[Physicians and occupational health: a qualitative study in south-eastern France].
BACKGROUND
Occupational health is a major public health problem in France. However, the level of investment of general practitioners and specialist physicians in this field is not well documented. We aimed at studying elements moving closer or differentiating groups of professionals (notably physicians) in the field of occupational health in terms of conceptions of their roles (prevention and care) and of practices (in particular detection and notification of occupational diseases and perceived barriers).


METHODS
We conducted a qualitative study in south-eastern France which consisted of in-depth interviews of physicians and actors involved in the prevention of occupational hazards or in their indemnification. Then discourse analysis was carried out on the corpus collected. Content analysis grouped the data into themes.


RESULTS
Several reasons could explain the low investment of physicians in the field of occupational health: insufficient detection of occupational causes of diseases, complexity of administrative procedures of declaration and bias of causal interpretation for the patients exposed to other risk factors such as smoking. The fear that notifying an occupational disease might have repercussions on patients' socio-professional situations places physicians in a situation of ethical dilemma: inducing a social risk on one side, ignoring his rights on the other. Physicians are not sufficiently prepared to deal with these situations, because they lack appropriate knowledge and support from specialists in the field, due to an important bulk-heading of actors and their practices.


CONCLUSIONS
To sensitize and train physicians to occupational health and to support multi-field practices are essential.
Saliba
M-L
ML
Inserm U 379, observatoire régional de la santé Provence-Alpes-Côte-d'Azur (ORS PACA), 23, rue Stanislas-Torrents, 13006 Marseille, France.
Iarmarcovai
G
G
Souville
M
M
Viau
A
A
Arnaud
S
S
Verger
P
P
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D004501:Education, Medical; D004992:Ethics, Medical; D005194:Family Practice; D005602:France; D006801:Humans; D008511:Medicine; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D016272:Occupational Health; D009787:Occupational Medicine / Q000193:education; D028701:Patient Rights; D010819:Physician's Role; D010820:Physicians; D012307:Risk Factors; D012907:Smoking; D012931:Social Environment; D013038:Specialization