General practitioners’ perceptions of working with the certification of sickness absences following changes in the Swedish social security system: a qualitative focus-group study

Abstract

BackgroundMany physicians in Sweden, as well as in other countries, find the matter of certification of sickness absence (COSA) particularly burdensome. The issuing of COSAs has also been perceived as a work-environment problem among physicians. Among general practitioners (GPs) are the highest proportion of physicians in Sweden who experience difficulties with COSA. Swedish authorities have created several initiatives, by changing the social security system, to improve the rehabilitation of people who are ill and decrease the number of days of sick leave used. The aim of this study was to describe how GPs in Sweden perceive their work with COSA after these changes.MethodsA descriptive design with a qualitative, inductive focus-group discussion (FGD) approach was used.ResultsFour categories emerged from the analysis of FGDs with GPs in Sweden: 1) Physicians’ difficulties in their professional role; 2) Collaboration with other professionals facilitates the COSA; 3) Physicians’ approach in relation to the patient; 4) An easier COSA process.ConclusionsSwedish GPs still perceived COSA to be a burdensome task. However, system changes in recent years have facilitated work related to COSA. Cooperation with other professionals on COSA was perceived positively.

Medizinische Atteste und Untersuchungen in der allgemeinärztlichen Praxis

“…Seit der Reform in Schweden sank der Anteil der arbeitsunfähigen Erwerbspersonen von 4,2% auf 2,2% (Kühbauch, Weber 2010). Ärzte geben an, dass die Reformen die Bescheinigung der Arbeitsunfähigkeit erleichtert haben, auch wenn sie sie immer noch als Belastung sehen (Carlsson et al 2015).…”

Registered nurses’ work with sick leave questions by telephone in primary health care

“…, Carlsson et al . ). Reported problems with sickness certification are connected to the physician's dual role as both the patient's carer and a medical expert when issuing the sickness certification (Hussey et al .…”

“…, Carlsson et al . ), cooperation and communication with both internal and external stakeholders (Foley et al . , Nilsing et al .…”

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

“…A study using questionnaires distributed to physicians in different specialties in Sweden revealed that sickness certifications were regarded as too extensive and problematic, especially among GPs [13]. A Swedish focus group interview study showed that GPs and GP trainees were positive to include other healthcare professionals in the patient's rehabilitation process [14]. Still, the patients are the prime sources of information about themselves as emphasized in a study where recorded dialogues between patients and physicians were assessed by GPs from different European countries [15].…”