Curbside Medical Surveillance Program Brings Healthcare to the Workplace

Over the last three decades, the UC Davis Medical Surveillance Program has grown from serving 150 patients a year to almost 5000 – an extraordinary accomplishment given it operates without a traditional bricks and mortar clinic. Using two RVs custom-built from the chassis up as self-contained health clinics, the mobile program allows employers the flexibility to schedule group screenings delivered right to their door.

A four person team of board-certified Occupational-Environmental Medicine physicians, physician assistants, nurse practitioners, as well as NIOSH-certified spirometry technicians provide a wide range of occupational health services including medical surveillance examinations, respirator clearance, and vaccinations. Within an 8-hour period they see up to 25 employees at a client’s facility.

The mission of the UC Davis Medical Surveillance Program is to increase the health, safety, and well-being of California workers by delivering comprehensive employee medical screening services. “We’re committed to providing the most expert and meticulous patient care possible, while striving to be responsive and adaptive to the needs of our clients,” says Dr. Sheri Belafsky, associate director of the Medical Surveillance Program.

In 2002, COEH faculty member, Dr. Robert Harrison, was instrumental in connecting the Department of Corrections and the Medical Surveillance Program together to establish an agreement that would protect the respiratory health of correctional officers, medical staff, and maintenance personnel, who could be exposed to TB and other airborne diseases in the prison system. This contract supplied the Medical Surveillance Program with a new mobile clinic specifically equipped for testing the fit of the respirators that these employees don in the course of their duties.  During the 3-year contract, the medical team visited 33 prisons and tested over 30,000 people throughout the State. They trained staff about TB protection and the proper use of N95 respirators, which are specifically designed to protect against TB exposure. The Medical Surveillance program currently works with over 25 private and state agencies to provide health screening throughout California.

Their patients vary from agricultural workers working with pesticides, to peace officers, firefighters, narcotic agents, environmental scientists, nurses, veterinarians, and even park rangers. Their client list grows by word of mouth. “Our largest clients are state agencies. They'll often intersect in some way and recommend us one to another,” notes Belafsky.

Within the state of California, the team can travel as far north as Susanville and as far south as Monterey. For one client, they visit 18 fire stations in a 6 month period.

In both the northern and the southern part of the state, they also use subcontracted clinics that follow Program protocols, sending the results to the main office in Davis. “I'll review the results and provide the clearance recommendation,” says Belafsky.

Each surveillance program is custom designed to serve the client’s needs. For example, one state agency sought their advice after an adverse event with heat exposure. “I researched the Cal OSHA standards and looked for recommendations from the CDC and then proposed changes for them programmatically,” explains Belafsky. “The great thing about having the multidisciplinary team here at UC Davis is that I could reach out to Dr. Marc Schenker and tap him for some of the most recent data that he's been collecting from his agricultural workers studies. He put me in contact with the outreach coordinator at the UC Davis Western Center for Agricultural Health and Safety and that person was able to provide me with training materials both in English and Spanish.”

The team customized their screening protocols for the client to increase the educational component for patients. “We also increased our communication with the supervisors and the employer to ensure that the groups of individuals who may be at greater risk for heat related illnesses are getting the support that they need,” stated Belafsky.

“These workers sometimes don't go to the doctor, so this is the only health screening that they would ever receive,” added Program Manager Sophia Haro. There are times where the medical team discovers a medical issue unrelated to the patient’s work. “I can count probably at least five times where a client has shown appreciation to our practitioners for saving their life, where they've had a medical condition they didn't know about,” says Haro. “To me, that really is an important impact of our program.”

Visit the Program’s website for more information, visit http://medsurv.ucdavis.edu/index.php.

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