Does the doctor or the patient control sick leave certification? A qualitative study interpreting patients' interview dialogue.
BACKGROUND
Sickness certification poses challenges and problems for the GP. Patient factors may influence the sick leave period.


OBJECTIVE
To explore how sickness certification occurred based on patients' reports of medical consultations for a new episode of low back pain.


METHODS
A qualitative study using semi-structured interviews with 16 employees who were currently or had recently been off work with an episode of low back pain.


RESULTS
We present a preliminary typology of sickness certification responses by medical practitioners comprising four response types: 'process', 'cued', 'consultative' and 'laissez-faire'. All but the process response allows the patient some influence in the sickness certification decision. It is possible that certain types of response may occur at specific stages of recovery.


CONCLUSIONS
Doctors may allow patients input into the sickness certification process for a number of reasons. As yet, we do not know if this helps or hinders the return to work process.
Centre of Methods and Policy Application in the Social Sciences, The University of Auckland, Auckland 1142, New Zealand. w.wrapson@auckland.ac.nz
Wendy
W
Wrapson
Avril J
AJ
Mewse
D000328:Adult; D001291:Attitude of Health Personnel; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010817:Physician-Patient Relations; D036301:Qualitative Research; D018582:Sick Leave / Q000706:statistics & numerical data*; D014942:Workers' Compensation