Problems in sickness certification of patients: A qualitative study on views of 26 physicians in Sweden

Knorring, Mia von; Sundberg, Linda Richter; Löfgren, Anna; Alexanderson, Kristina

doi:10.1080/02813430701747695

Cited by 82 publications

(88 citation statements)

References 8 publications

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“…These professionals' described challenges in defending the physician's decision to not issue a sickness certificate, convincing the patient to stay at work, or arguing with the physician about the patient's need for sick leave. The challenges identified in this study agree in many ways with those from von Knorring and colleagues [8], e.g. regarding the challenges with lack of time, problems in assessing work ability, communicating with the SIO, and the role conflict.…”

Section: Handling Sickness Certificationssupporting

confidence: 69%

“…There may also be an internal conflict in the advocacy role, as shown in the difficulties deciding whether to meet a patient's request for a sickness certificate or not, primarily when clinical findings are missing. Our findings suggest that the challenges with handling the need for sick leave in PHC are not only faced by physicians, as previously reported [38,9,8,4,11], but also by other professionals. These professionals' described challenges in defending the physician's decision to not issue a sickness certificate, convincing the patient to stay at work, or arguing with the physician about the patient's need for sick leave.…”

Section: Handling Sickness Certificationssupporting

confidence: 67%

“…One of the problems related to sickness certification is the difficulty in handling the dual roles of patient advocate and medical expert for other authorities like social security, where the responsibility to the patient often outweighs that of medical expert [9,8,13,4,11,14]. Physicians have reported assessments of functioning, work ability, and the need for sick leave as being problematic [6,15,4], especially when the patient describes symptoms that are difficult to diagnose and clinical findings are missing [9,5,13,16].…”

Section: Introductionmentioning

confidence: 99%

“…When there is a need for sick leave the physician together with the patient considers the advantages and the disadvantages of being on sick leave, determines the grade (full-time or part-time) and duration of sick leave, and what actions that need to be taken during the sick leave period in terms of investigations, treatments and rehabilitation interventions [3]. Previous research has shown that physicians belief that sickness certifications would benefit of involvement of other healthcare professions [18,10,8,23] and that physiotherapists [24,23] and occupational therapists [25] feel they have the competence to participate in work ability assessments. The few studies investigating the team members' roles indicate however an ambiguity in the team whether other healthcare professionals are supposed to work with work ability assessments [26].…”

Section: Introductionmentioning

confidence: 99%

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Primary Healthcare Professionals’ Experiences of the Sick Leave Process: A Focus Group Study in Sweden

et al. 2013

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Section: Handling Sickness Certificationssupporting

confidence: 69%

Section: Handling Sickness Certificationssupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Primary Healthcare Professionals’ Experiences of the Sick Leave Process: A Focus Group Study in Sweden

et al. 2013

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“…Many physicians find it problematic to handle these two roles (Gulbrandsen, Hofoss, Nylenna, Saltyte‐Benth, & Aasland, 2007; Hussey, Hoddinott, Wilson, Dowell, & Barbour, 2004; von Knorring, Sundberg, Lofgren, & Alexanderson, 2008; Larsson, Sydsjo, Alexanderson, & Sydsjo, 2006; Lofgren, Hagberg, Arrelov, Ponzer, & Alexanderson, 2007; Swartling, Peterson, & Wahlstrom, 2007; Timpka, Hensing, & Alexanderson, 1995; Wahlstrom & Alexanderson, 2004). …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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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.

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Cooperation in Return-to-work Interventions for Common Mental Disorders: An Ideal Theory Analysis of Actors, Goals, and Ethical Obstacles

Hartvigsson,

Sandman,

Bergström

et al. 2024

Health Care Anal

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The rise in the number of people on sick leave for common mental disorders is a growing concern, both from a societal and individual perspective. One common suggestion to improve the return-to-work process is increased cooperation between the relevant parties, including at least the employer, the social insurance agency and health care. This suggestion is often made on the presumption that all parties share the common goal of reintegrating the patient-employee back into the workplace. In this paper we investigate this presumption by mapping out the ethical frameworks of these three key actors in any return-to-work process. We show that although the goals of these actors often, and to a large extent, overlap there are potential differences and tensions between their respective goals. Further, we emphasise that there may be other limitations to an actor’s participation in the process. In particular the health care system is required to respect patient autonomy and confidentiality. There is also an inherent tension in the dual roles of health care professionals as therapists and expert witnesses in work ability assessment. In conclusion, there are potential tensions between the key actors in the return-to-work process. These tensions need to be addressed in order to enable an increased cooperation between actors and to facilitate the development of a feasible plan of action for all parties, including the employee.

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Problems in sickness certification of patients: A qualitative study on views of 26 physicians in Sweden

Cited by 82 publications

References 8 publications

Primary Healthcare Professionals’ Experiences of the Sick Leave Process: A Focus Group Study in Sweden

Primary Healthcare Professionals’ Experiences of the Sick Leave Process: A Focus Group Study in Sweden

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

Cooperation in Return-to-work Interventions for Common Mental Disorders: An Ideal Theory Analysis of Actors, Goals, and Ethical Obstacles

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