Accompanied consultations in occupational health

Abstract

Background: Accompanied consultations are often reported as difficult by occupational physicians but have not been studied in the occupational health setting.

Aims: To collect information about accompanied consultations and the impact of the companion on the consultation.

Methods: We collected data on all accompanied consultations by two occupational physicians working in a private sector occupational health service over the course of 16 months. Accompanied consultations were matched to non-accompanied consultations for comparison.

Results: We collected data on 108 accompanied consultations. Accompanied consultations were more likely to be connected with ill health retirement (P < 0.01), have a neurological diagnosis or multiple diagnoses (P < 0.01), be rated as complex (P < 0.01) and take longer than 30 minutes (P < 0.01) than non-accompanied consultations. Over half of the companions (54%) were a spouse or partner. An impact by the companion was recorded in 81% of consultations but this was most frequently that they had provided information (56%) and in over a quarter the impact was recorded as helpful. Interruptions were recorded in 28% of accompanied consultations but only 6% of consultations had free text suggesting that the consultation or companion was difficult.

Conclusions: Accompanied consultations are likely to be more challenging in terms of the reason for referral, the presenting medical problems, the complexity of the case and the duration of the consultation. However, the companion is more likely to be of benefit than cause difficulty. Occupational health practitioners may benefit from better understanding of accompanied consultations and guidance on their management.

Keywords: Accompanied consultations; occupational health services; occupational physicians; triadic..