Obstetricians/Gynecologists’ Problems in Sickness Certification Consultations: Two Nationwide Surveys

Abstract

Objective. To explore experiences by physicians working in obstetrics, gynecology, or maternal healthcare (O/Gs) of problems in sickness certification consultations and differences between two years. Material and Methods. Answers by O/Gs to two Swedish nationwide surveys, in 2008 (n = 1037) and 2012 (n = 992), were analyzed for frequencies and severity of problems and organizational support in sickness certification consultations. Results. One-third of O/Gs found sickness certifications problematic every week. The most frequent problem was patients requesting sick notes for reasons other than work incapacity due to disease/injury (2008: 21%; 2012: 16%). The most problematic were assessing work capacity (2008 and 2012: 52%) and having different opinion from that of the patient about need for sick leave (2008: 51%; 2012: 46%). In 2012, 27% used the national sickness certification guidelines weekly, compared to 9% in 2008. A larger proportion in 2012 than 2008 reported that the guidelines facilitated contacts with patients and different stakeholders. Conclusions. Although O/Gs perceived sickness certification as problematic, there was less perceived severity of problems in 2012 compared to 2008, possibly because interventions regarding sickness certification have been introduced in Sweden recent years. Still, more organizational support, for example, time and supervision, are needed to enhance O/Gs' sickness certification practices.

Implementation of maternity protection legislation: Gynecologists’ perceptions and practices in French-speaking Switzerland

“…The main reason mentioned which guides them in their decision was the patient's request. These findings agree with those of certain Swedish studies [32,49,50] which found that sick leave was often requested by pregnant employees because of the perceived arduousness of their work. Given that the costs of sick leave are often covered by an employer's loss-of-income insurance and that sick leave does not entail workplace's adaptations, employees may well prefer this type of leave to remain on good terms with their employers, especially for when they return from maternity leave.…”

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

“…The questionnaire was developed to collect information from physicians about their work with SC and their need for further training in insurance medicine. The questionnaire, containing 133 questions, was developed from previous such questionnaires (Lindholm et al, 2010; Ljungquist et al, 2015; Löfgren et al, 2007) that in turn were based on interview studies (individual and focus groups) (Engblom et al, 2010; von Knorring et al, 2008; Ockander & Timpka, 2001), systematic literature reviews (Söderberg et al, 2019; Wahlström & Alexanderson, 2004), pilot studies, as well as written comments in previous questionnaires (Bränström et al, 2013; Gerner & Alexanderson, 2009; Gustavsson et al, 2016; Lindholm et al, 2010; Ljungquist et al, 2012; Löfgren et al, 2007, 2010). The questionnaire used here was slightly revised from the previous one, with the addition of some questions to capture physicians’ experiences of recent interventions targeting SC.…”

“…| 3 of 14 Gustavsson et al, 2016;Lindholm et al, 2010;Ljungquist et al, 2012;Löfgren et al, 2007Löfgren et al, , 2010. The questionnaire used here was slightly revised from the previous one, with the addition of some questions to capture physicians' experiences of recent interventions targeting SC.…”

Physician’s use of sickness certification guidelines: a nationwide survey of 13 750 physicians in different types of clinics in Sweden

“… 14 The use of guidelines among GPs 14 and among gynaecologists/obstetricians 15 have increased over the years, as did the rate of gynaecologists/obstetricians who reported that the guidelines facilitated their contacts with patients. 15 Another study compared the quality of SC before and after the SC guidelines were introduced, in 2007 respectively 2009. 16 Improvement of the quality of the information provided in the certificates was found regarding descriptions on functioning—although body impairments still dominated the descriptions of functioning, contradictory to the SC guidelines emphasising of that functioning should be described in terms of activity and work incapacity.…”

“…Previous studies about physician’s use of these SC guidelines in Sweden show that a large majority (>85%) of GPs who have used guidelines find them beneficial to ensure high quality in handling sick leave cases 14. The use of guidelines among GPs14 and among gynaecologists/obstetricians15 have increased over the years, as did the rate of gynaecologists/obstetricians who reported that the guidelines facilitated their contacts with patients 15. Another study compared the quality of SC before and after the SC guidelines were introduced, in 2007 respectively 2009 16.…”