Clinical decision support that reasons like an occupational physician: run the bloodborne-exposure protocol on the clock, clear a fitness-for-duty return by function, catch the occupational lung disease, and protect hearing — with the decision rule and exactly what would change it. Built for verified physicians.
Two real occupational-medicine questions, each reasoned the way HeyHippocrates answers: the skills fire, the answer is cited, the decision rule is explicit, and what's missing is flagged. Scroll to each.
A nurse sustains a hollow-bore needlestick from a source patient of unknown status — the immediate protocol?
Wash the wound with soap and water at once, then run the bloodborne-pathogen protocol on the clock. Assess the exposure risk from the device and depth, test the source patient with consent and draw baseline HIV, hepatitis B and C on the exposed worker. Start HIV post-exposure prophylaxis as early as possible — ideally within two hours and no later than 72 — when the risk warrants it, without waiting for source results. For hepatitis B, give immunoglobulin and vaccine per the worker vaccination and response status; hepatitis C has no prophylaxis, so monitor and treat any seroconversion. Document and report.
Decision ruleNeedlestick → wash; risk-assess; test source (consent) + baseline HIV/HBV/HCV on exposed; HIV PEP as soon as possible (ideally under 2 h, up to 72 h) if indicated, do not wait for source; HBV immunoglobulin + vaccine by status; HCV monitor and treat seroconversion; document + report.
Not established from this alone — the source status, the device and the worker immunity change the prophylaxis.
A warehouse worker with a resolving low back strain wants clearance; the job requires 25 kg lifts — the approach?
Base the decision on function and fitness-for-duty, not on the absence of pain. Match the worker residual capacity to the essential demands of the job — here the 25 kg lift — using a job-demands analysis and, if needed, a functional capacity evaluation. Favor an early, graded return with temporary modified or light duty and specific restrictions over prolonged time off work, which itself worsens outcomes. Screen for psychosocial obstacles to recovery, set clear written restrictions and a review date, and coordinate with the workplace.
Decision ruleFitness-for-duty by function, not pain absence → match residual capacity to essential job demands (job-demands analysis / functional capacity evaluation); early graded return with temporary modified duty + written restrictions over prolonged off-work; address psychosocial flags; set a review date.
Not established from this alone — the job demands, the residual capacity and the psychosocial flags change the clearance.
Illustrative simulations. The physician always decides.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Anchor the diagnosis to a compatible exposure history — the pneumoconioses from asbestos, silica or coal, hypersensitivity pneumonitis from organic antigens, and occupational asthma from workplace sensitizers. Support it with spirometry, chest imaging and, for occupational asthma, serial peak-flow monitoring that shows improvement away from work. The key move is prevention and removal from further exposure, plus surveillance of co-exposed workers and the reporting a notifiable disease requires.ATS · occupational
Decision ruleCompatible exposure history → pneumoconiosis (asbestos/silica/coal), hypersensitivity pneumonitis, or occupational asthma (serial peak flow, better off work); spirometry + imaging; remove from exposure + surveillance + notify.
Missing data: the exposure history, the spirometry and the imaging change the diagnosis.
Treat every significant percutaneous or mucosal blood exposure on the clock. Wash the site, assess the risk, test the source with consent and take baseline HIV, hepatitis B and C from the exposed worker. Offer HIV post-exposure prophylaxis as soon as possible — ideally within two hours, up to 72 — for a meaningful exposure, and do not delay for source testing. Manage hepatitis B by the worker vaccination and antibody status with immunoglobulin and vaccine; hepatitis C has no prophylaxis, so monitor and treat seroconversion early. Document, report and arrange follow-up.CDC · PEP
Decision ruleWash → risk-assess → source test (consent) + baseline HIV/HBV/HCV on exposed; HIV PEP as soon as possible (ideally under 2 h, up to 72 h), do not wait; HBV by vaccine/antibody status (immunoglobulin + vaccine); HCV monitor + treat seroconversion; document, report, follow up.
Missing data: the source status, the exposure type and the worker immunity change the plan.
Decide on function against the essential job demands, not on symptoms alone or a request. Compare the worker residual capacity — from the exam, a job-demands analysis and, where needed, a functional capacity evaluation — to the specific physical and cognitive requirements. Prefer an early, staged return with temporary modified duty and clear restrictions, because prolonged absence itself harms recovery and employment. Identify psychosocial barriers, document written restrictions and a review date, and communicate with the employer within privacy limits.ACOEM
Decision ruleFunction vs essential job demands (exam + job-demands analysis + functional capacity evaluation) → early staged return with modified duty + written restrictions; avoid prolonged absence; address psychosocial barriers; review date; privacy-limited employer communication.
Missing data: the job demands, the residual capacity and the recovery trajectory change the decision.
Run a hearing conservation program wherever noise exposure reaches the action level: baseline and annual audiometry, comparison for a standard threshold shift, and confirmation with follow-up testing. Noise-induced loss is sensorineural, typically bilateral with a notch around 3 to 6 kHz, and is largely preventable. Prevent it at the source with engineering and administrative controls first, then hearing protection, and act on any confirmed threshold shift with retraining, better protection and evaluation. Refer atypical or asymmetric loss.OSHA · hearing
Decision ruleNoise at or above the action level → hearing conservation: baseline + annual audiometry, watch for a standard threshold shift; NIHL is bilateral sensorineural with a 3–6 kHz notch; controls first, then hearing protection; act on confirmed shifts; refer asymmetric/atypical loss.
Missing data: the exposure level, the audiogram pattern and the shift change the action.
Your whole practice, one specialist brain — grounded in champion-authored, cited knowledge.
A generalist occupational-medicine colleague across return-to-work, occupational lung disease, exposure and PEP, hearing conservation, ergonomics and toxicology — cited, non-directive, always with the decision rule.
Deep specialist agents for occupational lung disease, toxicology and biomonitoring, injury and disability management, and workplace surveillance — each its own soul and knowledge base — plus your own uploaded materials.
From the PEP clock to the return-to-work restriction the margin is thin. Only one of these reasons like an occupational-medicine colleague whose every claim you can trace.
The waitlist is a founding cohort. Members shape the occupational medicine build, get in before anyone else, and lock the founding price for good.
Leave your name and work email. We'll reach out the moment occupational medicine opens — with your Founding Occupational Physician offer.
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It reasons in the frameworks you use — the bloodborne-exposure protocol, the fitness-for-duty and return-to-work approach, the occupational-lung-disease workup and the hearing-conservation program — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Residents use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion in the clinic and on the plant floor. Access is gated to verified physicians.
Occupational lung disease, toxicology and biomonitoring, injury and disability management, and workplace surveillance each have their own deep specialist agent on the Pro plan, on top of the full occupational-medicine scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in champion-authored, cited occupational-medicine knowledge — traceable, not hallucinated — and always states the decision rule plus what data is missing, instead of a confident guess.
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