Occupational medicine, science and medical discipline with a practice for more than three centuries, recognises unequal development, linked with the interface human-work/occupation. This link has an accelerated growth for some companies or health systems that coexist with traditional ambience of other systems, even inside a country.Material and methods
By analogy with the three known axes 0x, 0y, 0z while time is the fourth dimension, the analysis is made by considering the four pillars, medicine, science, business, public/social policy for the ten items (the human resources, the specialised vocabulary and communication, the service type, the medical applications for preventive, curative, emergency, recovery, the medical technology-innovation, the types of financing, Q indicators, networking by sharing the data, the working and development environments, the strategy-law) which customise and differentiate the spherical content of a medical practices with a high turnover of the scientific work dedicated to the health of both the individual and the organisation, the community, the whole society.Outcomes and comments
Even though the initial premises were focused on curative medicine for the workers with occupational diseases (B. Ramazzini, XVIII century), the practice is enlarged, generating polemics, sometimes conflicts, pointing to all the dedicated professionals and/or beneficiaries.Outcomes and comments
Our study shows that the capacity and the context of the tendering is different on the four pillars and reflects the choice or decision of the professional/doctor to ensure the management of occupational medicine in its entirety or to transfer segments of intervention to other partners. This is reflected concretely for example in standardisation (new approach for time allocation per action), in the health benefits (the surveillance of osteoporosis at workers over 55 s, new hypotheses for the bond between the exposure profile and the occupational disease roadmaps, new design for the medical-toxicology screening programmes), economic development of the clients (inside digital innovation of the medicine under new workplaces’ technologies, mathematical studies for management-administration-finances)-the new themes under new premises for the medical practice in our health system.