Turkey’s İzmir Medical Chamber issued a report on the problems faced by workplace doctors during the pandemic. Drawing attention to the increase in workload, the report also stated that although there are regulations regarding public employees with chronic diseases, workers are ignored in this regard.
The statement made by İzmir Medical Chamber is as follows:
It is up to workplace doctors to protect the health of employees, and prevent the spread of the coronavirus pandemic in sectors that continue to work incessantly. Workplace doctors, whose personal rights, working conditions and working periods (the period foreseen to be allocated per worker) are currently insufficient against the duties and responsibilities expected of them, are being exhausted under the pandemic burden.
The difficulties experienced in workplace medicine practice during the pandemic can be summarized as follows:
1. Current guidelines on how to manage the COVID-19 pandemic in the workplace under the guidance of Turkey's Ministry of Health have not been sufficient for workplace doctors.
2. The contact / close contact definitions of the Ministry of Health cause confusion. It is difficult to decide who should be quarantined.
3. Whether the patients returning to work after treatment are fully recovered is based on symptom follow-up by the Ministry of Health Guidelines. That workplaces demand negative test results caused chaos.
4. The restriction for workplace doctors on reporting for more than 2 days causes difficulties in follow-up, and increases the workload of health institutions, which already have a high workload for employee reports.
5. Within the scope of the filiation study, family members who are considered to be in close contact are registered into the Public Health Administration System (HSYS). However, there is a problem in reporting the employee's close contact colleagues. District Health Directorates do not take into account that workplaces are also contact centers, and do not send a filiation team to the workplace. This task is undertaken by the institution medicine.
6. Since the workplace doctor cannot access the HSYS system, the statement of the employee is taken essential, and then the examinations that have been made are requested from the patient / contact. In case the examination results come out late, it is a problem how to name the non-working days.
7. It is not clear whether employees with COVID (+) and undergoing treatment will be reported as an occupational accident record, it is rather left to the choice of managers. The circular issued by Turkey’s Social Security Institution (SSI) has decided that employees who are infected with the disease during the pandemic will not have an occupational accident.
8. Although there is a regulation on public employees with chronic illnesses, there is no regulation regarding workers involved in working life.
9. The bitterness of the pandemic has taken all the time of the workplace doctors, and caused the interruption of the routine works and periodic tending that they are obliged to do professionally and legally.
As İzmir Medical Chamber, our demands are as follows:
1. The uncertainties about the management of the pandemic in the workplaces must be eliminated, and the problems regarding the duties, powers and responsibilities of workplace doctors must be resolved.
2. Appropriate conditions must be provided to correct these malfunctions that may arise from employees and workplace owners, and necessary legal arrangements must be made.
3. In a way to prevent the spread of the pandemic in the workplaces, the patient and contact workers must be supported to stay at home, the necessary precautions must be taken quickly in the workplace, decisions regarding the arrangement of the places where the employees have to be together must be taken in accordance with scientific guidelines, and public will mechanisms must be established to monitor all practices.
4. It is a big deficiency that workplace doctors cannot access the HSYS system and cannot add data. Considering the role of workplace doctors in the control of the pandemic, regulations that will increase the cooperation of workplace doctors with district health directorates must be implemented.
5. Considering the increasing workload of workplace doctors, public will must be provided for the regulation and supervision of workplace doctors’ personal rights, working environment and working conditions.
6. The need for adequate and qualified personal protective equipment must be met regularly and without interruption.
7. Measures must be taken to eliminate the problems of workplace doctors who cannot do their routine work, including periodic examinations.
8. Collaboration with relevant structures, especially with Turkish Medical Association (TTB), which has experience in the execution of workplace medicine, will be an important step in solving all these problems.