L. Englund et al., Variations in sick-listing practice among male and female physicians of different specialities based on case vignettes, SC J PRIM H, 18(1), 2000, pp. 48-52
Objective - To analyse the influence on sick-listing of speciality and sex
of the prescribing doctor and of patients' way of presenting their problem.
Design - A sample of 360 general practitioners (GPs), 180 psychiatrists and
180 orthopaedic surgeons were presented case vignettes and asked to fill i
n a sick certificate for each case. The cases were chosen to reflect common
causes of sick-listing in Sweden. The vignettes for each case were present
ed in three versions with uniform biomedical information plus a variation i
n the patient's attitude to sick-listing.
Setting - Swedish general practice and hospital physicians.
Main outcome measures - Proportion of cases not being sick-listed and costs
for the period certified.
Results - The most important factor affecting sick-listing was the patient'
s attitude to sick-listing. Patients wishing sick-listing were sick-listed
to a greater extent than those who were reluctant. In addition, GPs sick-li
sted more than orthopaedic surgeons and less than psychiatrists. Female doc
tors sick-listed more than male doctors, irrespective of speciality and pat
ient attitude.
Conclusion - Sick-listing is influenced by the physician's speciality and s
ex. Doctors are strongly influenced by how the patients present their probl
em.