How consistent are sick leave assessments? Variation among primary care physicians in Sweden

Area of Science:

• Occupational Health
• Medical Assessment
• Healthcare Policy

Background:

• Determining work capacity and sick leave is complex, with existing evidence suggesting variability in physician assessments.
• Previous studies have yielded inconclusive results, often focusing narrowly on whether to recommend sick leave.

Purpose of the Study:

• To examine the medical reliability and consistency of physicians' work capacity assessments.
• To analyze variations in reported reduced work capacity and recommended sick leave duration.

Main Methods:

• A cross-sectional survey involving 142 primary care physicians in Sweden.
• Physicians assessed six anonymized medical certificates for mental health and pain-related conditions.
• Data collected on reduced work capacity, sick leave duration, physician characteristics, and perceived managerial support.

Main Results:

• Considerable variation in sick leave scores was observed across physicians and cases.
• Male physicians and those with more experience recommended longer sick leave for pain-related cases.
• Perceived managerial support correlated with lower sick leave scores; no association found with patient involvement.

Conclusions:

• Sick leave assessments exhibit inconsistency, influenced by physician-specific factors, especially for pain conditions.
• Enhanced support structures, knowledge exchange, and clearer guidelines are recommended.
• Interventions should aim to reduce unwarranted variation and improve the reliability of medical assessments for sick leave.