[Physician's role in certification for sick leave]]

The aim of the study was to analyse general practitioners' decisions when certifying patients as sick. The study was conducted among 38 general practitioners in Bergen, Norway, during two weeks in March 1990. The need for certification of sickness was considered for 328 patients. Among these 91% were certified as sick and 9% were not found to be incapable of work. If the patients took the first initiative for certification, 95% received a certificate, while 84% were certified sick when the doctors took the first initiative (p < 0.001). When no objective signs, symptoms or findings were registered by the general practitioners, the patients took the first initiative for sickness certification in 85% and the doctor in 15% (p = 0.001) of the cases. The study indicates that the patients are a stronger controlling element than the general practitioners in the process of certification of sickness.