title: Frequency and nature of problems associated with sickness certification tasks: a cross-sectional questionnaire study of 5455 physicians.
abstract: OBJECTIVE
  To study the frequency and nature of problems associated with physicians' sickness certification practices.
  
  
  METHODS
  Cross-sectional questionnaire study.
  
  
  METHODS
  Stockholm and Ostergötland Counties in Sweden.
  
  
  METHODS
  Physicians aged < or = 64 years, n =7665, response rate 71% (n =5455).
  
  
  METHODS
  The frequency of consultations involving sickness certification, the frequency and nature of problems related to sickness certification.
  
  
  RESULTS
  A total of 74% (n =4019) of the respondents had consultations including sickness certification at least a few times a year. About half of these physicians had sickness certification cases at least six times a week, and 1 out of 10 (9.4%) had this more than 20 times a week. The items that the highest percentage of physicians rated as very or fairly problematic included: handling conflicts with patients over certification, assessing work ability, estimating optimal length and degree of absence, and managing prolongation of sick leave initially certified by another physician. There were large differences in frequency and nature of problems between different types of clinics/practices. General practitioners had the highest frequency of problems concerning sickness certification while the lowest was found among specialists in internal medicine and surgery.
  
  
  CONCLUSIONS
  Sickness certification should be recognized as an important task also for physicians other than general practitioners. The physicians experienced problems with numerous tasks related to sickness certification and these varied considerably between types of clinics. The high rate of problems experienced may have consequences for the physicians' work situation, for patients, and for society.
authors.affiliation: Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. anna.lofgren@ki.se
authors.forename: Anna
authors.initials: A
authors.lastname: Löfgren
authors.forename: Jan
authors.initials: J
authors.lastname: Hagberg
authors.forename: Britt
authors.initials: B
authors.lastname: Arrelöv
authors.forename: Sari
authors.initials: S
authors.lastname: Ponzer
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002568:Certification; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005194:Family Practice; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010821:Physicians, Family; D018582:Sick Leave; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D014938:Work Capacity Evaluation