[The management of individual cases and the role of the competent practitioner]

La gestione dei casi singoli e il ruolo del medico competente

Although a growing portion of european working population is facing with psycho-social risks, only about 30% of public and private institution identify individual cases and are implementing actions aimed to their prevention and management. In addition to the formal evaluation of work-related stress, it is crucial to identify individual cases in order to support people to face them efficiently. The ambulatory of Occupational Medicine jointly instituted by the University of Rome Tor Vergata and by the Policlinico Tor Vergata di Roma (having an agreement with the National Health System) offers to patients a multi-disciplinary approach including psychiatric and psychological evaluation in addition to the evaluation of the occupational setting. Since 2010, 264 patient have been visited, with a growing percentage in recent years of cases related to inter-personal conflicts as well as other forms of organizational constraints and some recent situations which could be linked to strain (which is a peculiar organizational consequence which may cause personal damage owing to the creation of psychological subalternity). Therefore, the psychological pathway given by the ambulatory seems increasingly useful in order to preserve the occupational relationship, at least in the cases in which it is not definitively compromised. The occupational physician has a primary role in identifying cases in which an in-depth evaluation is needed, in encouraging the sharing of negative experiences and in correctly evaluating the clinical picture.