When You’re in the Dog House, Don’t Rock the Boat

The Marine Welder (named ‘Rob) first showed me the ‘Dog House’ out in the shipyard. Made of solid steel, it was about 20 feet long, with five separate, 4-foot sections dividing it up. Each inner section had an 18-inch round portal to the next section, with similar openings at each end. Inside the Dog House, it was less than 3 feet high, hence its name. There were two side-by-side formations, which gave one the impression of an obstacle course where two contestants could race – while crawling – in one end to out the other in a timed heat. It looked like some giant maze reminiscent of laboratory research dreamed up by 1960’s Behaviorist, B.F. Skinner.

What the ‘Dog House’ replicates is a confined layer between the hull and the wheelhouse of a state-of-the-art, next-generation research vessel (better than a football field long from stem to stern). Within it, I’d be spending the coming work week. My job would be to perform Physical Demand Analyses on a half-dozen job titles in there. This compressed layer houses the plumbing, climate control, electrical and I.T. tech conduits for the entire ship. Marine Welders, Marine Pipefitters, Shipfitters, Marine Painters and others spend long hours working in such cramped places. These were the industrial athletes I’d be following around – apparently on my hands-and-knees – for at least part of the week.

As if sensing my doubtfulness that a grown adult could pass through such exceedingly tight spaces, Rob – a lean, grizzled, wiry welder in his late ‘40’s – nimbly slipped through this claustrophobic contraption with ease. Section-by-section – in one end and out the other – he passed in under 30 seconds. Easily emerging from our open end, he explained: “The welders we hire to build these ships may find themselves working an entire day in a space like this.” He added: “Oh, and when we test them in the Dog House out here in the shipyard, they’re not empty-handed, like I just was. They also have to move their (43 lb.) welding cabinet, their (22 lb.) coil of wire, their (16 lb.) rolled welding lead, and their (6 lb.) welding gun with them through those 18-inch holes.”

Physical Demand Analysis – A Rising Tide Lifts All Boats

As with many remaining skilled labor jobs in America, the work load is based on the work order. When international clients want state-of-the-art ships to sail the 7 seas, US ship manufacturers start hiring additional skilled labor employees in earnest to augment their core workforce. Yet as with many of the remaining skilled labor jobs in America, there seems to be a dearth of young people heading into these very rewarding – yet demanding – occupational fields. Hence, hiring-on applicants is fraught with land mines from poor physical capacity, to distracted mental acuity, to lack of just a plain old work ethic. The attrition rate is costly for all involved. Having applicants wash-out of the onboarding progression reverberates though the entire boat-building process, blowing deadlines, ruining cost estimates, upsetting equipment orders, and on-and-on.

In anticipation of this hobbling scenario, this ship manufacturer sought to control the process by hiring me to perform onsite Physical Demand Analysis (PDA) on their most challenging job titles. Marine Welders, Marine Pipefitters, Marine Painters, Shipfitters, Laborers and others were my responsibility. Once these PDA’s were complete, I was then called-on to create clinically professional-grade Post-Offer Employment Tests (POET). These POET’s were designed to help the shipbuilder assess applicants against our scientifically gathered and interpreted hiring criteria. Lastly, I was then charged with composing a Provider Manual for issuing the POET. With this manual, a nearby physical therapy clinic could be contracted to help screen applicants against the challenging job criteria expected of them in the shipyard.

The benefits of the information gathered in the Physical Demand Analysis doesn’t stop there. Not by a longshot. The very same PDA hiring criteria can also be utilized to better train incumbent workers through informed job coaching. Not unlike a position coach in sports, the informed onsite job coach can better train these industrial athletes in techniques for preserving their vital role in the workforce. Sure, some elements cross departmental lines. Everyone should participate in pre-shift Stretch-and-Flex warmups, for instance. Likewise, adequate hydration and stress-management benefits every worker. But with PDA data, job-specific elements can be added to customize injury-prevention efforts for the precisely imposed demands of each job title.

Should the shipbuilder decide some contracted onsite or near-site injury support is worthwhile, the very same PDA data can help clinical providers triage cases. Those appropriate for simple first-aid and advisement can be safely teased from those that deserve an upgrade to OSHA-recordable status. This frees up attention to only those cases most worthy, allowing lesser ‘strains-sprains-aches-and-pains’ to heal naturally. Hence, only the minimum necessary amount of intervention ensues. Just what’s required to allow full recovery to follow its expected course. Nothing more.

Of the fewer cases that cross into the OSHA-recordable / Workers Comp threshold, the very same PDA data can then be applied to more informed rehabilitation. This returns the industrial athlete faster to the job demands required of them. It spares time lost from nebulous, ill-defined clinical criteria conjured by a provider who has no idea of what tasks to which the injured work will return. The PDA provides a roadmap for benchmarking progress along the way. It results in compressing lost-time otherwise wasted in outdated ‘care’ models. Models more often designed to reward inefficiencies baked into our failing nationwide allopathic fee-for-service industry (what we generously call ‘healthcare’ in the US).

Lastly, the exceptionally few cases that plateau without an immediate return to work can be evaluated functionally against the job demand criteria outlined in the PDA. This allows the opportunity for successful return-to-work strategies – including accommodation testing where appropriate – to preserve the highest and best use of seasoned, skilled work force members. With valued skilled labor being in such short supply nationally, doing all we can to keep them staying safe, sound and secure in the workforce serves not only the worker, but also the worker’s company, the private industry and the US economy at large.

Onsite Injury Prevention Services – When Your Ship Comes In

In the week that followed, I found myself measuring the lift, carry, push, pull, kneel, squat, sit, stand, climb and crawl of these talented workers with an ever-increasing appreciation for their unique athleticism. They truly are industrial athletes in every reverent sense of the word. Serving them in this PDA, POET, Provider role cannot be matched within the insular, clinical world of allopathic fee-for-service. It’s night and day. The work is challenging, no doubt. The cognitive heavy-lifting is substantial. Every workplace I enter is as different as every worker within it I meet. Seeing each plant as ‘the patient’ and the injuries within it as it’s symptoms takes a broader clinical view, but the rewards are worth it. Keeping good people doing good work honorably serves their homes, their families and their communities. It’s a feeling like no other. And it’s emblematic of a clinical life well lived – even when it sometimes starts out in the Dog House.

A little about our author, Matt Jeffs DPT PSM CEAS –

Dr. Jeffs is a health and safety performance advisor for national and international firms. He’s also a seasoned ergonomics educator here at The Back School. Years ago, he excelled as a big-wave surfer and an experienced ocean lifeguard – with numerous rescues – prior to earning both his clinical undergraduate and doctoral degrees in physical therapy.

With well more than 13,000 working hours onsite across US industrial settings performing physical demand analyses, ergonomic analyses, post-offer employment testing, onsite job coaching, onsite injury triage, rapid return-to-work rehab benchmarking and more, Dr. Jeffs is sometimes lightheartedly known as the ‘Mike Rowe (from Dirty Jobs Fame) of Physical Therapy’. You name it, he’s tried it. And he’s learned something from every experience along the way.