Improving the physician role in evaluating work ability and managing disability: a survey of primary care practitioners

Abstract

Evaluations of work status and work ability are common PCP activities, but little formal training has been provided in this area. Rehabilitation professionals can have a significant role through provider education, developing improved systems for communication with employers, and encouraging employers to provide more alternative duty assignments.

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

“…Similar findings were made in a study by Pransky and colleagues [17] where the physicians reported barriers in helping the patient return to work, such as long-term sick leave requests, mental disorders, conflict with the employer, and work dissatisfaction [17]. According to previous research, individuals with older age, history of previous sick leave, worse mental and physical functioning, negative expectation of recovery, lower socio-economic status, and impaired work ability are at increased risk for long-term sick leave.…”

“…Physicians are responsible for documenting work demands in sickness certificates, but our findings indicate that physicians and other healthcare professionals have sparse knowledge regarding work demands, and insufficient prerequisites to contact the employer. This supports earlier studies reporting that direct contact with the employer is rare [17,21,37,5], and that physicians rely on patients' self-reports of working conditions and available work modifications rather than obtaining information from the employer [17]. The limited contact with the employer might have implications for patients' return to work.…”

“…Physicians have reported assessments of functioning, work ability, and the need for sick leave as being problematic [6,15,4], especially when the patient describes symptoms that are difficult to diagnose and clinical findings are missing [9,5,13,16]. The sickness certification is then based on the patient's description of his or her symptoms and work situation [17][18][19]. 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 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].…”

Neurologists dealing with sickness certification: Experiences of problems and need of competence

“…Also, most did not have contacts with patients' employers (Table 2). According to previous studies, physicians instead often rely on patients' self‐reports of working conditions rather than obtaining information direct from the employer (Edlund & Dahlgren, 2002; Pransky, Katz, Benjamin, & Himmelstein, 2002). Limited knowledge about work demands might delay the return to work since lack of workplace information gives less opportunity to discuss adjustments of work tasks in relation to the patient's current function.…”