Accepted: 9 January 2018
Discussion group networks in occupational medicine: A tool
for continuing education to promote the integration of
workers with disabilities
Lilah Rinsky-Halivni MD, PhD
Yehuda Lerman MD, MPH
Department of Occupational Medicine,
Jerusalem District, Clalit Health Services,
The Braun School of Public Health and
Community Medicine, Hadassah-Hebrew
University Medical Center, Jerusalem, Israel
Occupational Health Center, Clalit Health
Services, Tel Aviv University, Tel Aviv, Israel
School of Public Health, Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
Lilah Rinsky-Halivni, MD, PhD, Department of
Occupational Medicine, Jerusalem District,
Clalit Health Services, 1 Louis Lipski St,
Background: Despite their legal rights, individuals with disabilities face numerous
obstacles to integration in the workplace which can result in their discharge from the
labor force. Currently occupational physicians have few resources to help decide
whether to integrate disabled workers in pre-placement, or in cases of return-to-work.
Methods: A network of 13 discussion groups comprised of the occupational physicians
of each regional clinic of a large Health Maintenance Organization (HMO) in Israel was
created to deal with disability management dilemmas. A moderator compiles and
shares the physicians’ opinions and experiences with all network members thus
assisting the consulting physician in decision-making.
Results: Successful management of three representative cases is described to illustrate
real-life implementations of this network.
Conclusion: The network enables both the consulting and other physicians to tap a
large knowledge base and decision-making experience concerning cases of
occupational disability management, contributing to professional development and
improved service delivery.
continuing medical education, disability management, discussion groups, fitness for work,
occupational medicine, professional development, return to work, workers with disabilities,
Each year, millions of workers worldwide sustain long-lasting or
permanent occupational or non-occupational injuries and diseases that
interfere to varying degrees with their ability to work and which they
define as a “disability.”
The prevalence of self-assessed disability in
the general working-age population (20-67) in Israel has been
estimated to be ∼22-25% and involves roughly 800 000 to
1 000 000 people.
Only ∼35% of these individuals are granted a
disability benefit consisting of allowances mainly from the National
Insurance Institute or military sources, in addition to schemes for early
retirement on medical grounds provided by the pension funds.
Approximately 6% of the working-age population in Israel receives
which is comparable to percentages in other OECD
Their labor force participation rate, however, is significantly
lower than the OECD average; that is, 22% versus 33%, respectively,
with most working part-time or under the category of supported
This low level of participation may be related to the
amount of the allowance compared to the wages paid to these workers
Institution at which work was performed: Occupational Health Center of Clalit Health
© 2018 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/ajim Am J Ind Med. 2018;61:344–350.