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TMD Named to CoVa Biz’s 2018 Best Places to Work List

TMD Named to CoVa Biz’s 2018 Best Places to Work List

President of Taylor Made Diagnostics, Inc., Caroline Taylor, affectionately refers to her team of 24 employees as “Team Awesome.” Team Awesome is dedicated to providing quality occupational health services to businesses throughout Coastal Virginia from workers’ compensation and wellness programs to physical exams and drug/alcohol testing. Taylor Made Diagnostics even offers a Mobile Service that brings their exceptional occupational health skills directly to their customers.

Taylor explains that customer service is not simply a department but rather an attitude that she and Team Awesome have worked hard to establish. “Clarifying core values has been essential,” states Taylor. “Our core values are innovation, responsiveness and commitment to customer service excellence. Our core values are used to guide every aspect of our organization, from hiring to firing [and] strategy and performance management.”

Read Full Article on CoVa Biz >

Patient Wait Times

I am reaching out to you today because I’ve been very concerned about our customer service as it relates to wait times.  Since the maritime industry is booming and there is a lot of hiring going on I have seen extensive wait times for your employees.  It has not gone un-noticed and we want you to know what we are going to do about it.  Recently, we have acquired additional space at our current location to expand and increase our exam room availability.  We are hoping our buildout is complete in April which would give us 8 more exam rooms totaling 14.  Sounds great but that  isn’t going to help unless we increase our employee base so we have added an additional mid-level provider, Board certified Occupational doctor, seasoned LPN, and two additional medical assistants.  Our commitment to customer service excellence has led us be recognized as a leader in Occupational Medicine and we want to continue to be seen as that.  In the meantime, if you have large numbers of post-offer physicals, random drug screens or anything else please consider our onsite mobile services.  It’s convenient, fast and affordable. To schedule on site services please call Kay Stewart, LPN at (757) 435-9534.

I need your help.  Please ensure that anyone coming for respirator fit testing is clean shaven, that employees arrive with completed paperwork (Download Respirator Questionnaire) and authorizations are provided and clear.  Many times we have to call to get clarity so that would be a huge time saver for us and your employee.

Finally, please know that we appreciate your business and will continue to monitor our core values of responsiveness, commitment to service excellence and innovation as we all strive to provide you and your employees with the best experience.  Please let me know if there are any other issues you would like to discuss.  I can be reached at (757) 435-4680.

Praying for a Happy, Healthy and Prosperous New Year for All,

Caroline Taylor, CEO
Taylor Made Diagnostics

Put the “Merry” in Your Christmas and “Happy” in Your New Year with Positive Thinking!

Put the “Merry” in Your Christmas and “Happy” in Your New Year with Positive Thinking!

As I reflect on the past year’s roller coaster ride with the economy, a new president, the NFL’s issue with kneeling, I go back to my roots and reflect how I got here.  After being in business 22 years I have learned that I am in charge of my own destiny and my own success.  If I didn’t have access to the news or internet would I run my business differently? The answer is NO!  The distractions of the world are heard in my mind as annoying bleeps so I have to keep ME grounded and steadfast with my goals.  I’ve chosen to unlink with Facebook due to staunch negativity and the news as it merely reflects discontent and quite honestly I’m a pretty happy girl. I’m not saying that I don’t investigate what is important to me that is newsworthy but I can’t continuously moment by moment allow the distractions of doom and gloom, I’m just not built that way.  A perpetual optimist, I am. My cup runneth over!  There is always something to be grateful for!!!  As a business owner you have to find the positive from a negative situation.  It will help you to be a better business person.  Here’s my GIFT to you for a Prosperous and Happy New Year!!

Point to Ponder: If you count your blessings daily does that really relate to happiness?  This is what I found.

