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| Treating patients compassionately and returning them to work, says Edward Bernacki, is the goal |
A decade ago, Occupational Medicine limped along as a division, taking care of the occasional carpal tunnel case and barely earning its keep with paltry revenues of only $26,000 annually. But then-Chairman of Medicine Jack Stobo made a decision that dramatically altered the course of the division. He appointed Edward Bernacki, M.D., as chief.
Today, Occupational Medicine is a growing, entrepreneurial operation that contracts with more than 500 Mid-Atlantic employers, covering almost 300,000 lives. Not only does the division diagnose and treat employees from companies like General Motors in Baltimore and Cytec Chemical in Havre de Grace, it also assesses workplace environments and consults with clients about potential hazards and the causal connections of occupational disease – generating more than $2 million each year.
“Funny, but most people don’t expect to make any money in occupational medicine,” Bernacki quips.
The appeal of occupational medicine, he explains, is the opportunity not only to take care of individual patients, but to change environmental conditions that cause disease for whole populations. Were workers exposed to toxic chemicals or lead poisoning? Is the workplace unsafe, causing harm?
“You can intervene to reduce exposures and hazards, so that other employees don’t get sick or hurt,” Bernacki says. “It’s the only place I’ve found where you can truly apply preventive medicine and see real results.”
That thinking also is the foundation of Occupational Medicine’s business plan. While other academic medical centers tend to treat occupational medicine as a boutique specialty, the Hopkins model is more robust. In addition to consulting with employers and providing doctors, safety professionals and nurses onsite, Occupational Medicine is a primary care center for toxic exposures and musculoskeletal problems like back pain and repetitive-trauma disorders. Physical assessment and therapy are provided and, if necessary, referral to specialties like orthopedics and neurosurgery. The formula? Treat patients compassionately while always advancing an agenda of returning to productive work.
“Employers like that, and patients pick up that we want to see them get better,” Bernacki says. “And if we do a good job, patients will think of Hopkins, for their families, too.”
Occupational Medicine is engaged in other initiatives, too, like monitoring the health of workers in Nevada who are disposing of long-buried ordinance chemicals and other hazardous waste for the federal government. Closer to home, the division has cut Hopkins’ yearly workers’ compensation costs by more than $4 million through ergonomics and other initiatives.
Also, the program has captured the imagination of hospitals throughout the United States, which has led to another line of business – teaching the Hopkins model to other medical centers. Occupational Medicine can represent a tremendous revenue stream for internal medicine divisions, Bernacki says, proudly noting that his division’s collection ratio averages 95 cents on the dollar: “There’s no HMOs involved here – it’s fee for service and whatever the market will bear.”