Authorization to Disclose: How Occupational Physicians Interpret Confidentiality in Return-to-Work Negotiations

Area of Science:

• Occupational health
• Medical ethics
• Healthcare policy

Background:

• Return-to-work (RTW) negotiations involve multiple stakeholders, including occupational physicians (OPs).
• Confidentiality of employee health information is a critical ethical and practical consideration in these RTW processes.
• Understanding OPs' perspectives on confidentiality is essential for effective healthcare and workplace collaboration.

Purpose of the Study:

• To analyze how occupational physicians interpret and manage health information confidentiality during multistakeholder return-to-work (RTW) negotiations.
• To explore the complexities and situational factors influencing OPs' decision-making regarding confidentiality in the context of healthcare and working life.

Main Methods:

• A qualitative approach using reflexive thematic analysis.
• Analysis of 14 video-recorded RTW negotiations.
• Analysis of 14 in-depth interviews with participating occupational physicians.

Main Results:

• Four key themes emerged regarding OPs' navigation of confidentiality:
• OPs manage knowledge gaps, balance dual roles to build trust, and link confidentiality to employee disclosure willingness.
• Confidentiality is approached flexibly to facilitate RTW solutions, with interpretations varying based on situational context and negotiation goals.

Conclusions:

• OPs aim to protect employee health discussions and respect autonomy in disclosure during RTW negotiations.
• Confidentiality management in RTW is complex, influenced by competing incentives and requiring careful ethical consideration and policy guidance.
• Enhanced training in interaction skills for OPs is recommended, alongside further research into confidentiality strategies in RTW collaboration.