Based on an historical and sociological inquiry, this article shows that the recent reform of French occupational medicine services is part of a broader policy, initiated by French employers since the 1970s. The industry-supported organization which runs these services (CISME) has used various political and managerial levers to limit professional autonomy for occupational physicians, officially because of the need for “pluridisciplinary” action in the new paradigm of “health at work”. The aim of this shift is to limit the costs of prevention and compensation of occupational hazards, as well as the legal risk for employers.