Sickness certification of patients--a work environment problem among physicians?

Area of Science:

• Occupational Health
• Medical Practice Management
• Public Health Policy

Background:

• Physician-reported challenges with sickness certification are documented.
• Smaller studies suggest these difficulties stem from psychosocial work environment problems (WEP).

Purpose of the Study:

• To assess the prevalence of physicians experiencing sickness certification as a WEP.
• To examine associations between this experience and clinic type/workplace factors.

Main Methods:

• A nationwide questionnaire survey of physicians in Sweden (aged <65) performing sickness certification tasks (SCTs).
• Prevalence rates (PR) and 95% confidence intervals (CI) were calculated for WEP experiences.
• Statistical adjustments were made for educational level and consultation frequency.

Main Results:

• A 61% response rate yielded 14,210 eligible physicians.
• 50% of physicians experienced SCTs as a WEP, with 11% reporting it to a great extent.
• Highest WEP prevalence in general practice (73%), orthopaedics (68%), rheumatology (67%), neurology (59%), and psychiatry (58%).
• Adjusted PRs for significant WEP were 4.05 (general practice), 2.67 (psychiatry), and 2.66 (orthopaedics) vs. internal medicine.

Conclusions:

• Physicians frequently perceive sickness certification as a significant work environment problem.
• Specific clinical areas, notably general practice and orthopaedics, show disproportionately higher WEP rates.
• Interventions are crucial to enhance the physician work situation concerning sickness certification.