Interview: Sumeet Batra, MD – A Fresh Perspective on Occupational Medicine

Crossover has been planning to integrate Occupational Medicine as part of our comprehensive Primary Health model for some time. We’d been looking for not only a Medical Director to lead the effort but also a champion to build this service in a way that aligns with our care philosophy. With an extensive background in Occupational Medicine, and a sincere desire to reinvent Occupational Medicine as part of a broader Primary Health offering, Dr Sumeet Batra is that leader. We’re excited to welcome him to our team because we know he definitely sees how “health should be”. 

Crossover has been intending to integrate Occupational Medicine for some time, and now you’ve joined to lead those efforts. What’s your backstory?

I was born and raised in Houston. I went to Northwestern in Chicago, where I did a combined BA and MD program with the initial thought that I would go into radiology. Unfortunately, I found that specialty to be claustrophobic and repetitive. I tried to figure out what else I could do with my license that would be more interesting to me, and tangentially became aware of Occupational Medicine. I reached out to a few programs and chose to do my Occupational Medicine residency at the University of Illinois. During my training I began to gravitate towards a mix of clinical and administrative work and started interviewing for roles that incorporated both. 

My first job after residency was being the medical director of an Occupational Medicine program at a children’s health system in the Fort Worth, TX area. I realized that literally no one was looking after the employees health except for my Occupational Medicine department. That meant that no one was taking care of chronic care needs, mental and physical health, or anything else that was going on with their health. This became my first opportunity to get exposure to onsite primary care. We looked at a number of vendors, and this was the first time I became aware of Crossover, although we ended up working with a local company. The entire process of realizing the need, surveying the market, and then actually implementing onsite care really opened my eyes to the whole space of direct and comprehensive primary care.

Based on that experience, did you seek a new role to expand your scope?

Soon after, I left Texas and moved to California, where I took a role with UC Davis as their Medical Director of EmployeeHealth. The timing was such that I started the same week that COVID hit! I went in expecting to be doing a lot of workers comp, like treating musculoskeletal injuries, but spent most of the next two years managing the different requirements that we had to keep employees safe– everything from their personal protective equipment, to managing isolation, developing quarantine policies, and ultimately to how we managed the rollout of the vaccines. I felt like I got a PhD in real time pandemic decision making as well as the long term impacts of COVID on workers, organizations, and our national policy approach. This experience also began to combine my original interest in Occupational Medicine (systematic view of employee health) with my newfound interest in broader aspects of health (for individuals as well as communities). 

Occupational health is generally thought of as a behind the scenes function of policies, procedures, and following lots of rules and regulations. However, that COVID experience showed me how dynamic the specialty could be, how rapid the science was changing, and the great opportunities we had to look at employee health in an entirely new way.  Everything–including things like science and protocols and policies–which are usually very stable, was constantly in flux. It was a wonderful, but highly intense  experience, and after things stabilized, I started looking for new opportunities that would get me back closer to my specialty of Occupational Medicine and supporting  large corporate employers.

That led me to a role at International SOS. This is a long-standing company that has been providing  various types of international health care support to organizations around the globe. While this was a highly satisfactory role learning from so many different large companies, I wasn’t close enough to the practices to actually implement the changes that I was recommending. I am a builder by nature and wanted to scratch the itch of building something from the ground up. 

What was the opportunity at Crossover that peaked your interest in Occupational Medicine?

I’d been introduced to Crossover back in 2014 when Scott and Amit Batra, MD spoke at a conference. I’d done some work at several companies in the valley and their comprehensive, integrated, and accountable approach to “Primary Health” was intriguing to me. I could definitely see how Occupational Medicine–as a “specialty” extension of Primary Care–could really help the model. I tracked the company intermittently over the years and was thrilled to get a call regarding the interest to hire a medical director for Occupational Medicine as a new service line. Crossover has given me the exciting opportunity to work with one of the leaders in employer-based primary care while also fulfilling a career aspiration to more deeply incorporate in Occupational Medicine services. 

Over the years, Occupational Medicine has definitely evolved. In the 60’s and 70’s, manufacturing organizations would hire a doctor to work on site at their plants, mostly managing acute injuries or dealing with some of the common workplace exposures that we know cause harm, like asbestos or lead exposure. But as work in the United States has become more white-collar, service oriented, and less risky, the role of the Occupational Medicine physician has often become more consultative with broader, more generalized implications for the organization. This consultative, creative evolution is very positive from my perspective.  

