DiMasi, Frank T.

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The Linacre QuarterlyVolume 27 | Number 2 Article 4May 1960Medicine in IndustryFrank T. DiMasiFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationDiMasi, Frank T. (1960) "Medicine in Industry," The Linacre Quarterly: Vol. 27 : No. 2 , Article 4.Available at: http://epublications.marquette.edu/lnq/vol27/iss2/4Medicine in Industry FRANK T. D1MASI, M.D. " ... and to the questions recommended by Hippocrates, he (the doctor) should ac. one more - What is your occupation?" 8. Ramazzini « « » )) A SURVEY Historical Note: Industrial medicine probably dates back to Hippocrates and Galen who observed th t certain occupations and trades were a menace to health. However, Bernadino Ram;s -zini ( 1633-1714), author of a monumental work on occupational diseases. has be n called the father of industrial medicine. Oddly enough, America was delinquent n matters of occupational health, the birth of industrial medicine here occurring betwe n 1905 and 1915. Milestones in the development of industrial medicine include: (I) 19 1 - establishment by the United States Public Health Service of its Division of lndt ,. trial Hygiene; (2) 1915 - formation of the American Association of Industrial Ph) i­cians and Surgeons (now called the Industrial Medical Association); (3) 1918 -establishment of a course leading to a degree in industrial hygiene at Harvard U i­ve.rsity; ( 4) 1942 - formation of the American Association of .Industrial Nurses, I ) 1953 - creation, by President Eisenhower, of the Department of Health, Educat n and Welfare. Scope The type of physician engaged in the practice of medicine in in­dustry varies from the general practitioner giving part-time serv­ice in one or several small plants, to the consulting specialist, and finally to the full-time industrial physician. What percentage of the 210;000 physicians in the na­tion at this time is engaged in part-time or full-time industrial work is difficult to estimate, but the figure is sizable. Medical Director The medical director is a full­time employe of the plant. The Dr. OiMasi at the time of preparing this article served as full-time industrial phy­sician to the Norton Co., Worcester, Mass. and the statistics used are for that firm, 68 amount and type of post-gradu, ·e training varies; he may or may r Jt hold a degree in public health a d may or may not be board certif :d in industrial medicine. Aside fr mpurely administrative functions 1e serves as an educator and c n­sultant to his medical staff. H, is aware of occupational hazard� in his industry and is constantly onthe alert to prevent accidents a d/ or to correct conditions. He se1 ves as a buffer between managerr.ent and labor in medical matters .. nd has the interests of both at he.irt. He establishes a comprehen ive program to keep the empl iye sound in physical and m!". 1tal health. Industrial Hygienist The industrial hygienist is a kind of detective in industry. His LINACRE QUARTERLY work involves routine surveys on heal�h hazards indigenous to thepa_rt1cular industry. For example,th�s may involve detection of radi­�tJOn hazards in industry employ-1�g the use of radioactive mate­rials, dust counts in the abr . . d . as1ve m ustnes, high e n vironmentaltemperatures in plants using fur­naces, _and so forth. In addition�o routine surveys, he is involvedm the investigation of specialproblems which might occur. Thusa grou� of employes working ona particular project in industrymay develop a dermatological dis­order; the medical department calls�pon. the industrial hygienist toidentify the responsible agent andto_ �ak� recommendations for theehmmatton or modification of th. agent. 1s ,i :.,stry in which he is employed,: d is concerned with the reduc­m of these. ETHICAL CONSIDERATIONS . n�! this the carpenter the Son of ·irg7 , p· St. Mark, 6:3 :irst and foremost, the doctoru; industry should hold dear th concept of the. "dignity of labor,�as �-xpounded in the inspired en­cycucal of Pope Leo XIII Th Condition of Labor. The ph;sicia: employed in industry has a dualtask of fulfilling his obligations to management as an employe and of discharging his duties asa physician to the workingman. The Pre-EmploymentExamination Safety Engineer The safety engineer is con­;:rn_ed with making or keepinge mdustry a safe place at wh. hto k H . ic wor · e is involved in such matters as the distrib.ution of safe­!