Barriers to good sickness certification — an interview study with Swedish general practitioners

Swartling, Malin; Alexanderson, Kristina; Wahlström, Rolf

doi:10.1177/1403494808090903

Cited by 57 publications

(56 citation statements)

References 20 publications

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“…However, others13 have observed extensive use of sickness certification guidelines among GPs with higher qualifications, as have we. The communication between the GPs and their patients has an important role in sickness certification, especially in cases involving doctor–patient conflicts 1 18 28. Furthermore, problems in the contact between the GPs and the SIOs have been reported,29 and SIOs have stressed the significance of mutual understanding in that context 30.…”

Section: Discussionmentioning

confidence: 99%

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

et al. 2011

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ObjectivesDiagnoses-specific sickness certification guidelines were recently introduced in Sweden. The aim of this study was to investigate to which extent general practitioners (GPs) used these guidelines and how useful they found them, 1 year after introduction.DesignA cross-sectional questionnaire study. A comprehensive questionnaire about sickness certification practices in 2008 was sent to all physicians living and working in Sweden (n=36 898, response rate 60.6%). In all, 19.7% (n=4394) of the responders worked as GPs.SettingPrimary healthcare in all Sweden.ParticipantsThe participating GPs who had consultations concerning sickness certification at least a few times a year (n=4278, 97%).Main outcome measuresDescriptive statistics and prevalence ratios for the 11 questionnaire items about the use and usefulness of the sickness certification guidelines.ResultsA majority (76.2%) of the GPs reported that they used the guidelines. In addition, 65.4% and 43.5% of those GPs reported that the guidelines had facilitated their contacts with patients and social insurance officers, respectively. The guidelines also helped nearly one-third (31.5%) of the GPs to develop their competence and improve the quality of their management of sickness certification consultations (33.5%). About half experienced some problems when using the guidelines and 43.7% wanted better competence in using them. A larger proportion of non-specialists and of GPs with fewer sickness certification consultations had benefitted from the guidelines.ConclusionsThe national sickness certification guidelines implemented in Sweden were widely used by GPs already a year after introduction. Also, the GPs consider the guidelines useful in several respects, for example, in patient contacts and for competence development.

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Section: Discussionmentioning

confidence: 99%

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

et al. 2011

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“…On the other hand, we also found that there was uncertainty in what the patient expected and a lack of trust in the information given by patients, and the assessment of work ability was described as a guessing game. Earlier research suggested that physicians may not have sufficient competence to assess work ability [7,20], and scarce knowledge about workplaces, the labour market, and the social security system [9,15,17,21].…”

Section: Work Ability Assessmentsmentioning

confidence: 99%

“…The challenges physicians face in sickness certifications may come from insufficient competence to assess work ability [10,7,20] as well as scarce knowledge about workplaces, the labour market, and the social security system [9,17,15,21]. The sickness certification tasks also include interactions with other stakeholders, but physicians have reported problems in cooperating with stakeholders within or outside the healthcare system [17,18,9,21,7]. The stakeholders comprise the healthcare, legal (social insurance office), workplace (employer or employment agency), and personal systems (the patient) [22].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…The physiotherapists working in occupational health care had access to the workplaces and regularly performed workplace visits and found this to be a prerequisite for work ability assessments. Ergonomic competence is primarily within the occupational health care sphere; however, the level of collaboration between primary health care and occupational health care has been reported to be low (Swartling, Alexanderson, and Wahlström, 2008). In long-term follow-ups, collaboration between occupational health care, the employer, and social insurance officers was found to be beneficial (Kärrholm et al, 2008).…”

Section: Societal and Organisational Prerequisites For Pt Engagement mentioning

confidence: 99%

Work ability: Concept and assessment from a physiotherapeutic perspective. An interview study

Stigmar¹,

Ekdahl²,

Grahn³

2011

Physiotherapy Theory and Practice

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The aim of this study was to ascertain experiences and perceptions among physiotherapists (PTs) in Sweden regarding the concept of work ability as well as their perspectives of their professional role in work ability assessments. We conducted an in-depth interview study with four male and twelve female physiotherapists working in the field of occupational health care, orthopaedics, primary health care or rehabilitation. Qualitative content analysis was applied to the data. Work ability was perceived as the ability to perform work tasks as requested. Having the potential to adjust at work and to allocate resources, having an attachment to the workplace and time factors were vital. The physiotherapists were striving for a well-defined role within a multiprofessional team, where work ability assessments were performed in a real work environment. The PTs experienced contradictory roles in relation to the patient but believed they could contribute with valuable material for assessments; this professional help was not always requested. It was noted that there was a need for experience and further education to enable PTs to further engage in work ability assessments. It is important to improve collaboration and to further discuss the work ability concept from the viewpoints of different professionals.

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Barriers to good sickness certification — an interview study with Swedish general practitioners

Abstract: GPs experienced a number of barriers to what they perceived to be good sick-listing practice. Such barriers need to be addressed in interventions for change. We propose communication skills training, with a special emphasis on difficult situations in sick-listing practice.

Cited by 57 publications

References 20 publications

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

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

Work ability: Concept and assessment from a physiotherapeutic perspective. An interview study

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