Abstract
BackgroundThe study aimed to explore the views of general practitioners (GPs), nurses and physiotherapists towards extending the role of sickness certification beyond the medical profession in primary care.MethodsFifteen GPs, seven nurses and six physiotherapists were selected to achieve varied respondent characteristics including sex, geographical location, service duration and post-graduate specialist training. Constant-comparative qualitative analysis of data from 28 semi-structured telephone interviews was undertaken.ResultsThe majority of respondents supported the extended role concept; however members of each professional group also rejected the notion. Respondents employed four different legitimacy claims to justify their views and define their occupational boundaries in relation to sickness certification practice. Condition-specific legitimacy, the ability to adopt a holistic approach to sickness certification, system efficiency and control-related arguments were used to different degrees by each occupation. Practical suggestions for the extension of the sickness certification role beyond the medical profession are underpinned by the sociological theory of professional identity.ConclusionsExtending the authority to certify sickness absence beyond the medical profession is not simply a matter of addressing practical and organisational obstacles. There is also a need to consider the impact on, and preferences of, the specific occupations and their respective boundary claims. This paper explores the implications of extending the sick certification role beyond general practice. We conclude that the main policy challenge of such a move is to a) persuade GPs to relinquish this role (or to share it with other professions), and b) to understand the ‘boundary work’ involved.
Highlights
The study aimed to explore the views of general practitioners (GPs), nurses and physiotherapists towards extending the role of sickness certification beyond the medical profession in primary care
Previous research highlights that cost savings achieved through the substitution of doctors for primary care nurses may be offset by the lower productivity of nurses and potential increase in doctor-workload due to nurses meeting previously unmet needs or generating demand for care where previously none existed [6]
GPs highlighted their skill in managing complex multimorbidity, indicating that sickness certification by nurses or physiotherapists for such cases would be less acceptable whilst nurses reinforced GP views of nurses certifying straight-forward cases
Summary
The study aimed to explore the views of general practitioners (GPs), nurses and physiotherapists towards extending the role of sickness certification beyond the medical profession in primary care. This is relevant to primary health care teams, who have evolved to include extended roles for non-medical health professionals including nurses and physiotherapists. Primary care nurses are increasingly becoming the first point of contact for healthcare and are managing chronic disease [3] and physiotherapists often manage patients with minimal input from the general practitioner [4]. Previous research highlights that cost savings achieved through the substitution of doctors for primary care nurses may be offset by the lower productivity of nurses and potential increase in doctor-workload due to nurses meeting previously unmet needs or generating demand for care where previously none existed [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
