NEW RESEARCH:GENERAL PRACTITIONERS find the process of writing "sick notes" both complex and challenging, new research has found.
Michelle Smith, an epidemiologist at the School of Health Science at the Waterford Institute of Technology, told The Irish Timesthat the issue of sickness certification was not as "cut and dried" as employers group Isme claimed.
Last January, Isme carried out a survey of its 750 members in which companies said some 83 per cent of unauthorised time off was due to feigned illness or malingering.
Ms Smith said her in-depth survey, which is part of research to be presented for a PhD at Manchester University, showed family doctors felt the certification process conflicted with the traditional aspects of the doctor-patient relationship. "If you have built up a relationship with a patient then it is difficult to refuse a sick note in tragic circumstances," one doctor noted.
Respondents also said it was easier to certify chronic illness when clinical signs were present. And GPs said employment policies in different companies affected sick certification decisions. There was mixed opinion among doctors as to whether an exact diagnosis needed to be disclosed to employers. Some GPs felt if the problem was stress-related, it would be helpful if the employer was aware of the issue.
However, all agreed the final decision ay with the patient.
"Many GPs wish to change the current system by expanding the role of occupational health departments [ in industry] through the introduction of a self-certification system for short-term certification and through a graded return to work," Ms Smith said.
A study of diabetes presented at the meeting found that people with type 2 diabetes who were cared for by family doctors achieved similar outcomes to patients in hospital.
Dr Laura O'Flynn, a GP registrar with the Royal College of Surgeons in Ireland training scheme, carried out the survey among patients attending practices in Dublin's inner city.
She found that while improvements had occurred since a similar survey in 2004, weight and blood pressure control "continues to remain ongoing challenges in terms of optimal care in the GP setting".
Her research won the GP registrar's research prize at the meeting.