The Mayo Clinic states, health benefits that positive thinking may provide include:

  • Increased life span
  • Lower rates of depression
  • Lower levels of distress
  • Greater resistance to the common cold
  • Better psychological and physical well-being
  • Better cardiovascular health and reduced risk of death from cardiovascular disease

Positive thinking is a mental and emotional attitude that focuses on the bright side of life and expects positive results.

With a positive attitude we experience pleasant and happy feelings. This brings brightness to the eyes, more energy, and happiness. Our whole being broadcasts good will, happiness and success. Even our health is affected in a beneficial way. We walk tall, our voice is more powerful, and our body language shows the way we feel. Here is link to making a conscience change for a better outlook.


Positive and negative thinking are contagious.

We affect, and are affected by the people we meet, in one way or another. This happens instinctively and on a subconscious level, through words, thoughts and feelings, and through body language.

Is it any wonder that we want to be around positive people, and prefer to avoid negative ones?

People are more disposed to help us, if we are positive, and they dislike and avoid anyone broadcasting negativity.

Negative thoughts, words and attitude, create negative and unhappy feelings, moods and behavior. When the mind is negative, poisons are released into the blood, which cause more unhappiness and negativity. This is the way to failure, frustration and disappointment.

Practicing positive thinking every day.

If you tend to have a negative outlook, don’t expect to become an optimist overnight. But with practice, eventually your self-talk will contain less self-criticism and more self-acceptance. You may also become less critical of the world around you.

When your state of mind is generally optimistic, you’re better able to handle everyday stress in a more constructive way. That ability may contribute to the widely observed health benefits of positive thinking.

So is your glass half-empty or half-full? How you answer this age-old question about positive thinking may reflect your outlook on life, your attitude toward yourself, and whether you’re optimistic or pessimistic — it’s up to you!  Be the change you want to see in the world because someone is always watching.  Wishing you a glass full of possibilities!

Merry Christmas,

Caroline Taylor, President
Taylor Made Diagnostics

P.S. Taylor Made Diagnostics will be closed December 22-December 25 for the Christmas holidays. See you Tuesday, December 26th!

Post Offer Employer Medical Screening Tool

Post Offer Employer Medical Screening Tool

It is vital for private employers to understand what sort of medical inquiries may be made during the hiring process. The U.S. Equal Employment Opportunity Commission (EEOC) spells out the difference between lawful and unlawful medical inquiries under the Rehabilitation Act, the Genetic Information Nondiscrimination Act (GINA), Title VII of the Civil Rights Act of 1964, and the Age Discrimination in Employment Act (ADEA). Section 501 of the Rehab Act, which applies to federal employees, adopts the standards of Titles I and V of the American Disabilities Act (ADA). This article will help your company avoid any unnecessary issues with the ADA and other federal anti-discrimination laws.

Medical inquiries and the ADA: Key ADA restrictions on medical inquiries of applicants:

  • There is no exception to the straight-forward rule that disability-related inquiries or medical examinations are prohibited in the pre-offer stage of the application process.
  • If applicants must fill out any medical questionnaires prior to the receipt of a conditional job offer, use of the forms violates the Rehabilitation Act [and the ADA].
  • After a conditional offer is made, an employer may ask disability-related questions and require medical examinations as long as it does so for all entering employees in the same job category.
  • Once employment begins, an employer generally may make disability-related inquiries and require medical examinations only if they are job-related and consistent with business necessity.
  • In the post-offer stage of the application process individual applicants may be asked questions not asked of other applicants if those questions are “medically-related” to medical information previously received.

Offer Withdrawal

Under the ADA Amendments Act, withdrawing an offer based on the information obtained from a post-offer health history inquiry or follow-up medical questions will likely result in a finding that the applicant was regarded as having a disability. Therefore, the employer would be required to establish that the particular impairment renders the individual unqualified to perform the essential functions of the job or, where the employer has excluded the applicant due to safety concerns, that the applicant poses a direct threat because of the impairment.

