Neurologists dealing with sickness certification: Experiences of problems and need of competence

Abstract

Rationale and AimsMost studies on physicians' sickness certification practices include general practitioners (GP) while there hardly is any knowledge on this regarding neurologists although neurological diseases often involve work incapacity and need of sick leave.AimThe aim was to describe experiences among neurologists in Sweden concerning their work with sickness certification of patients.MethodA cross‐sectional study of 265 neurologists' responses in a nationwide survey regarding their work with sickness certification of patients was conducted.ResultsThe majority (81.5%) had sickness certification consultations at least once a week and a third experienced problems every week in handling sickness certification. Among the 251 who at least sometimes had sickness certification consultations, the following two aspects were experienced as very or fairly problematic: “assess the degree to which the reduced functional capacity limits a patient's capacity to perform his/her work assignments” (67.3%) and “make a long‐term prognosis about the future work capacity of patients on sick leave” (60.5%). At least once a week, 78.7% experienced lack of time regarding managing patient‐related aspects of the sickness certification task. Moreover, 21.8% considered sickness certification to be a work environmental problem, at least once a week. In all, 84% stated that they had a large or fairly large need for more competence concerning sickness certification tasks.ConclusionsSickness certification is a common task among neurologists, involving several problematic aspects related to, e.g., lack of competence in assessing function and work capacity and of time. There is a need for improvement.

Interventions regarding physicians’ sickness certification practice – a systematic literature review with meta-analyses

“…In addition, political decisions on laws and regulations for medical SA can be aggravating aspects for physician’s sickness certification practice [ 20 ]. Physicians have also expressed the need for more competence and organisational requisites, including support regarding management of sickness certification tasks [ 16 , 21–24 ].…”

Oncologists’ experiences of and prerequisites for sickness certification tasks: A nationwide questionnaire study

“…It also involves to, together with the patient consider the pros and cons of being on SA, determine duration and grade (full‐ or part‐time) of SA, develop an action plan concerning what is to happen during the SA, decide if there is a need for involvement of/contacts with other professionals or organisations, write a sickness certificate, and document actions taken. In consultations that involve SC, physicians have two different roles: as the patient's treating physician and as a medical expert providing information and assessments to other organisations, for example, the employer and the Social Insurance Agency (Alexanderson et al, 2018; Ljungquist et al, 2015; Snöljung et al, 2017; Söderberg et al, 2019; Winde et al, 2012).…”