title: Problems experienced by gynecologists/obstetricians in sickness certification consultations.
abstract: OBJECTIVE
  To explore frequencies and experiences with problems in sickness certification consultations among gynecologists and obstetricians in two different years.
  
  
  METHODS
  Cross-sectional surveys on two occasions; in 2004 and 2008.
  
  
  METHODS
  Gynecological, obstetric and maternal health care.
  
  
  METHODS
  Physicians working in gynecology, obstetrics or maternal health care in two Swedish counties from two samples: in 2004 (n = 315), and in 2008 (n = 327).
  
  
  METHODS
  Data regarding sickness certification consultations were obtained from comprehensive questionnaires that had been mailed to the physicians in two Swedish counties in 2004 and in 2008, respectively.
  
  
  METHODS
  Frequencies and types of problems in sickness certification consultations, organizational support, and need to acquire more competence.
  
  
  RESULTS
  The majority experienced that patients requested to be on sick leave for a reason other than work incapacity due to disease or injury, at least a few times per year (85% in 2004 and 88% in 2008). The most problematic situation to handle was when the physician and the patient had different opinions about the need for sick leave (2004: 66% and 2008: 58%). The physicians expressed a need for more competence about the options and responsibilities of employers, social insurance officers and physicians in sickness certification cases.
  
  
  CONCLUSIONS
  Most gynecologists/obstetricians find sickness certification consultations problematic and especially when encountering patients requesting to be on sick leave for reasons other than disease. The physicians expressed a need for more competence in insurance medicine, especially about their own and other stakeholders' options and responsibilities.
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. catharina.gustavsson@ki.se
authors.forename: Catharina
authors.initials: C
authors.lastname: Gustavsson
authors.forename: Linnea
authors.initials: L
authors.lastname: Kjeldgård
authors.forename: Richard
authors.initials: R
authors.lastname: Bränström
authors.forename: Christina
authors.initials: C
authors.lastname: Lindholm
authors.forename: Therese
authors.initials: T
authors.lastname: Ljungquist
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Nilsson
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006176:Gynecology; D006801:Humans; D009774:Obstetrics; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Gynecology; maternal health care; obstetrics; physicians; sick leave; sickness certification consultations