When the applicant’s impairment substantially limits a major life activity or constitutes a record of a substantially limiting impairment, the employer’s determination of whether the applicant can perform the essential functions of the job must also include consideration of whether a reasonable accommodation would enable performance of the job functions or would reduce any direct threat to an acceptable level.

GINA-Related Considerations

Pursuant to Title II of GINA, employers are prohibited from requesting, requiring, or purchasing genetic information — including family medical history — from applicants or employees, except under very limited circumstances. Therefore, questions about an applicant’s family medical history or genetic information are unlawful under GINA. “There is no exception to the general rule prohibiting employers from requesting genetic information of an applicant in a medical questionnaire.


Part of the Peace Corps’ application process included post-offer medical questionnaires required only of applicants in certain protected groups — e.g., a “Mammogram Form” required only of women age 50 and over. Thus, it appeared that women and a protected age group were required to undergo medical tests not required of applicants outside of these protected groups. This requirement raised a big red flag under Title VII, which prohibits sex discrimination, and the ADEA, which prohibits discrimination against persons age 40 and over. An application process with these requirements is deemed “facially discriminatory.”

What does all this mean for employers?

The EEOC points to several best practices worth keeping in mind:

  • Do not subject applicants to disability-related inquiries or medical exams prior to a conditional offer of employment.
  • After a conditional offer of employment, make disability-related inquiries and require medical exams only if the same is required of all entering employees in the same job category.
  • After employment commences make sure that any disability-related inquiries or medical exam requirements are job-related and consistent with business necessity.
  • Any post-offer questions not asked of others must be confined to those which are medically related to medical information already provided by the applicant.
  • If an offer is withdrawn based on medical information provided by the applicant, make sure it can be established that either:
    • the particular impairment at issue renders the individual unqualified to perform the essential functions of the job; or
    • the applicant was excluded for safety reasons because he or she poses a direct threat due to the impairment.
  • Do not ask questions about an applicant’s family medical history or genetic information.
  • Do not make medical inquiries of or require medical exams for protected category members, such as women and older applicants, unless the same inquiries and exams are also imposed on applicants outside the protected categories
Oceaneering Safety Director Discusses Effective Communication in Occupational Health

Oceaneering Safety Director Discusses Effective Communication in Occupational Health

Safety Director Joe Lavender describes Oceaneering International’s experience with Taylor Made Diagnostics’ occupational health services. Mr. Lavender highlights the effective communication that they have enjoyed while working with TMD.

Transcript: It’s no secret that the ship repair industry is an aging workforce overall. It’s important that we take care of the folks we have and just give them the best care that that we can
provide for them through Taylor Made.

Oceaneering’s local branch is the Marine Services Division and we primarily do repairs on US Navy submarines and some other ship repair work. Taylor Made Diagnostics is one of the few I’ve ever come across that deals solely with occupational health care therefore they understand our industry. They are familiar with the type of injuries that occur in our industry and how to best treat those.

I remember when when she started with humble beginnings in a rented bank building.

The communication is very good. We don’t have to explain to them each time who we are and worry about insurance issues and all of those types of things. When we bring someone to Taylor Made the doctor or physician’s assistant who provides the care for that person personally calls you after the care has been given and lets you know exactly what was done what you can expect with this person and any follow-up care that’s needed. So that’s huge for us that we can actually talk to the person and get a good understanding of what’s going on. You can’t get that in most places.

How Can We Serve Your Business' Occupational Health Needs?

Video: What is Occupational Medicine?

Video: What is Occupational Medicine?

Dr. Michael Picio our Medical Director explains what Occupational Medicine is and how it can benefit your company.

Transcript: Hi, I’m Dr. Michael Picio. I’m the Occupational Medicine Specialist and the Medical Director here at Taylor Made Diagnostics. We’re here to protect the health of your business and we do that by providing you the best occupational medicine care available for 25 years.

