Variations in sick-listing practice among male and female physicians of different specialities based on case vignettes.
OBJECTIVE
To analyse the influence on sick-listing of speciality and sex of the prescribing doctor and of patients' way of presenting their problem.


METHODS
A sample of 360 general practitioners (GPs), 180 psychiatrists and 180 orthopaedic surgeons were presented case vignettes and asked to fill in a sick certificate for each case. The cases were chosen to reflect common causes of sick-listing in Sweden. The vignettes for each case were presented in three versions with uniform biomedical information plus a variation in the patient's attitude to sick-listing.


METHODS
Swedish general practice and hospital physicians.


METHODS
Proportion of cases not being sick-listed and costs for the period certified.


RESULTS
The most important factor affecting sick-listing was the patient's attitude to sick-listing. Patients wishing sick-listing were sick-listed to a greater extent than those who were reluctant. In addition, GPs sick-listed more than orthopaedic surgeons and less than psychiatrists. Female doctors sick-listed more than male doctors, irrespective of speciality and patient attitude.


CONCLUSIONS
Sick-listing is influenced by the physician's speciality and sex. Doctors are strongly influenced by how the patients present their problem.
Englund
L
L
Department of Public Health and Caring Sciences, Uppsala University, University Hospital, Sweden.
Tibblin
G
G
Svärdsudd
K
K
D005260:Female; D017048:Health Care Costs; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010820:Physicians; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D012737:Sex Factors; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data*; D013038:Specialization; D013548:Sweden