[Longer medical certificates do not improve the quality of physicians' assessments]

Sickness certification is a common and demanding task in Swedish primary care, particularly for patients with mental health conditions, for whom assessments of work ability and functional impairment are often associated with considerable uncertainty. Drawing on the findings of Falk et al., the authors argue that longer or more detailed sickness certificates do not improve the consistency or quality of physicians' assessments but do increase the administrative burden. The authors advocate shifting the focus from documentation towards active rehabilitation. Suggested strategies include earlier access to evidence-based treatment, greater use of part-time sickness absence, stronger workplace involvement, and closer collaboration among healthcare services,occupational health services, employers, the Social Insurance Agency, and the Public Employment Service. Behavioural medicine approaches may also help strengthen patients' problem-solving skills and reduce the risk of prolonged dependence on sickness absence.