Aims: To develop a questionnaire that measures specific aspects of patient satisfaction with occupational health physicians. Methods: General patient satisfaction questionnaires, a literature survey, and interviews with patients were used. An initial questionnaire was distributed among sick listed patients (n = 432) of occupational physicians (n = 90) from different occupational health services. To reduce items and to develop scales exploratory factor analysis and reliability analysis was used. A linear regression model was used to predict satisfaction ratings from the scales of the questionnaire.

Background: Rheumatic diseases are a major cause of permanent work disability. In the process of occupational rehabilitation several health professionals may have a role. Objective: To assess the quality and quantity of communication and cooperation between Dutch rheumatologists and occupational physicians. Methods: A postal survey among 187 Dutch rheumatologists. Results: 153/187 rheumatologists (82%) returned the questionnaire. They considered reducing pain and fatigue to be their major responsibility in the process of occupational rehabilitation, followed by improving work participation (68/153 (44%)) and quality of work (55/153 (36%)). Although 112/153 (73%) of the rheumatologists judged the communication and cooperation with occupational physicians as reasonable to good, 119/153 (78%) of them were willing to improve the collaboration. Perceived bottlenecks mentioned were a lack of clarity about the occupational physician's position and activities, and the absence of practice guidelines. The most important prerequisites for improvement were found to be guarantees about the occupational physician's professional independence and more clarity about the competence of the occupational physicians and how they used the information provided. Conclusion: Dutch rheumatologists are willing to improve cooperation and communication with occupational physicians. The perceived lack of clarity about their mutual tasks appears to be a major obstacle. Thus the development of a joint education programme and a guideline for occupational rehabilitation in rheumatic diseases may be appropriate first steps towards improvement.

Samenvatting In dit artikel worden de resultaten beschreven van een onderzoek naar de kwaliteit van de bedrijfsgeneeskundige begeleiding van werknemers met rug-of psychische klachten. 1 Hierover zijn in 2002 in totaal 34 bedrijfsartsen geı¨nterviewd en de betrokken patie¨nten schriftelijk ondervraagd. Uit dit onderzoek komt het volgende naar voren: 1. Bijna de helft van de werknemers die door de bedrijfsarts worden begeleid zijn werknemers met rug-of psychische klachten. Zij zijn bijna allemaal ook gelijktijdig onder behandeling van de curatieve sector. 2. Bij eenderde van deze patie¨nten is er sprake van arbocuratief contact. Bij bijna 3 op de 10 echter niet hoewel dat volgens de NVAB-LHV-Leidraad wel geı¨ndiceerd was. 3. Bedrijfsartsen wijken bij hun begeleiding eveneens nog vrij vaak af van de NVAB-richtlijnen. 4. De patie¨nten oordelen desalniettemin positief over de begeleiding van de bedrijfsarts. 5. Hun oordeel luidt echter wel positiever als de bedrijfsarts een adequate probleemorie¨ntatie verricht, hierin de informatie van de curatieve behandeling betrekt en bij de interventies richting de patie¨nt eveneens volgens de richtlijnen handelt. Keywords begeleiding Á bedrijfsarts Á patie¨nt Á kwaliteit Á rugklachten Á psychische klachten Á arbocuratief Inleiding