Occupational physicians' perceptions of professional role change following health policy reform in France: A qualitative study.

Objectives: To explore occupational physicians' perceptions of the 2 August 2021 reform and changes in their professional role, identify reported barriers and perceived facilitators to practice change, and describe reported health promotion practices. Study design: Qualitative study using semi-structured interviews. Methods: Ten occupational physicians practising in Normandy, France, were interviewed between November 2024 and March 2025. Data were analysed using thematic content analysis with a hybrid deductive-inductive coding approach. Results: Participants expressed contrasting perceptions of the reform, ranging from support for its objectives to concerns about feasibility and dilution of the occupational physician's specific role. Reported barriers were mainly organisational, including limited time, workload and staffing constraints. Dedicated time, additional resources, training and multidisciplinary support were described as conditions that could facilitate implementation. Participants also reported health promotion practices that predated the reform and were not always perceived as distinct public health activities. Conclusions: Among the physicians interviewed, few changes in practice were directly attributed to the reform, while several health promotion activities were reported to have predated it. The findings suggest a tension between expanded public health expectations and perceived boundaries of the occupational physician's role within an already constrained organisational context.