I’ve been a family medicine physician and I’ve done that on active duty in the Navy. You go out to sea you’re already in an industrial medicine environment. A ship is nothing more than a big floating factory. You’re already managing programs like hearing conservation and heat stress and radiology and ready radiation health. So these skills which I was already trained in now I’ve been doing every day. I wanted to formalize that to be an actual occupational medicine specialist.

I’ll summarize what occupational medicine is in just a quick fundamental phrase. It’s the specialty of preventive medicine and the diagnosis, treatment and management of workplace related injuries, disabilities and illnesses.

Objectively, studies have even shown in journals and publications that patients do get better faster and they recover much more quickly if they stay engaged in work. And that’s better for the company line because the bottom line is that they’ll make money. They’ll keep that patient engaged there’ll be more productive if they keep the patient at work.

It’s a different intellectual challenge that you bring to this job. The intellectual challenge of investigating whenever patients have illnesses that aren’t quite clear cut when they come in from work and the intellectual challenge of figuring out how to diagnose it, treat it, manage it and get the patient back to work.

If you come to Taylor Made Diagnostics not only are you going to experience the best occupational medicine available and the delivery of that but we’re going to be serving your company as if you’re the only company we have. We’re going to make sure that your patients are going to get the best care possible as if they’re the only patients we have today.

Relationships in Business and Life

Relationships in Business and Life

You’ve heard that relationships in business are critical, doing business with people you know, that’s great advice. How do you get to know them? It’s clear to me that knowing your audience, customers and employees, can have an impact on you personally and professionally. Getting to know PEOPLE first, is the foundation to a strong relationship.  In business, many cut to the chase, and wonder why they’re not successful.

A Pandora commercial connected wives merely by their charm bracelets. I wish it were always that easy but there’s no replacement for face to face interaction and asking the right questions.  People generally like to talk about “Themselves”.  Take the time to listen and get to know them.  Yes, it takes some time and effort but in the long run you’ve made a friend, contact, colleague or resource that can span a lifetime.

It’s not just about business but getting to know people as individuals. Make it your passion to know who “they” really are, learn about their family, their interests and their position or viewpoint. Their STORIES interest me and I often realize there are many common threads to our journey of being. Whether an entrepreneur, business leader, or domestic goddess, the struggles are real, their powerful and it reinforces the connectedness that is forged in our success timeline.

At TMD I take the time to get to know my customers and seek to understand their unique needs as a business owner. The example I show is not only for customers but also for my “Team Awesome”. I listen and learn about each unique person in the organization. I measure their strengths and help them to be the most successful person they can be. If not for them, their loyalty and commitment the mission would fail. Brick by Brick we’ve built a trustworthy relationship to include responsiveness and commitment to always support the mission. You and your Team must represent your core values at all times.

A leader needs to give credit where credit is due. Give back when you can because it will bless you 10 fold, recognize the above and beyond efforts of your team and tell them you think they’re a “big deal”.  If you’ve ever been an employee you know how good that feels!!  Keep inspiring, because we should always lift others as we climb!

On our journey to serve, remember that your inspiration has a ripple effect and can lead to positive change so go out there and make a difference wherever you can.  May 2017 inspire, ignite, and encourage you.

Now go and make a difference!

Leadership and Accountability for a Drug Free Workplace Program

Leadership and Accountability for a Drug Free Workplace Program

The impact of drug abuse on our national workforce is astounding.  Every day, in every city throughout Hampton Roads and the nation, substance abuse costs employers billions.

FACT:  Only about 23% of our Nation’s drug-abusers are sitting around in the abandoned buildings and back alleys of our cities ‘shooting up’ heroin, ‘snorting’ coke, ‘taking a hit’ of grass, or ‘popping’ some meth…’

FACT:  The other 77% of all drug-abusers are EMPLOYED!  (How many are employed by your company?)

Almost everyone has heard of Buzzed Driving, but have you heard about buzzed working? Additional facts, Drug Users:

  • Are 5 times more likely to file workers’ compensation claims than non-drug users.
  • Are involved in 200% to 300% more industrial accidents.
  • Sustain 400% more compensable injuries.

