Difficult reputations and the social reality of occupational medicine

This response to Tee Guidotti's (2008) critique of Elaine Draper's 'The Company Doctor: Risk, Responsibility, and Corporate Professionalism' (2003) argues that a forthright examination of the conflicts of those working in the field of occupational medicine is essential to maintaining the health of the profession and to promoting constructive policies. Research for 'The Company Doctor' reveals how doctors walk a tightrope of professional demands on them. The author describes how corporate employment affects medicine and science and how professionals working in corporations are subject to the decisions of company managers and to economic and legal imperatives stemming from their status as corporate employees. Analyzing company doctors' role in confronting toxics and responding to liability fears in corporations, the author argues that problems of lost credibility, stigmatization, and tarnished reputation that company doctors describe largely stem from the organizational constraints, economic interests, and other aspects of the social context of their work. These social forces exert powerful pressure on the ethical framework and daily work lives of these professionals as well as on the reputation of their field. The author discusses ways in which the conflicting demands from being both a corporate employee and a physician are a social and structural problem beyond individual ethics.