No physician gender difference in prescription of sick-leave certification: A retrospective study of the Skaraborg Primary Care Database

Abstract

Objective. The primary objective was to investigate how physicians’ gender and level of experience affects the rate and length of sick-leave certificate prescription. The secondary objective was to study the physicians’ gender and professional experience in relation to the diagnoses on the certificates. Design. Retrospective, cross-sectional study of computerized medical records from 24 health care centres in 2005. Setting. Primary care in Sweden. Subjects. Primary care physicians (n = 589) and patients (n = 88 780) aged 18–64 years. Main outcome measures. Rate and duration of sick leave certified by different categories of physicians and for different diagnoses and gender of patients. Results. Sick leave was certified in 9.0% (musculoskeletal (3%) and psychiatric (2.3%) diagnoses were most common) of all contacts and the mean duration was 32.2 days. Overall there was no difference between male and female physicians in the sick-leave certification prescription rate (9.1% vs. 9.0%) or duration of sick leave (32.1 vs. 32.6 days). The duration of sick leave was associated with the physician's level of professional experience in general practice (GPs (Distriktläkare) 37, GP trainees (ST-läkare) 26, interns (AT-läkare) 20 and locum (vikarier) 19 days, p < 0.001). Conclusion. Contrary to earlier studies we found no difference in sick-leave certification prescription rate and length between male and female physicians.