The majority of employers are committed to providing their employees a safe, drug-free work environment.  The weapon of choice is a Drug-Free Workplace program that includes:  written policies, education, employee assistance programs, stiff consequences, and yes, drug testing.  Leadership at your facility must be a fundamental component by enforcing strict and defined policies to guide and to hold all that fail accountable.  Leadership must be engaged to support the clear mission because without it, the program will have no substance.  Believe me, all employees will know.

However, it is imperative employers know and understand the dos and don’ts of drug testing, especially with the new OSHA rule which states you cannot have a blanket policy for post-accident drug testing. That means you cannot test everyone post-accident.  If you do…you will be fined!  In translating the rule it does not prohibit post-accident testing, but it does require that there be a reasonable possibility that drug or alcohol use by the employee was a contributing factor. This does not mean that the employee must appear to be impaired or under the influence after the accident. Instead, it requires that the nature of the accident is such that drug or alcohol use could have been a plausible factor.  OSHA explains with examples: it “would likely not be reasonable to drug test an employee who reports a bee sting, a repetitive strain injury, or an injury caused by a lack of machine guarding or a machine or tool malfunction.”  However, an employee who is injured when he inadvertently drives his forklift into another piece of stationary equipment can be drug tested.  This would not be in violation because the employee’s conduct was directly tied to the injury, and drug use can impact conduct.

Do you know your State laws governing drug testing?

The FAQ page regarding the new rule on the federal OSHA website, https://www.osha.gov/recordkeeping/finalrule/finalrule_faq.html states, “If an employer conducts drug testing to comply with the requirements of a state or federal law or regulation, the employer’s motive would not be retaliatory and this rule would not prohibit such testing.”  While Virginia does not have a law governing workplace drug testing, other States do and testing required under federal or “other” state regulations, such as Department of Transportation (DOT) post-accident testing, is not impacted by the new rule.

Do have a random testing program; it will deter drug use in the workplace. Another alternative, particularly where drug use is suspected, would be to increase the frequency and scope of random drug testing.  Industry experts agree that random testing is the single-most effective deterrent to workplace drug-abuse.

Do require your supervisors to be properly trained by a Substance Abuse Professional to identify drug and alcohol use. Training would alarm supervisors to identify whether reasonable suspicion exists based upon physical, behavioral, speech and performance indicators of probable alcohol or controlled substance use.

To alleviate time and money, do post in all employment ads that you are a Drug Free Workplace Employer.   It’s a well-known fact that drug users are going to apply for a position at companies who do not have or enforce a drug-free workplace environment. Once again, the word does get around!

Be consistent with your drug testing program.  Don’t pick and choose who you are going test. Follow ALL terms of your company’s written testing policy strictly, fairly, and equally with ALL employees-Do not engage in favoritism, or make exceptions.

As with any change in regulation, we recommend employers consult counsel to determine the proper steps for ensuring compliance with a drug-free workplace program in your state.  You can save valuable time and money by making this a priority sooner than later!

About the Author
Stella McClain is Director of Operation and Third Party Administration for Taylor Made Diagnostics (TMD), a leader in providing occupational medical services and workers’ compensation care for all types of industries. For over 18 years TMD has been both provider and resource specializing in DOT and OSHA regulations as well as clinical testing, wellness programs, physical ability assessments and other critical services. She can be reached at 757-494-1688 or via email: smcclain@tmd.bz.

Fit Testing and Facial Hair

Fit Testing and Facial Hair

While beards and mustaches are very fashionable, they do present a challenge to workers who are required to use a respirator and receive proper fit testing in accordance with OSHA standard as referenced in 1910.134(g)(1) Face piece Seal Protection.  Facial hair can put workers at increased risk because a beard or mustache, if not trimmed properly, can compromise the performance of tight-fitting respirators.  Anything that comes between the face and the respirator’s seal, or gets into the respirator’s valves, can allow contaminated air to leak into the respirator face piece, reducing your worker’s protection.