/evices including safety glasses,hety shoes, r e s p i r a t ors- andt ers. In areas involving hightvels of ?oise, suitable protection�r ears is provided. Safety de-VJces have been a great boon to occupational health On d on) t · e nee y o speak, for example, with �n opht_halmologist who has been th practice for some time to realizee great importance of safetyIt is the duty of the physicianto perform as accurate and. objec­ti_ve an examination as time andc_1rcumstances permit. An evalua­tJOn_ of the individual for suit­ability to the work involved ismade; health limitations are re­corded. It is just to both th candidate for employment and th:employer that these limitations berecorded. For example, it is hardlyad�antageous or sensible for the md1VJdual with lung disease to beempfoyed under conditions involv­mg high environmental dust andthe threat of silicosis; neither. should management be obliged toglasses in the prevention of ocularcatastrophes. Finally, the safety engineer is::are of the accident rate in vari­s operational phases of the in­MAY, 1960 · ��e such a high risk individual. . is factor varies tremendously with the · d t . . m us ry mvolved; thep_omt is this.: management has the right to employ whosoever it de­sires, and for the individual who 69 " not employed this is not the end of the road; there are probably other avenues of work for which he is better suited. I have been amazed at the acceptance of this fact by the individual who is re­fused employment for medical rea­sons when these considerations are satisfactorily and intelligently explained to him. The Industrial Accident Once again the dual obligation of the physician to both labor and management prevails. The work­ingman who is treated for an in­jury is not returned to work if the circumstances created by the accident make the performance of his work detrimental or dangerous to him. despite the fact that the loss of time accident rate is in­creased. There are other proper means by which the employer may lower this rate. On the other hand, the individual who has sus­tained an injury which is not a deterrent to the proper execution of his work is not encouraged to leave work simply because the employer will pay for it. The Medical Emergency As in any instance where death is imminent, the spiritual needs of the individual should not be for­gotten. I have in no small way been impressed by the emergency data sheets which include the question: What is your religion? 70 THE 9UESTION OF "SOCIALIZED MEDICINE" Industrial medicine need not b the forerunner of "socialized mec icine." The problem is non-exist ent if this simple rule is followe the physician in industry shoul not treat any condition which not industrial in origin; for the, : latter the patient should be r £erred to his family physician. [ have seen this done agreeably. t should not be in the province . f the physician in industry to tre t any condition of which the er -ploye may complain. This is n to say that emergency treatme should not be given; such care s perfectly in order and I am SL e the physician in private pract, e would accede to this. However. when industry set s to build and staff its own hospitc. s. as has recently happened with 1 1e New York labor unions, this � 1s a bearing on the private pract �e of medicine. The industrial phy i­cian comes to treat not only · 1e employe. but his wife and fam y, This can have an adverse elf, t. CONCLUSION Industrial medicine has becc ne an integral part of our econo 1y. The opportunities are plenti ul: it is estimated that at least en physicians are needed in indu 'ry for every one now spending his full time in such service. The industrial physician •1as obligations to both managerrent and labor. Industrial medicine need no· be contradictory to the private prac• tice of medicine. L1NACRE QUARTERLY The following is an outline of th . I h a pl"nt I . e 1 t and safety personnel .  emp oymg approximately 5000 p ople:m HEALTH Medical 1 Industrial M.D. I Woman M.D. 3 Internists Nursing (part-time) Orthopedic surgeon (part-time) Roentge nologisf ( consultant) I Head R.N. I Visiting R.N. 9 Staf  R.N. Ttthnica1X-ray technician Lab. technician 3 Medical secretaries MEDICAL DIRECTOR INDUSTRIAL HYGIENE Industrial Hygienist SAFETY Safety Engineer Technical Assistant Optometrist (part-time) Consultant to Eye Protection Program Secretary 71 Table program 1 ·JJustrates the annual statistics for the industrial• 1 . 