ACOEM challenges OSHA on TB standard
ACOEM challenges OSHA on TB standard
Questions focus on who administers care, testing
A proposal by the federal government to allow nonphysicians to manage tuberculosis (TB) cases poses a serious health threat to the public, according to the American College of Occupational and Environmental Medicine (ACOEM) in Arlington Heights, IL. If the standard is not changed, employers may be able to direct TB patients to nonphysicians for less expensive care even if that care is insufficient.
The ACOEM represents 7,000 occupational health physicians, and its leaders say the government's wording for the proposed standard for occupational exposure to tuberculosis is weak. Under the medical surveillance provision, the federal Occupational Safety and Health Administration (OSHA) in Washington, DC, requires all medical evaluations and procedures, as well as medical management and follow-up, be performed by or under the supervision of a physician or other licensed health care professional. Previous OSHA standards have required medical surveillance be conducted by or under the supervision of a physician.
But in the proposed TB standard, "physician or other licensed health care professional" is defined as an individual whose legally permitted scope of practice allows him or her to independently provide or be delegated the responsibility to provide some or all of the health care services required.
Language change requested
ACOEM recently submitted a request to OSHA for a revision of the proposed language. In that request, the group says "the proposed standard suggests to employers that health care professionals, other than licensed physicians, may be qualified to make the critical medical decisions that are integral to the medical surveillance process. In fact, a medical surveillance program will require physician involvement and the standard should make that clear."
The proposed wording sets up the employer as a gatekeeper who can determine what level of care is provided to a worker with TB, ACOEM says. That would make it possible for the employer to select the least expensive option without considering if the nonphysician is capable of providing adequate care and surveillance for tuberculosis.
OSHA has not yet responded to ACOEM's request for a change in the proposed standard.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.