Higher than expected exposures to a contaminate may occur if users have poor face seals with the respirator, resulting in excess leakage.  No attempt should be made to fit a respirator on an employee who has facial hair which comes between the sealing periphery of the face piece and the face, or if facial hair interferes with normal functioning of the exhalation valve of the respirator.  Employees should be monitored throughout the fit testing process to determine if they can keep a seal during respirator use.

Respirator Usage Written Program

OSHA mandates that all employers requiring respirator usage have a written program. That program should include defining facial hair policies if tight-fitting respirator masks are used. Often, this is enforced only at the time of hire or at annual fit-testing; yet, it is equally important to monitor and remind employees of the policy and its purpose throughout the year. A mustache grown for a social cause is not necessarily a point of concern – as long as it is trimmed and maintained to the point that it does not violate the seal area of the respirator and the length does not interfere with exhalation valves, which prevent inward leakage of hazards during inhalation.

Understand OSHA Guidelines

Whether you are fit testing internally, or using an outside vendor, ensure your written program includes a facial hair policy and that your fit testers clearly understand OSHA guidelines for fit testing.  The OSHA Respiratory Protection Standard addresses the issue of respirator use and facial hair; clearly stating tight-fitting respirators are not permitted to be worn by employees who have facial hair that comes between the sealing surface of the face piece and the face, or that interferes with valve function. Be sure your workers are aware and understand the purpose of the regulation, as it will eliminate delays in the fit testing process, and ensure your workers are fully protected while wearing the respirator at all times.

Audiogram Validity

Audiogram Validity

OSHA mandates that employers are required to provide annual audiometric testing for employees exposed to 85 decibels or greater in an 8 hour time weighted average.  If you provide hearing protection to control your employees’ noise exposure you must provide annual audiometric testing.

According to the Centers for Disease Control and Prevention, the most common workplace injury is hearing loss. In fact, according to the Centers for Disease Control and Prevention, it is the most common work-related injury, with approximately 22 million workers exposed annually to hazardous levels of occupational noise. Workers in the mining sector, followed by those in construction and manufacturing, are most likely to suffer from hearing impairment. According to the Department of Labor, an estimated $242 million is spent on worker’s compensation annually for hearing loss disability.

OSHA mandates that employers are required to provide annual audiometric testing for employees exposed to 85 decibels or greater in an 8 hour time weighted average.  If you provide hearing protection to control your employees’ noise exposure you must provide annual audiometric testing.

Maximize Audiogram Accuracy

To maximize the accuracy and to ensure valid audiometric testing:

  • Employee should not be exposed to workplace noise for 14 hours prior to testing.
  • For workers who have audiometric testing conducted during their work shift, hearing protection may be used to meet the “no noise” requirement.
  • Employees should also avoid high volume, non-occupational noise levels 14 hours prior to testing.  These activities include: grass cutting, loud television or radio, motorcycle riding, use of firearms or other activities that generate noise in excess of 85 dB.
  • Employees with a build-up of earwax or a history of wax impaction should clean their ears prior to presenting for the hearing test.

Importance of Employee Awareness & Training

Employers should enforce and remind their employees the day before and the day of their scheduled audiometric test to take necessary precautionary measures ensuring they limit their noise exposure.  By doing so the audiogram will be more valid and repeat testing may become unnecessary.  Employee training is very important. Workers who understand the reasons for the hearing conservation program – and the need to protect their hearing – will be more motivated to wear their hearing protection.

When audiometric testing is required for employees, it is recommended that employers ensure the audiometric service provider complies with the relevant requirements of AS/NZS 1269.4:2005 – Occupational noise management – Auditory assessment and CFR 1910.95.  Employers need to ensure testing is accurate and carried out by an appropriately certified audiometric technician.