Neurologists dealing with sickness certification: Experiences of problems and need of competence.

Rationale and Aims: Most studies on physicians' sickness certification practices include general practitioners (GP) while there hardly is any knowledge on this regarding neurologists although neurological diseases often involve work incapacity and need of sick leave. Aim: The aim was to describe experiences among neurologists in Sweden concerning their work with sickness certification of patients. Method: A cross-sectional study of 265 neurologists' responses in a nationwide survey regarding their work with sickness certification of patients was conducted. Results: The majority (81.5%) had sickness certification consultations at least once a week and a third experienced problems every week in handling sickness certification. Among the 251 who at least sometimes had sickness certification consultations, the following two aspects were experienced as very or fairly problematic: "assess the degree to which the reduced functional capacity limits a patient's capacity to perform his/her work assignments" (67.3%) and "make a long-term prognosis about the future work capacity of patients on sick leave" (60.5%). At least once a week, 78.7% experienced lack of time regarding managing patient-related aspects of the sickness certification task. Moreover, 21.8% considered sickness certification to be a work environmental problem, at least once a week. In all, 84% stated that they had a large or fairly large need for more competence concerning sickness certification tasks. Conclusions: Sickness certification is a common task among neurologists, involving several problematic aspects related to, e.g., lack of competence in assessing function and work capacity and of time. There is a need for improvement.