Occupational health physicians have better work conditions for handling sickness certification compared with general practitioners: results from a nationwide survey in Sweden.
OBJECTIVE
To study whether occupational health physicians (OPs) have a better work situation regarding handling of sickness certification compared with other physicians, in particular general practitioners (GPs), and to analyze associations between OPs' experiences of assessing and providing a long-term prognosis of patients' work capacity and some potentially interrelated factors.


METHODS
Answers to a nationwide survey from physicians who had sickness certification consultations at least once monthly were analyzed. Differences among OPs (n=481), GPs (n=4257) and physicians working in other clinical settings (n=9452) were estimated by chi square tests. Associations between OPs' experiences as above and potentially interrelated factors were estimated using logistic regression analyses.


RESULTS
Among OPs, a lower proportion experienced clinical work situations related to sickness certifications as 'very problematic', compared with the other physicians, and especially so compared with GPs. A higher proportion of OPs also had organizational support for handling sickness certifications. For OPs, experience of sickness certification consultations as problematic once a month or less often, not experiencing sickness certification tasks as a work environment problem, and having a well-established workplace policy regarding sickness certification matters were significantly positively associated with finding assessing and providing a long-term prognosis of work capacity as 'not at all/somewhat problematic'.


CONCLUSIONS
OPs' work situation regarding sickness certifications was favorable compared with that of other physicians, and especially compared with that of GPS. Our results underline the importance of organizational support for ensuring physicians' experience of having professional competence in handling assessments of patients' work capacity.
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden therese.ljungquist@ki.se.
Therese
T
Ljungquist
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden.
Kristina
K
Alexanderson
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden.
Linnea
L
Kjeldgård
Stockholm County Council, Sweden.
Britt
B
Arrelöv
Department of Neurobiology, Care Sciences and Society, Centre for Family and Community Medicine, Karolinska Institutet, Sweden.
Gunnar H
GH
Nilsson
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002568:Certification; D005260:Female; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D054538:Occupational Health Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D015279:Organizational Culture; D018582:Sick Leave; D012944:Social Support; D013548:Sweden; D014938:Work Capacity Evaluation; D017132:Workplace / Q000458:organization & administration; D055815:Young Adult
General practice; general practitioner; insurance medicine; occupational health physician; physician; sick leave; sickness certification