Harborview Medical Center
Occupational Medicine Service
Drew Brodkin, MD
Associate Professor, Medicine
325 9th Avenue
Seattle, WA 98104
Phone: (206) 744-3005
Overall Educational Purpose
To provide broad exposure to patients with occupational and environmental
Principle Teaching Methods
Case discussion and review
Each case is discussed extensively in clinic.
There is a weekly case conference in which residents may voluntarily
There is a weekly journal club/didactic lecture/research in progress
review session available for residents to attend on a regular basis.
Mix of Diseases
Patients presenting to the Occupational Medicine Service encompass a broad
spectrum of disorders which may be caused or aggravated by occupational
exposures. Common cases include patients with occupationally-related respiratory
diseases (asthma, asbestosis), hepatitis secondary to hepatotoxins (solvents),
nephritis (solvents), and musculoskeletal diseases, including low back
pain and cumulative trauma disorders of the upper extremity.
The Occupational Medicine Service sees a broad range of patients from
varying socio-economic groups, and approximately forty percent of patients
are covered under workers’ compensation, with the remainder divided
among third-party insurance, Medicaid and self pay. The ethnic mix of
patients reflects that of the city of Seattle.
Types of Clinical Encounters
The vast majority of patients are see in the Occupational Medicine Outpatient
Clinic, with less than ten percent seen on acute consultative bases. Evaluations
usually include an initial in-depth encounter which lasts approximately
forty-five minutes to one and one-half hours and includes full medical
history, occupational history, physical examination and appropriate laboratory
Occasional Carpal Tunnel Injections.
The Occupational Medicine Program maintains a full library of textual
materials to facilitate research on occupational and environmental diseases
and exposure assessment. In addition, access to Medline is provided. A
smaller set of reference texts is provided in the immediate clinic area
for use during clinic hours.
Rotation Specific Schedule
8:00 Medicine Grand Rounds
9:15 Resident Teaching Conference
Call and Weekend Responsibilities
Principle Educational Materials Used
Methods Used in Evaluating Resident and
At the end of the rotation, the resident is evaluated in writing and their
performance reviewed with them verbally by every attending and fellow
he or she has interacted with for a significant amount of time. The evaluator
rates the resident on a nine-point scale in each component of clinical
competence (i.e. patient care, medical knowledge, practice based learning
improvement, interpersonal and communication skills, professionalism,
system based learning, educational attitudes, leadership, overall clinical
The resident is given the opportunity to evaluate in writing the quality
of the curriculum and the extent to which the educational goals and objectives
of the rotation have been met. The resident also evaluates the teaching
competence of each attending and fellow with whom s/he has interacted
for a significant amount of time.
Explicit Lines of Responsibility for Care
of Patients on this Service
Patients are seen either via a consultation service or, more commonly,
in the Occupational Medicine Clinic. Residents see individual patients
and present each case to the attending physician. The attending discusses
the cases in detail with the residents and personally sees each patient.
The care of all patients is the direct responsibility of the Occupational
Medicine attending. Attendings directly oversee the care of each patient
at the time of the encounter by a resident/fellow.
Last Revised April 13, 1998 by Scott Barnhart, MD