Sickness certification difficulties in Ireland--a GP focus group study

Abstract

Background Sickness certification causes problems for general practitioners (GPs). Difficulty with the assessment of capacity to work, conflict with patients and other non-medical factors have been shown to influence GPs' decision-making. Inadequate leadership and management of certification issues add to GPs' difficulties. AimsTo explore problems associated with sickness certification, as part of a larger mixed method research project exploring GPs' experiences and perceptions of sickness certification in Ireland. MethodsA qualitative study in an urban region of Ireland. A focus group of four male and four female GPs explored problems encountered by GPs in certifying sickness absence. Thematic data analysis was used. ResultsThree major themes emerged: perception of the sickness certification system, organization of health care and cultural factors in sickness absence behaviour. Employment structures in public and private sectors and lack of communication with other health care providers and employers were identified as complicating sickness certification. ConclusionsGPs encounter a complexity of issues in sick certification and are dissatisfied with their role in certifying sickness absence. Our results open the debate for policy change and development in Ireland.

Primary care physicians’ concerned voices on sickness certification after a period of reorganization. Focus group interviews in Sweden

“…The problems concerning sickness certification has also been described from other countries, especially in Scandinavia and northern Europe. Results similar to ours were described in a Nordic survey [25] and in qualitative studies from Ireland [28] and Finland [29]. These studies describe the same kind of problems with conflicts with other stakeholders, lack of time and insufficient knowledge on how to assess the patients' work ability.…”

Reasons for Sickness Absence: A Review of Medical Certification Data in the Republic of Ireland between 2008 and 2014

“…Indeed, concerns have been raised in relation to the skills of doctors in managing fitness for work, their knowledge of a patient's working tasks [19]. Recent research conducted with GPs workings in the ROI also supports these findings [20,21]. The benefits of work are widely recognised and in particular for those with mental health related conditions.…”

Sickness Certification Behavior amongst Primary Care Physicians: A Descriptive Analysis of Indirect Measures Using the Theory of Planned Behavior

“…The need to provide patients with sick leaves is a decision most general practitioners (GPs) make on a daily basis. [1][2][3][4] Studies in various countries reported that physicians were reluctant to perform the role as a gatekeeper in the provision of sick leaves. 3,[5][6][7][8][9][10][11][12][13][14] Physicians often face conflict with patients in the process of providing sick leaves, which ultimately leads to emotional strain at the workplace.…”

“…18,19) Concurrently, similar trends were observed in sick leave practices in the United Kingdom and other European countries. 1,4,[6][7][8][9][10]12,13,20) Current circumstances create great potential for sickness certification abuse, thus necessitating an urgent need for intervention. [1][2][3][4][5][6] This study focused on a descriptive analysis of the beliefs (indirect measures) that control sick leave-prescribing behavior among GPs.…”