Why do doctors issue sick notes? An experimental questionnaire study in primary care

Campbell, Amaryllis; Ogden, Jane

doi:10.1093/fampra/cmi099

Cited by 28 publications

(15 citation statements)

References 14 publications

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“…These results support findings from previous studies reporting problems with sickness certification and highlight the conflicting role of GP 'gatekeeping' in sickness certification [3][4][5], the desire to maintain a positive doctor-patient therapeutic alliance [6] and problems with communication, lack of support and rehabilitation opportunities [7,8]. This study was small and the findings cannot be generalized, but it identified cultural and process aspects of sickness certification not previously described in an Irish context.…”

Section: Discussionsupporting

confidence: 83%

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

Foley

Thorley

Hout

2013

Occupational Medicine

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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.

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Section: Discussionsupporting

confidence: 83%

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

Foley

Thorley

Hout

2013

Occupational Medicine

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“…The prescribing of sickness leave is often based on the GPs ' desire to preserve the doctorpatient relationship (5 -7). Non medical factors such as social circumstances and demand for certifi cation rather than fi tness for work have been implicated in GPs ' decision making on sickness certifi cation (8,9). Diffi culties include negotiation with the patient about fi tness for work and disagreement between the GP ' s and patient ' s perceptions about their ability to work (4).…”

Section: Introductionmentioning

confidence: 99%

Assessing fitness for work: GPs judgment making

Foley

Thorley

Hout

2013

European Journal of General Practice

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Background:The complexity of a fi tness for work consultation is well documented. General practitioners (GPs) fi nd that such consultations often create confl ict and they feel ill-prepared for the task. Objectives: We aimed to examine the consultation process in the fi tness for work consultation and to report on the response of GPs to two hypothetical consultations of work related sickness absence, one of a psychological and one of a physical nature. Methods: Three areas of the consultation were examined; social/family circumstances, workplace history and information required assessing the severity of the condition. We used a randomized design using an online questionnaire completed by 62 GPs located in the Republic of Ireland. Analysis was conducted in NVivo 8 qualitative software using thematic and content analysis techniques. Results: GPs may be expected to collect and consider information relating to social, domestic, fi nancial, lifestyle and workplace factors, including workload, job satisfaction, job strain, work ethic, inter staff relationships and employee support mechanisms. The mode of presentation may trigger specifi c information seeking in the consultation. Conclusion:GPs may evaluate fi tness for work in a variety of ways depending on medical and non-medical factors. Further research should further examine the factors that may infl uence the GPs decision to prescribe sickness leave.

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“…[16][17][18][21][22][23][24] This study also indicated that a patient with depression was more likely to be advised to refrain from work than a patient with back pain.…”

Section: Comparison With Existing Literaturementioning

confidence: 91%

Working towards a ‘fit note’: an experimental vignette survey of GPs

Sallis¹,

Birkin²,

Munir³

2010

Br J Gen Pract

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BackgroundThe Department for Work and Pensions (DWP) has designed a trial medical statement. AimTo compare fitness for work assessment outcomes and written advice across current and trial medical statements. To examine the use of and suggestions to improve the trial medical statement. Design of studyComparative study with a two-way mixed design using questionnaire-based vignettes presenting GPs with three hypothetical sick leave cases (back pain, depression, combined back pain and depression) and medical statements (current or trial). The questionnaire also gathered GP views of using the trial Med 3. SettingNine primary care organisations (PCOs) in England, Scotland, and Wales.

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Why do doctors issue sick notes? An experimental questionnaire study in primary care

Abstract: Doctors have more positive beliefs about patients with a psychological problem and are more likely to offer them a sick note. Issuing sick notes is unrelated to the patient's family circumstances or patient demand.

Cited by 28 publications

References 14 publications

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

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

Assessing fitness for work: GPs judgment making

Working towards a ‘fit note’: an experimental vignette survey of GPs

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