Background <p>Occupational safety and occupational health are multidisciplinary fields in which occupational health physicians (OP) are the only profession according to theories of profession. So far little is known about the professional self-conception of OPs. This study therefore addresses the following research question: what can we learn about the professional self-conception of OPs from the secondary analysis of qualitative data?</p> Methods <p>We reanalyzed qualitative data from three previous research projects undertaken by the institute in a secondary analysis. The original studies addressed the following topics: the cooperation between general practitioners and OPs, the offers for psychosomatic consultation in the workplace and the availability and utilization of occupational healthcare. The original data were generated in 2009–2012. The secondary analysis was based on five focus group discussions and an interview with OPs in Germany. In total, 23&#xa0;OPs were part of the secondary analysis. The professional identity of OPs was addressed in all the original data but was not the focus of the studies. We used the integrative basic method to reanalyze the data in detail and with a focus on semantics, syntax and metaphors as well as agency and positioning.</p> Results <p>The OPs criticised the lack of knowledge about their work among other stakeholders. They described several modes of operation of OPs within the company: the fighter, the negotiator and the disengaged OP. They positioned themselves first and foremost as physicians, using medical confidentiality and ethics to protect themselves from attempts of instrumentalization by others. They discussed the employees fear of OPs partiality and how their work was partly dependent on the employers’ willingness to invest in occupational health. They made it clear that their work was nevertheless independent.</p> Discussion <p>The OPs in our study addressed a&#xa0;status triangle dilemma. We could identify five strategies by which they navigated the dilemma: pragmatic orientation, shaping the contractual framework conditions, marketing the benefits of the work of OPs, self-positioning as physicians and turning the status triangle dilemma into a&#xa0;unique competence. The latter can be seen not only as an invitation to discuss the future of occupational medicine but also to ask what physicians from other specialities can learn from OPs in navigating conflicting roles and in constructing strategies for action.</p>