title: Occupational Physicians' Reasoning about Recommending Early Return to Work with Work Modifications.
abstract: Previous research indicates that work modifications can effectively enhance return to work (RTW) at an early stage of work disability. We aimed to examine how occupational physicians (OPs) reason about recommending early return to work (RTW) with work modifications. Pre-defined propositions regarding the use of work modifications in promoting early RTW were discussed in four focus groups with altogether 11 Finnish OPs. Discussions were audio recorded, and the transcribed data were analyzed using qualitative content analysis. Five different rationales for supporting early RTW were identified: to manage medical conditions, to enhance employee well-being, to help workplace stakeholders, to reduce costs to society, and to enhance OP's own professional fulfillment. However, OPs identified situations and conditions in which early RTW may not be suitable. In addition, there were differences between the OPs in the interpretation of the rationales, suggesting variation in clinical practice. In conclusion, encouraging early RTW with work modifications was perceived by OPs as a meaningful task and, to a large extent, beneficial for employees and several stakeholders. However, this practice was not accepted without consideration to the RTW situation and context. If early RTW and work modifications are to be promoted, OPs should be offered education that addresses their views regarding this practice.
authors.affiliation: Prevention of Work Disability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Horppu
authors.affiliation: Prevention of Work Disability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Kari-Pekka
authors.initials: KP
authors.lastname: Martimo
authors.affiliation: Prevention of Work Disability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Eira
authors.initials: E
authors.lastname: Viikari-Juntura
authors.affiliation: Prevention of Work Disability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.|Centre for Research on Work Disability Policy, Institute for Work & Health, Toronto, Canada.
authors.forename: Ellen
authors.initials: E
authors.lastname: MacEachen
mesh_terms: D003657:Decision Making; D006801:Humans; D016272:Occupational Health; D010820:Physicians; D062707:Return to Work; D018582:Sick Leave; D013997:Time Factors