The Company Doctor

Draper, E. The Company Doctor: Risk, Responsibility, and Corporate Professionalism . New York : The Russell Sage Foundation , 2003 , US$ 39.95 (hbk) xi + 396pp . ISBN 0-87154-249-8 In The Company Doctor Elaine Draper provides a fascinating insight into a previously little researched area. Basing her work on 100 interviews with company doctors, government occupational health officials, labour officials and academic occupational health staff she explores the tensions between corporatisation and professionalisation of the medical staff in large companies. Company doctors perceived in equal measure by employees and unions as corporate stooges and by management as ‘soft’ on the labour force have much to complain about. Those trying to do a good job, protecting employees, have an uphill struggle to persuade management that what is good for employees is also good for the company. Paradoxically, until very recently they were discouraged from finding hazards in the workplace and the environment for fear that it would create potential lawsuits, and the book spends some time on the strategies doctors employ to overcome this. The same pressures have prevented the publication of good-quality occupational health research in the US. Surprisingly, it is the corporate lawyers who have supported them in opposing this short-term view, not of course for any altruistic reason, but because the perception that a company has tried to identify, warn about and minimise hazards, plays well in court. Additionally the book touches on the sensitive issues of privacy and confidentiality, drug testing in the workplace, general and genetic screening of employees and more worryingly the use of the company physician as a means of controlling the difficult employee, almost reminiscent of the abuse of psychiatry in the old Soviet block. The author argues strongly for a legal framework which empowers physicians, institutionalises the promotion of preventive practices and permits ‘whistle blowing’. However she concludes that in the long term the best solution may be the separation of occupational medicine from the control of employers. This is a readable, scholarly and well-argued book which I would strongly recommend to anyone interested in occupational medicine or labour relations generally

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