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Barriers to good sickness certification -- an interview study with Swedish general practitioners
Malin S Swartling1, Kristina A E Alexanderson, Rolf A Wahlstrom
1Department of Neurosciences, Rehabilitation Medicine, Uppsala University, Sweden. malin.swartling@rehab.uu.se
Scandinavian Journal of Public Health
|June 10, 2008
Summary
General practitioners (GPs) face numerous barriers to optimal sick-listing practices. Addressing these challenges, particularly communication skills in difficult situations, is crucial for improving sickness certification and patient care.
Area of Science:
- Medical Practice
- Healthcare Management
- Occupational Health
Background:
- No established gold standard exists for sick-listing practices.
- Physicians encounter significant challenges in sickness certification.
- Previous interventions to improve sick-listing have yielded ambiguous results.
Purpose of the Study:
- To identify barriers preventing general practitioners (GPs) from optimal sick-listing.
- To inform the development of effective interventions for sick-listing practices.
Main Methods:
- Qualitative content analysis of semi-structured interviews.
- 19 GPs from 17 primary healthcare centers in Sweden participated.
- Focus on identifying barriers to good sick-listing practices.
Main Results:
- Internal healthcare system barriers include complex clinical judgments, physician competence issues, and system deficiencies.
- External barriers involve societal attitudes, labor market dynamics, patient social issues, and stakeholder collaboration.
- GPs reported difficulties in managing conflicting perceptions of sickness certification needs.
Conclusions:
- GPs face multiple barriers to their perceived ideal sick-listing practices.
- Interventions must address identified barriers for effective change.
- Recommended interventions include communication skills training, focusing on challenging sick-listing scenarios.
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