It’s an interesting evolution thatleads to the question of how Occupational Medicine differs from, as well as how it should integrate with, Primary Care?

Maybe a simple way to think through this is that Occupational Medicine is intended to look at healthcare from the Employer’s lens, and all their responsibilities and obligations, whereas Primary Care is intended to focus on the needs of the individual member and populations of members. What’s most interesting to me is that these interests and obligations overlap in sometimes  clear and at other times  more nuanced ways. For example, while Crossover is providing excellent primary care to employees across the country, the clinicians aren’t always aware of the details of the person’s job or work environment. Whereas, an Occupational Medicine provider wants to understand those things more intimately given how important it is to their specialty. Occupational Medicine will often go into the workplace environment to literally see what an employee does, what work is being performed, and what risks or concerns might be present or preventable. They identify issues that affect employees’ abilities to do their jobs and also come up with recommendations for the employee, and often an entire class of worker or environment, from both a micro and macro perspective.  This knowledge of the worker and the workplace then feeds back to the clinical environment, where tailored medical services can be provided to protect the health and wellbeing of the worker.

Crossover has long focused on the Social Determinants of Health as well as taking a preventive and proactive approach to care. How does introducing Occupational Medicine impact or change this?

We need to think about social determinants of health in the workplace, like a shift schedule, the food available to employees during their shift, or the stresses of a particular job class. When we’re providing Occupational Medicine services along with primary care services, we can collect a lot of data on new hires, injury trends, or the disability or accommodation issues that come across our desk. It’s a complementary stream of information to what’s already being collected from primary care, giving employers a more complete view of the variety of issues affecting the health of their workforce.

How is Crossover uniquely positioned to offer or integrate with Occupational Medicine?

Most other integrated providers entered employer healthcare through Occupational Medicine and evolved to primary care due to customer or market demands. Crossover is coming at it from the other way around. Building the relationships and making changes at an individual and population health level is hard work, and Crossover has one of the best models in the industry for doing that. Adding Occupational Medicine complements what we’re already doing well, because it opens our funnel even wider at the top and gives us another new stream of potential patients coming in. It will also be an entirely new set of data points for our care model, as well as integration and coordination, and will increase the range of impact of the care model. It’s exciting to see how these two approaches can be brought together for even greater impact.

We are in many situations where an Occupational Medicine provider already exists with a client. Much like when a primary care provider relationship already exists, clients have the option to have a different partner and we can still surround them with our other services. In the case of Occupational Medicine, we can offer our entire virtual Primary Care team in support, we can augment the care and communication with our technology, or we can provide other engagement support as necessary. This allows us to continue to work with the many providers in the market, as well as begin to offer these services on our own where that makes sense. In the end, the employer is the one who is making the decisions about which vendors they choose to work with and how they request that those vendors work together. We are very comfortable in either role. 

Given Crossover’s history of innovation in employer health, where do you think you can push innovation in Occupational Medicine?

Most Occupational Medicine delivered today is just not a very pleasant experience. I’m really focused on bringing Crossover’s level of customer service and patient centric experience to Occupational Medicine. In addition, the care coordination, tech enabled communication, referral management, and general measurement-based approach to care will all contribute to something that I believe is going to be fantastic for Occupational Medicine. 

Occupational Medicine is also a highly fragmented industry / service. There is a lot of paperwork, and one of my objectives is to streamline processes and use the kinds of digital tools Crossover has to make more information visible for the employer through dashboards or reports. This would dramatically cut down on the number of phone calls, emails, faxes, and paperwork. With Occupational Medicine, the employer is “in the room” and shapes the decisions around the treatment or services, so better communication and information will allow our team and the employer to make true evidence-based decisions.

There are also many emerging and novel tools available such as AI assistants which suggest best practices for clinical and case management decisions, wearable sensors to help predict and prevent injury, and far more capabilities for virtual Occupational Medicine than even just a few years ago. I’d like to be able to provide these tools to our clinicians, and to have that level of coordination with the employer on the front end, so that we understand the patients that we’re treating, and we hope we can provide the care that we know will lead to the best outcomes for both the patient and employer.