1 ti· d ( Statistics are for 1957.) previous y ou me medic I Table I. HOSPITAL• STAFF OPERATIONS . . . .... .38,456 Total Visits to All Hospitals .. ·-····························-································ · ......................... 2,172Total Accidents (At home, On highway, At work)...... . . 9,824 .. ------··-···-- -··--······-·· ···· Total Accident Retreatments-.... ...... . ... -................ ...14,706 Total Medical Cases............. · · ·······--··-··-··· · __ 5,724: Total Medical Retreatments .......... ____ ............ --........... _. . ... 2,752 . . (P e-employment a.nd routme) ... ,--·-··-··---··-· Medical Examinations r 5,000 Total Investigations by Visiting Nurse-.... ----· ····-------··--·-···---. . .. ..... 3,274 Total Number of X-rays Taken.. __  ........... -... . ... 4,713 Total Number of Laboratory Procedures ...... 117 Total Number of Industrial Hygiene Surveys ·· · ····· ···- -· -.. -······-The word Hospital as used fr�quently in industry, is not analogous to the commL ,ityhospital but is rather like a cl1mc. Bibliography Fl , A J D'Alonzo, C. A., Zapp, emmg, · ·• .. J. A.: Modern Occupatio�al Medicine. Philadelphia: Lea and Feb1ger, 1954. Hunger. Donald: The Diseases of Occu­pations. Boston: Little, Brown and Co., 1955. 72 K ho R A . Occupational Medici �5-1 e e, · ·· M l·I 9 · Whither and How! J. O. ··. 1 · H, ,Ith. Sa ington, C. 0.: lndustria . 9 Chf:ago: Industrial Commentaries, ( .9\R G Id C . Five rea Treacy. ev. eray k:· The p ulist Encyclicals. New or . Press. 1953. LINACRE QUARTERLY Thomas Linacre: >oyal · Physician THE L1NACRE Qu.�RTERLY gains new r jou;na/'s name is often the topic of questio of the English physician and priest for u•h Guilds had great admiration and respect, chcwork. Perusing early issues of the magacin,·. December 1932, gives information that fills , the past in republishing the material as a "re/ , with each issue's publication. The,,, periodically w e  include a vignette ·" early members of our Physicians'Thomas linacre as patron for this :'ound that the very first number, in .. ,·cd adequately. so we borrow from '·er"' of the subject. THE selection of this term THE LINACRE QUARTERLY for our journal deserves some explanationto those who are not students ofhistoric medicine. Thomas Linacre founded the Royal College ofPhysicians and through it regu­lated the practice of medicine. This occurred early in the 16th century.At the time there had been a great increase of irregular practitionersand of violation of ethics amongthem. The constitution of the Col­lege, drawn up by Linacre, stillin force, is a standing monumentto his far-seeing judgment. It rep­resents the principles that con­stitute the working basis ·of ourmovement for the organization ofCatholic Physicians' Guilds.th'- intellectual world owes a debtto his activities because he un­doubtedly was the most learned physician of his time. After taking the degree of Doctor of Medicineat the University of Padua heg,·aduated an M.D. at Oxford. He himself made a .large fortunein the practice of medicine and was Royal Physician to Henry VIII in his younger days; he was an inti­mate friend of Sir Thomas Moreand Erasmus. He gave his fortuneto the foundation of Chairs in Greek medicine at both Oxfordand Cambridge. Greatly respectedby his contemporaries, his Englishbiographer says of him that heseems to have no enemies, and he Was greatly admired by Sir Wil­�am Osler and S. Weir Mitchell of our day. Not only England, but His enlightened mind viewed with distress the practice of medi­cine in his day. By no legal re­straint was its exercise restricted to competent practitioners. This he endeavored to correct by the es­tablishment of the College of Physicians. With the assistance of Cardinal Woolsey, he procured from Henry the Eighth and the Parliament the authority, but he had to use his own funds for the establishment of the college. His was the first effort to confine med­icine to those who were qualified to practice it. The words of the Charter of the College ran thus: Before this period, a great multitude of ignorant persons, of whom the greaterpart had no insight into physic, nor in any other kind of learning; some couldnot even read the letters on the book, sofar forth, that common artificers, assmiths, weavers, and women, boldly andaccustomably took upon them great curesto the high displeasure of God, great in­famy to the faculty, and the grievoushurt, damage and destruction of many ofthe King's liege people. ftfAv, 1960 Prior to the establishment ofthe College of Physicians, the73 

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