CRITERIA FOR AOEC ASSOCIATE MEMBERSHIP

Orientation

AOEC Clinics have long provided a multidisciplinary, patient-centered, prevention oriented, public health approach to care, including adherence to the AOEC Patient Bill of Rights. The AOEC recognizes that many occupational clinics which practice and adhere to the high ethical standards of the organization are nonetheless ineligible for membership because they are unable to accept patients without regard to referral source or source of payment. Recognizing that affiliation of these clinics with the AOEC is of mutual benefit, the following criteria will be used to evaluate clinics applying to become associate members:

1. Physicians must tell patients when their conditions are work or environmentally related and, routinely, must provide all patients with information about the health hazards of their work and environment as well as the appropriate ways to limit exposure to such hazards.

2. The clinic must be willing to provide patients with the results of their evaluations unless medically contraindicated. Furthermore, clinics must routinely inform patients of their right to request and receive copies of all medical test results and other information in the medical record. Clinics must routinely inform their patients of their right to receive copies of all clinic-generated correspondence regarding said patient, unless medically contraindicated.

3. The clinic should be able to cite at least one clinic initiated environmental or workplace intervention that had as its goal the prevention of occupational and/or environmental illness or injury.

4. The clinic must be willing to visit workplace and/or environmental sites and should cite past examples. For associate members clinics that provide corporate occupational health services, details of their access to workers and worksites should be given.

5. After obtaining patient consent, clinics should take action to inform employers, manufacturers, government agencies and other relevant parties of measures needed to reduce hazardous exposures. Occasionally, the public health will require informing such parties irrespective of the individual patient's expressed wish.

6. The clinic should be able to cite at least one worker-focused or community-focused educational effort dealing with occupational and/or environmental hazards and risks.

Expertise

Associate member clinics should have on site a staff physician with either board-certification, or demonstrated expertise in occupational medicine. AOEC pediatric clinics must have a board certified pediatrician on staff. In addition, pediatric clinics must have either on staff or in a formal part time consulting position, a physician with either board-certification or demonstrated expertise in medical toxicology. Expertise may be demonstrated through publication in the peer-reviewed literature, a regional or national reputation, or recommendations of AOEC member clinic physicians. International clinics applying for associate membership should have a physician with the requisite training and certification applicable to the specialty practice of occupational medicine in the country where the clinic is located, or demonstrable expertise in the field as outlined above. Pediatric clinics outside the United States should have a physician with training and qualifications equivalent to that of a US board-certified pediatrician.

The AOEC stresses a multi-disciplinary approach to occupational health and health care. Associate clinics should have established contacts with industrial hygienists and other professionals with expertise in occupational and/or environmental health such as nurses, social workers, and health educators. These may be either on staff or available through a pre-arranged referral network.

Availability

The clinic provides initial evaluation of occupational and/or environmental disease or injury. Associate members are not bound by the requirement to see referral patients from any source, but should detail the scope of the clinic’s practice, and the eligibility of patients for clinical services should be specified., It is desirable that an appropriate referral network is established for patients who may not be eligible for the associate member’s clinical services.

Ethics

Members of clinic staff must adhere to the International Commission on Occupational Health’s International Code of Ethics (ICOH, 1992). Clinics must also agree to abide by and distribute the AOEC Patient Bill of Rights to all individuals being evaluated. Associate member clinics should provide assurances that patient health information is retained and protected in a confidential manner, and is not shared with non-medical personnel. The applicant should describe an experience in which a potential conflict of interest was resolved in a patient-centered manner.

AOEC Database

The clinic should be prepared to collaborate fully in the development of a patient database to be shared among AOEC members with appropriate confidentiality safeguards. Participation will be voluntary until such time as AOEC can reimburse the clinics for the time required to implement this activity. Clinics that can not obtain permission to participate either from their administration or from their institutional review boards will not be required to participate.

Quality Assurance

The clinic will submit a quality assurance report on a biennial basis to the AOEC office. Ideally, such a plan would include items specifically related to occupational and/or environmental health. The clinic agrees to consider quality assurance guidelines developed by AOEC in the future.

Training and Education

In recognition of the need for trained personnel, the clinic must be willing to assist the AOEC in its efforts to provide continuing education activities.

Peer Review

New member clinics must share existing members' readiness to accept peer review to aid them in continuing to meet AOEC membership criteria.