Dr. Steven M. Moffat is an internal medicine trained physician and the Chief Medical Officer for wellness and other medical/occupational medicine services provided to the Indianapolis Fire Department (IFD). In this capacity he supports IFD with all aspects of its health and wellness operations. For example, he is the technical expert related to the IAFF/IAFC Joint Labor-Management Wellness Fitness Initiative (WFI) and provides program consultation and administration of medical and occupational services related to IFD. He has served in this capacity since the founding of the WFI in 1997.
Dr. Moffatt also serves as the technical representative for medical and occupational services, providing consultation to IFD administrators on all matters related to the implementation and modification of the WFI. Additionally, he oversees the medical and psychological post offer hiring process, the medical and psychological fitness for duty process, and the pension applications process.
Dr. Moffatt has made significant contributions to fire fighter health and wellness since he began providing his services to the fire community in 1990. He was a member of the group of technical experts who worked alongside labor and management representatives from the 10 task force cities who founded the WFI. Since its inception, he has had the privilege of supporting, championing and advancing the WFI within the fire service by participating in IAFF/IAFC national conferences and participating in almost all of the John P. Redmond Health and Safety Symposia as a speaker or technical expert.
Dr. Moffatt’s medical practice sees over 7,500 fire fighters annually across the state of Indiana and extending into southern Ohio and the Chicago area. His practice has one of the largest searchable clinical fire fighter databases in the world as they have been evaluating over 10,000 firefighters annually over 20 years using clinical laboratory, pulmonary function and cardiac stress testing measures. His team has provided a generation of medical and psychological evaluations on applicants to the Indiana Fire Service over the past 25 years, performing, conservatively, over 10,000 of these evaluations over that time-frame. Also over the same time-frame, he and his team have performed over 10,000 fitness for duty evaluations.
In 2014, Dr. Moffatt founded a non-profit clinical research institute, the National Institute for Public Safety Health (NIPSH), which has collaborated with many academic institutions, including, Harvard, Skidmore, Indiana University, University of Oregon, and University of Arizona, to develop a comprehensive understanding of cardiovascular disease and risk factors associated with heart disease in the fire service. NIPSH has been awarded two FEMA grants as the principal investigator involving cancer in the Indiana Fire Service, and a case controlled study and surveillance of coronavirus (COVID) infection among Indiana fire fighters. Dr. Moffatt has been an advocate for cancer and cardiac disease presumption laws in the state of Indiana and has consulted on numerous cases as they relate to the relationship between cancer and cardiac disease, respectively, and employment in the fire service.
Beyond Dr. Moffatt’s work with IFD and with his institute he has made numerous other contributions to the advancement of fire fighter health and wellness. For example, he has been privileged to serve as a member of the National Fire Fighter Cancer Registry Sub Committee along with other members from the National Institute for Occupational Safety & Health and the private sector; he contributed to the Fire Fighter Cardiovascular Mortality Study; he continues to serve as a technical committee member for NFPA 1500, 1582, 1583, 1584, and now 1585; and he serves as a medical consultant to the U.S. Department of Labor, where he provides medical opinions regarding fire fighter cancer cases in the Department of Labor and the Department of Defense. Dr. Moffatt has been privileged to be an advocate for the prevention of unnecessary death or disability resulting from occupational exposures to fire fighting, and an advocate for the United States Fire Service generally, ,throughout his career.
As for many, exercise doesn’t come easy for Dr. Moffatt. However, over the past 10 years he has made a focused effort to build regular physical activity into his life. His main motivation to do so is to maintain his physical health, since all of the experiences that enrich his life are predicated on being healthy and functional. Dr. Moffatt wants to remain productive both mentally and physically and recognizes that leading an active lifestyle can help him achieve these goals. He enjoys walking and hiking, and enjoys visiting parks and trails to partake in these activities. Dr. Moffatt also enjoys biking, playing golf and has taken up sailing over the past few years. The main habit he has developed to help him promote his personal wellness and fitness is to participate almost daily in some form of physical activity or movement associated with nature.
Reflecting on the over 30 years of experience Dr. Moffatt has amassed as a leader in the field of fire fighter health and wellness, he would advise departments looking to invest in the wellness and fitness of their members in the following way. Firstly, most fire fighters desire to continue in their positions until retirement (a period of potentially 30 years or more), and most will retire with the same department that initially hired them. The majority of fire fighters love the work and service they perform. It remains an important identity and noble service.
The overwhelming majority of career ending early disability or death is related to preventable conditions; these include cardiovascular disease, cancer, diabetes and/or orthopedic conditions. The loss associated with early death or disability has a significant financial burden associated with direct healthcare costs, early pension payouts, lost time and the need for replacement staff. These costs are staggering as seen in state or local pension burdens. Additionally, there is an unnecessary loss of valuable technical experience.
Against this backdrop, Dr. Moffatt would remind departments that the fire fighter is the most valuable part of the resource equation over and above the equipment. They bring the skill, knowledge and experience which guides all equipment in the performance of successful fire-fighting and life-saving duties. It only stands to reason that protecting the most important asset will provide the greatest return on investment. The public expects and deserves this critical investment.
Research has consistently shown that the early identification and prevention of disease in wellness and fitness programs will, at a minimum, pay for themselves. This is infinitely underscored when investments are made in a stable population such as the fire service where the majority stay with the same agency and serve for at least 30 years before retiring. Unfortunately, these evaluations do not discuss the greater productivity of a healthy population and the profound value that brings to the agency and the community in which they serve.
Dr. Moffatt would recommend several principles departments should use to drive their efforts: 1) Always build consensus around the mission and vision when developing a program. Securing buy in from members is the significant momentum-maker that is needed with any program; 2) Be strategic in starting where you can and not necessarily with everything you want. You need some wins, results, and/or success stories to drive momentum. The ask for more funding is always easier than securing initial funding; 3) Always address the underlying fear that change may mean that someone may lose their job because of the program. On the contrary, the motivation of a wellness fitness program is to keep individuals on the job allowing them to choose the reason and time for retirement on their terms and not because of a disease or disability. This message must be reinforced.
For the individual fire fighter who is thinking about investing in their wellness and fitness, Dr. Moffatt would recount how he approaches those fire fighters currently under his care. Over his years, he has seen many fire fighters wait until their fifties to begin to be serious about their level of fitness; and their motivation is usually related to a health scare. The demands fire- fighting impose on an individual become progressively more challenging with age, especially if a fire fighter lacks fitness. As a means of impressing on fire fighters the importance of addressing their wellness and fitness early in their careers, Dr. Moffatt tries to relate with the concept of retirement.
He spends time talking about the financial planning a fire fighter is doing for their retirement and the seriousness that this issue takes on around the age of 40. Next, he discusses the financial deposits a fire fighter is likely making and then equates these to physical/health deposits they need to be making as well. He outlines the all too common situation of early disability due to a preventable condition that could have been prevented if afflicted fire fighters had made physical/health deposits 10 years earlier. Further, he discusses that the security required for a successful retirement comes from two sources, financial health and physical health, and if a fire fighter wants to get the most out of retirement they need both of them.
Unfortunately, in Dr. Moffatt’s experience some fire fighters respond by saying, “I gotta die of something”, to which he reminds them that unfortunately most fire fighters do not die quickly, but rather, live physically restricted lives with regret watching others do physically what they are not able to do. To avoid such a regrettable outcome Dr. Moffatt would strongly encourage fire fighters to invest in their health and wellness early on in their careers.
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