the job is their knowledge of clinical physiotherapy and to be able to apply that to the client in the workplace. So having a few years out in clinical practice behind you is of great benefit. Going straight from graduation is not such a great move.

Communication is important in any area of physio but it gets to be really crucial in occupational health. The type of communication skills you need are somewhat different and expanded from clinical work. You need to be able to relate to both blue and white collar workers, union representatives, insurance claims officers, GPs and other specialists, treating physios, middle managers and managers at the board level. Your job is often advisory and you have to be able to influence people, not always coming from a position of a lot of clout. So having the empathy there is very important but also being able to demonstrate that you know what you are talking about and at times you have to be quite assertive. The communication at times can be quite stressful as in this type of rehab there is often been underlying conflict in the workplace around the injury - and everyone has there opinion about what should happen.

The rehab consultant's job involves a lot of sales - I found that challenging but in a low key way I found I was quite good at it. The job might involve account management so you need to be able to forge and maintain good working relationships with organisations. This part of the job I loved.

Whatever you do you will really need to know the relevant legislation back to front. Knowing how WorkCover for the state you are in, Comcare, Third party motor vehicle accident insurance, and the occupational health legislations are a must. A lot of these organisations offer short courses for rehab consultants and health practitioners and you can often do them as part of your induction to a rehab consultants job.

Two good peer reviewed journals are Work and Journal of Occupational Rehabilitation. You might be able to get them if you belong to an institution library.

Another thing you should have is skills in functional capacity evaluation. FCEs attempt to simulate the physical aspects of work tasks, prgressively increasing the forces and stressors as the testing proceeds. Here your knowledge of biomechanics and exercise science helps. I think nowadays that most companies do generic type of evaluation and you might get training in it on the job. Alternatively you study one or more proprietory FCEs. these courses are very expensive for what you get but they can be a great learning experience. Try to do one of the systems that have been validated. Most of the systems have not been properly validated so are probably not worth the paper the are written on. The PWPE and the Isernhagan work systems are two that have been validated. the most popular one in Australia has not been validated.

You may want to think of undertaking some post grad study part time while you are working. the choices are courses in occ rehab - I think there is one at University of Newcastle which you can do at a distance (?). I really got into the prevention side of the job and so I did a post gad qualification in ergonomics - it was really interesting and greatly improved my skill base.


so occ rehab, prevention/ergonomics as a consultant are two routes of career development. A third one is moving into occupational health position in a company - such jobs in medium to large companies might combine occ health with rehab management. From there you can move into other areas of management so the world is your oyster! If you are interested in this third option, starting as rehab consultant for a rehab company is the best place to start.

Some occ rehab companies also offer hybrid jobs where you do a bit of rehab consultancy and a bit of clinical physio - the physio is usually at the physical activation end of things when the client isn't getting better from standard treatment offered.

At the end of the day if you have a go at it and find it isn't for you and you deicide to go back to clinical practice- I think you will find it will make you a much better clinician. I found that I was much more proactive and communicative with drs and the workplace after working in the area and tended to think beyond just what I was doing in the clinic.

Best of luck with your career move!

Great, thanks a lot for your extensive answer, it was definately very interesting and helpful! I think what really attracts me in Occupational Rehab is the fact that -as you said- you deal with the "real life" and try to get people back into work, with a more holistic approach. I often feel somewhat isolated working in a private practice.
I did have an interview at a rehab company today, they´re looking for a rehab consultant, so fingers crossed:)
Thanks again for your help!

Hello Gcoe !
I have just started in Occupational Health. Can you suggest me some assessmnet tools that I can use.
At present I have looked through RULA and just doing job analysis and doing general physio tehrapy assessmnet (obviously problem specific)

Thanks
Sana

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Hi sanagupta1

I am not that up with the latest available as I no longer practice in occ health. However RULA is a good tool for evaluating postures and forces adopted by the upper limb. OWAS is another direct observation method but I would just choose one or the other. REBA (Rapid Entire Body Assessment) is a more general body one which is written by the same authors as RULA:

CUergo: REBA

As a quick hazard identification tool I found the PLIBEL good

ScienceDirect - Applied Ergonomics : A method assigned for the identification of ergonomic hazards — PLIBEL

http://www.ttl.fi/NR/rdonlyres/AC99D...3/0/PLIBEL.pdf

However there are so many methods and tools available and no one tool will cover all your needs. The type of industries you are covering are important to consider - do you want to have more manual handling evaluation tools or more data processing/office tools for instance. Occ Health and safety Government authorities often produce tools which may or may not be validated. - such as the HSE in the UK, NIOSH in the the US, the WorkCover authorities in Australia and ACC in NZ all have such tools

The area is complex and there is a lot to learn. I would highlly recommend you consider getting a text book that catalogues the various ergonomics tools:

Evaluation of Human Work by JR Wilson and EN Corlett is an excellent British text and while it is massive it is good value for money. it includes sections on basic ergonomic methods, assessment and design of the physical workspace, analysis of work activities and analysis, evaluation of work systems, and implementing change. There is a good American one too (Handbookd of Occupational Ergonomics by Maras) but this UK one is better value for money and should have more than enough for your purposes.

Another thing to do is join the special interest group in your physiotherapy association. You may also consider joining the national ergonomics/Human factors association which is multidisiplinary. You may find that your ergonomics soc will have a special interest group on occupational rehabil. or workplace ergonomics.

As far as evaluation of the individual worker re: injury/disablement then looking at the rehabilitation literature for outcome measures can be helpful. For example if you have an worker anxious about reinjury and/or resisting going back to work, the TAMPA (Kinesphobia), pain self efficacy questionnaire and Fear-avoidance beliefs questionnaire are all good things that can help shed light on cognitive and emotional factors about injury.

And as I wrote earlier you may want to study are particular functional capacity evaluation - I found the IWS FCE and the PWPE FCE both good competitors. Find out what people are using (if any) in your part of the world.

Hope this is of help and good luck with your career move.