- Overall population: France has 3 times more inhabitants than Romania (62 millions compared to 21 millions)
- Working population: France has 4 times more workers than Romania (16 millions compared to about 4 millions) – possible explanation: several millions of young/middle age Romanians went to work abroad in the last 15 years
- Occupational physicians: in France there are about 6500-7000 occupational physicians, in Romania there are only about 330 and some 2000 general practitioners with limited competence in occupational medicine
- Young occupational physicians: currently, in both countries, about 60 young specialists start working in occupational medicine every year – this will help overcome the lack of professionals in Romania within the following years. In France the prospects are however dramatic: about 1500 occupational physicians are expected to retire in the next 5 years, while only 300 young physicians will replace them and there is already a serious penury of such physicians.
- Occupational health system: in France, employers organize an internal occupational health & safety service (“services autonomes”) or associate with hundreds/thousands of other employers (“services interentreprises”) in order to better manage the health and safety aspects of work. These medical services employ occupational physicians, auxiliary staff, other health and safety personnel (industrial hygienists, ergonomists, organizational psychologists, toxicologists). In Romania, occupational medicine is mainly a liberal profession, the occupational physicians work under a direct contract with the employer. In large industrial units, however, internal occupational medicine services are set up. In both countries, there are some occupational physicians employed by governmental agencies supervising the functioning of the occupational health and safety system.
- Workplace activity of physicians: in France, a third of the entire working time of an occupational physician is regulated to take place in the workplace (ergonomic studies, risk identification and evaluation, employers and workers counseling, health promotion, other activities). In Romania, there is not a regulated time, although this is a normal part of an occupational physician’s job; however it depends on the contract with the employer.
- Numerus clausus of workers under medical surveillance / occupational physician: 3300 in France, not regulated in Romania. Due to the lack of occupational physicians in France, in many medical services, occupational physicians are assigned the maximum number of workers. In Romania, occupational physicians supervise the activity of general practitioners with restricted competence in occupational medicine, so being assigned an unspecified number of workers, possibly several thousands.
- Medical examinations required by the law: pretty much the same, yet different procedures – pre-employment examinations, periodic examinations, other examinations, better regulated by the law in France. For instance, certain low-risk professional categories in France are examined every two years, in order to save time and medical resources. In Romania, periodic examinations are to take place yearly, however, many small unit employers choose to send new employees only to pre-employment examinations and not to have them followed on a regular basis, given that the enforcement governmental agencies are rather weak.
- Hospital-based services of occupational medicine: somehow similar as organization, they are assigned to help diagnose difficult cases of suspected occupational diseases.
- Risk evaluation: mandatory in every enterprise, in both countries. The occupational physician in France maintains an overall risk evaluation document (“fiche d’entreprise”) which may be used by the employer in the elaboration of the official risk evaluation document (“document unique”). In Romania, occupational physicians may be part of the team evaluating health&safety risks, but this is generally not the rule.
- Occupational diseases: thought to be underreported in both countries, yet much more in Romania. There is a determined list of occupational diseases which may be reported in both countries. In France, the table also specifies the maximum time interval between the end of exposure and the diagnostic/reporting of an occupational disease. In Romania, except for occupational cancer and pneumoconiosis, the worker must be employed at the respective firm, so that the occupational disease might be reported and acknowledged. The reporting is performed by the worker himself in France, by the occupational physician in Romania (or any other physician).
- Number of occupational diseases in 2006: 42306 in France, 910 in Romania, the huge difference results mainly from the massive underreporting of occupational musculoskeletal diseases (31639 reported in France in 2006, compared to only 47 in Romania). Other figures are closer, take for instance - silicosis: 315 cases reported in France, 268 cases in Romania.
- Last but not least, the gross salary of an occupational physician: 4000-6500 euros monthly in France, compared to 700 to 1500 euros in Romania
This entry was posted
on Monday, December 24th, 2007 at 12:06 pm and is filed under General.
You can follow any responses to this entry through the RSS 2.0 feed.
You can leave a response, or trackback from your own site.
Very interesting comparison between the Romanian and French system. I’m from the Netherlands, former occupational physician, now working at the Netherlands Center of Occupational Diseases. I’ll tell a little about the Dutch situation:
The overall population of the Netherlands: 16,5 million inhabitants, the working population is estimated a bit over 7 million.
There are approximately 2000-2200 occupational physicians (The professional society on occupational medicine counts 2150 members).
The professional training of OP’s takes four years and there are no general practitioners involved in occupational health. Like in France a big cohort will retire in the next 5-10 years and not too many new occupational physicians start a career in occupational health.
In the Dutch occupational health system there are occupational health services (OHS) that have contracts with tens of hundreds employers and there are internal occupational health services in the bigger companies and organizations. These OHS employ occupational physicians, industrial hygienist, safety engineers, organizational psychologists and ergonomists. There is a growing number (250-300) occupational physicians that work freelance for companies. A lot of the working time of the OP is spend on work ability assessment and rehabilitation. Besides that the OP takes up the same tasks as in France and Romania.
Maybe more later.
Success with your interesting blog
Interesting research. The difference between France and Romanian medicine systems is fascinating. \
“Occupational physicians: in France there are about 6500-7000 occupational physicians, in Romania there are only about 330 and some 2000 general practitioners with limited competence in occupational medicine”
France seems to be outweighing Romanian system by far with these numbers.
Good Post.
Thanks