It’s interesting how much more visibility an employer has into Occupational Medicine data as opposed to primary care data where privacy is paramount.  How do you reconcile this apparent conflict in Occupational Medicine as part of an integrated offering? 

It’s a fundamental tension that does exist and we’re addressing it from a number of angles. We’re putting in technological safeguards and barriers, the main one being a separate EMR for Occupational Medicine which ensures that issues noted in the member’s general record don’t make it back to their Occupational Medicine record or to the employer. This is a critical distinction and one that all of our clinicians need to be able to crisply articulate to members, care teams, and clients. But it’s not like everything work related has to be segregated off. The primary care doctor, for instance, should know that their patient has been treated for a work-related injury or that an abnormal finding was picked up on a work-related physical exam. In addition, if a Crossover Occupational Medicine provider is treating an injury, we might refer to our own PT services or refer externally to an orthopedic or other specialist, depending on the injury, and those medical encounters will live in the general chart.

There are many new modalities and monitoring capabilities especially in virtual care. How do you see their importance in providing Occupational Medicine in the future?

In the past few years, there has been a large expansion in the types of Occupational Medicine services that can be delivered virtuously and asynchronously. As an example, many types of Occupational Medicine surveillance or screenings can be conducted via questionnaires and reviewed virtually or asynchronously, expanding the pool of patients and employers we can serve. It’s something we’ll build into our Occupational Medicine model, coordinating with Crossover’s existing virtual care team  or building capabilities depending on the specific need.

How do you see Occupational Health evolving, in general and with Crossover?

I think one of the biggest areas in which we’re seeing more research and some practical implementation is the use of wearable devices. For example, we just went through the hottest summer we’ve ever had, and the impact of heat on workers has been a growing concern, affecting underlying health issues and increasing the rate of workplace injuries. A number of employers are putting in measures like core temperature monitors on some of their employees, to measure heat and sweat and let them know when to hydrate or take a break.

That’s the preventive side of the wearables, but I’d also like to use wearables technology to guide therapy and recovery. A lot of Occupational Medicine and primary care physicians are using best guesses and judgment to do the assessment and care plans about what a patient can or can’t do, but when we have devices that can measure strength levels, range of motion, or the ability to do repetitive tasks, you can make much more objective recommendations, and provide that guidance to the patient and employer so they can work on a plan that allows the patient to remain at work. I believe this will fundamentally change Occupational Medicine. 

Do you see Occupational Medicine at Crossover providing guidance to both individual and population level decisions for the employers?

Most companies don’t have the resources or haven’t seen the value of having an internal Occupational Medicine subject matter expert.  When such companies look at Occupational Medicine, they see it as a compliance function. However, there are some companies who really understand the value. And in those examples, Occupational Medicine is much more focused on things like looking at the health of their worker population, providing C-Suite guidance regarding policies and practices, and really making strategic recommendations on how work gets done at companies. My sense is that the companies that have already realized the value of the investment in having Crossover provide direct primary care, and all the other services, will also benefit from the insights that Occupational Medicine can provide. With the whole picture we’ll be offering and the data that we’re gathering for employers, we can really help them make better decisions.

In terms of our planning, we’re first taking stock of our existing partnerships and who we work with today. Second, we’re in parallel building out our Occupational Medicine services, which has been a long standing request from many of our clients. Third, we will be putting together our value narrative as we enter the market in early 2024. We definitely see the opportunity to offer a competitive and differentiated product that will leverage all the unique capabilities of Crossover.

What about Sumeet Batra might surprise the reader?

I’m fortunate to be a father of a young child now, so my life has become a bit more adult, but I used to travel a lot and include some form of extreme activity in my travels. I’m also a big trivia nut and I’ve tried out for game shows like Jeopardy, even flown down to the studios when I passed the initial hurdles. Once you prove you know enough, the shows put you into a pool and names get drawn out of a hat, and you get to go on the show. I haven’t been lucky enough to be selected yet, but every couple of years I keep throwing my name back in, so maybe I’ll have a chance at some point.

Many thanks to Peter Heywood (our long-standing brand advisor and business consultant partner) who helped conduct these interviews. Please read Peter’s other Crossover Leader Series Interviews.