Massachusetts Medical Society: Work Is Medicine - Strategies for Improving Functional Outcomes

Work Is Medicine - Strategies for Improving Functional Outcomes


We have all been there. You are about to wrap up a patient encounter and catch up on your schedule. Then the patient pulls out paper forms for you to complete. Caught off guard, you get that uncomfortable feeling in your gut when asked to comment on your patient’s work or disability status. Yet, for the patient, this form may have greater health consequences than any medicine or intervention you have just prescribed.

At a time when physicians are busier than ever and occupational medicine specialists are in short supply, it is important for primary care physicians and specialists alike to be educated and aware of how to provide needed direction to best help these patients.

In response to a resolution adopted by the MMS House of Delegates, the MMS developed Work Is Medicine — Strategies for Improving Functional Outcomes. This online educational tool can help any physician anticipate and approach these moments with the best evidence-based research. It will give you the confidence to make vital decisions that can have crucial long-term consequences for a patient.

The course’s author is online instructional designer and expert physician Marianne Cloeren, MD, MPH, an associate professor of medicine in the Division of Occupational and Environmental Medicine at the University of Maryland School of Medicine and board-certified in both Occupational Medicine and Internal Medicine.

The course effectively tackles the topic through highly interactive case studies in eight short (15–30 minute), digestible segments. Using guided, simulated conversations, the course provides opportunities to practice talking with patients about their work issues and is approved for AMA PRA Category 1 Credit™.

This course’s content uniquely combines neuroscience research, motivational interviewing, and simple decision-making in real-life scenarios. Discovering the barriers that patients perceive with their work goals and then agreeing on steps to improve health, productivity, and a sense of purpose can be immensely rewarding for both the patient and the physician. Matching work ability with safe and realistic work goals is key to success.

Dr. Cloeren exposes the effect of adverse childhood experiences (ACEs) on work and health outcomes, along with the psychological factors that influence work as a social determinant of health. The compelling research on ACE’s informs the real-life examples of motivational interviewing that are woven into the course.

The timing of the course’s release in early 2020 was overlooked by many during the immense challenges of the pandemic but has been embraced by those who have experienced it. Comments from participants include:

  • “Great content! Would like to hear more on this subject.”
  • “I wish I had had this course in residency.”
  • “Excellent format. I liked the quizzes in the course to reinforce learning.”
  • “Great course! I plan to encourage my colleagues to take this.”

A free sample of the course is available here. The course has been renewed through January 14, 2026, and is available at Work Is Medicine — Strategies for Improving Functional Outcomes.

MMS member Janet Limke, MD, practices spine physiatry at the Center for Orthopedics, Spine, and Sports Medicine, South Shore Health. She is board-certified in Physical Medicine & Rehabilitation and a diplomate of the American Board of Lifestyle Medicine. Dr. Limke chairs the MMS Committee on Environmental and Occupational Health and is a member of the MMS Committee on Nutrition and Physical Activity.

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