Recent changes in occupational medicine in The Netherlands

In some respects, the Dutch seem to be forerunners in Europe. Occupational health care for all workers can be considered as a substantial progress. No netheless, The Netherlands has taken the lead in Europe regarding high work pressure, sickness absence and disability for work. The resulting focus on sickness absence management in many companies is associated with changes i n the tasks and position of the occupational physician. Quality of occupati onal health care is not always as high as it should be, partly as a result of the commercial approach occupational health services have to adopt nowad ays. However, the post-academic education programme, with special attention for training of skills, is increasingly adapted to occupational physicians working in a commercial environment. Moreover, a basis has been laid for a better infrastructure and occupational physicians show an increase in prof essional enthusiasm. Furthermore, co-operation between different profession als has become increasingly common, resulting in a more comprehensive suppo rt for companies. Efforts are being made for better co-operation with gener al practitioners and medical specialists. Finally, the priorities for futur e research have been clearly outlined by a programming study. Experts are i n demand for studies regarding implementation and evaluation of interventio ns, especially cost-benefit analysis. Furthermore, work stress and musculos keletal disorders remain on the research agenda.