The future of occupational health practice: Reconciling customer expectation and evidence-based practice

In the twenty-first century the HCO will reduce costs and improve quality as its core strategy for determining long run success. This strategy will include continuous improvement of clinical performance and specific outreach and prevention activities. (15) The need of improving the quality of professional practice and of limiting costs affects the present direction and future trends of preventive activities. The latter, however, will attract investments and resources as long as the quality of the interventions, such as their conformity to clients’ expectations, will be demonstrated. (16, 17) Research in this field aims at: (i) assessing intervention effectiveness by means of appropriate indices, and (ii) developing guidelines based both on sound scientific evidence and stakeholders’ agreement. This approach to health problems of the individual (patient/worker) involves a shifting from the traditional paradigm (emphasis on clinical experience and on physician’s intuition) towards a new paradigm (critical appraisal exercise, skills in searching, evaluating and applying medical literature data). Faced with the need to provide concrete answers to health needs, OP should employ the extensively experimented new paradigm of EBM. This approach will warrant: (i) understanding workers’ and employers’ needs and expectations, (ii) using scientific evidence for decision making, (iii) establishing increasingly challenging health improvement goals of value to workers in terms of health benefits as well as to other stakeholders in term of customers’ satisfaction.