Notably, a systematic review of the literature has also provided evidence that physicians frequently find it problematic to handle sickness certification tasks and that the sick notes they issue are often of low quality [ 1].
Physicians working in gynaecology have been shown to find it especially problematic to handle situations when not agreeing with the patient about need for sick leave [ 8, 46], and more than half (52%% in 2004 and 55%% in 2008) in the former surveys also reported that they perceived it problematic to assess work capacity [ 46].
The proportion having such consultations at least six times per week was higher among specialists, whereas the non-specialists were more likely to find it problematic to handle sickness certifications.> More than half of the physicians perceived it as very or fairly problematic to assess patients' work capacity (57.8 %) and especially so if the patient was unemployed (64.4 %) (Table 3).
GPs in Norway more often worried that patients would go to another physician if they did not issue a certificate, and a higher proportion of Norwegian GPs found it problematic to handle situations where they and their patient disagreed on the need for sick leave.
A significantly larger proportion of GPs in Norway also found it problematic to handle situations in which they and their patient disagreed on the need for sick leave.
Among the physicians who handled sick-leave spells exceeding 90 days, 63 % found it very or fairly problematic to handle spells which had lasted 91 180 days, and 69%% answered the same regarding spells lasting >180 days (Table 3).
However, a significantly larger proportion of GPs in Norway (75%) reported finding it problematic to handle situations in which they and their patient disagreed on the need for sick leave.
That opinion could possibly have contributed to the somewhat high ORs for finding it problematic to handle sickness certifications of most durations among orthopaedists in our study.
Physicians in PHC had the highest ORs (range: 2.70-4.32) findingditg it problematic to handle sick-leave spells with duration of at least 15 days (Table 5).
The proportion having such consultations at least six times per week, and that found them problematic as often, was higher among men compared to among women, whereas the proportion finding sickness certification very or fairly problematic to handle was higher among women.
