The Role and Influence of Care Providers on Work Disability
Although health care providers often have a central role in the prevention and treatment of work disability, their contribution has not been consistently positive. This is unfortunate, as the consequences of unnecessary work disability include ill health and economic deprivation. Often, patients report that health care providers pay little attention to the work-related consequences of their illness, except when required by law to issue sickness certificates. Common problems include failure to recognize work disability as an important consideration, over-focus on biomedical issues and symptoms rather than on function, irrational cognitions about work and health, employing ineffective treatments, and inability to deal with workplace and social issues. Provider education, economic incentives, peer leadership, and support to address work disability issues can make a difference in provider influences on work outcomes. A change in paradigm is suggested, based in large part on improved communication among workers, employers, and health care providers. The evidence base for a positive health care providers’ influence is growing and in several countries evidence-based practice guidelines are available that directly address work disability issues. Practical research on how to achieve meaningful change in health care provider attitudes and practices in relation to work disability is still needed. Work disability prevention should be a goal for all health care providers.
KeywordsFatigue Arthritis Depression Dermatitis Lost
- Anema, J. R., Jettinghoff, K., Houtman, I. L. D., Schoemaker, C. G., Buijs, P. C., & van den Berg, R. (2006). Medical care of employees long-term sick listed due to mental health problems: A cohort study to describe and compare the care of the occupational physician and the general practitioner. Journal of Occupational Rehabilitation, 16(1), 41–52.PubMedCrossRefGoogle Scholar
- Anema, J. R., Van Der Giezen, A. M., Buijs, P. C., & Van Mechelen, W. (2002). Ineffective disability management by doctors is an obstacle for return-to-work: A cohort study on low back pain patients sick listed for 3–4 months. Occupational and Environmental Medicine, 59(11), 729–733.PubMedCrossRefGoogle Scholar
- Black, C. (2008). Working for a healthier tomorrow. London: The Stationery Office.Google Scholar
- Black, C., & Frost, D. (2011). Health at work—An independent review of sickness absence. London: The Stationery Office.Google Scholar
- de Boer, W. E., Mentink, R. H., Hulshof, C. T., van Barneveld, T., Sterk, A., & van Vliet, C. (2008). Blauwdruk participeren in richtlijnen Leidraad voor het effectief opnemen van participeren en functioneren in werk in richtlijnen (Guidance for the effective integration of work-related aspects in clinical practice guidelines). Utrecht: VGI/NVAB/CBO.Google Scholar
- de Boer, A. G. E. M., Taskila, T., Tamminga, S. J., Frings-Dresen, M. H. W., Feuerstein, M., & Verbeek, J. H. (2011). Interventions to enhance return-to-work for cancer patients. Cochrane Database of Systematic Reviews, (2), CD007569. doi: 10.1002/14651858.CD007569.pub2.
- Domenech, J., Sánchez-Zuriaga, D., Segura-Ortí, E., Espejo-Tort, B., & Lisón, J. F. (2011). Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: A randomised clinical trial. Pain, 152, 2557–2563.PubMedCrossRefGoogle Scholar
- Faber, E., Bierma-Zeinstra, S. M. A., Burdorf, A., Nauta, A. P., Hulshof, C. T. J., & Overzier, P. M. (2005). Training general practitioners and occupational physicians to collaborate does not influence sick leave of low back pain patients. Journal of Clinical Epidemiology, 58, 75–82.PubMedCrossRefGoogle Scholar
- Health and Work Development Unit. (2010). Depression detection and management of staff on long term sickness absence—Occupational health practice in the NHS in England: A national clinical audit—Round 2. London: RCP.Google Scholar
- Healthcare Professionals’ Consensus Statement. (2008). Retrieved February 13, 2012, from http://www.dwp.gov.uk/docs/hwwb-healthcare-professionals-consensus-statement-04-03-2008.pdf.
- Heijens, M. R. M., Elders, L. A. M., & Burdorf, A. (2003). Prognostische factoren voor langdurig ziekteverzuim door klachten van het bewegingsapparaat onder verzuimers. TSG/Gezondheidsw, 81, 142–147 (in Dutch).Google Scholar
- Houben, R. M., Ostelo, R. W., Vlaeyen, J. W., Wolters, P. M., & Peters, M. (2005). Health care providers’ orientations towards common low back pain predict perceived harmfulness of physical activities and recommendations regarding return to normal activity. European Journal of Pain, 9(2), 173–183.PubMedCrossRefGoogle Scholar
- Hulshof, C. T. J., & Frings-Dresen, M. H. W. (2011). International OH systems Part 2: Occupational health delivery in the Netherlands. Occupational Health at Work, 6(5), 19–23.Google Scholar
- Institute of Medicine. (2011). Clinical practice guidelines we can trust. Washington, DC: The National Academies Press.Google Scholar
- Kremer, L. C. M., & Burgers, J. S. (Eds.). (2011). Guideline for guidelines (in Dutch). Den Haag: Regieraad Kwaliteit van Zorg.Google Scholar
- NVAB (Netherlands Society of Occupational Medicine), Coronel Instituut voor Arbeid en gezondheid, NFK, CBO. (2008). Blauwdruk Kanker en Werk (Guidance Document on Cancer and Work). Utrecht: NVAB.Google Scholar
- Occupational Health Clinical Effectiveness Unit. (2009). Back pain management—Occupational health practice in the NHS in England: A national clinical audit. London: RCP.Google Scholar
- Rebergen, D. S., Bruinvels, D. J., Bos, C. M., van der Beek, A. J., & van Mechelen, W. (2010). Return to work and occupational physicians’ management of common mental health problems-process evaluation of a randomized controlled trial. Scandinavian Journal of Work, Environment & Health, 36(6), 488–498.CrossRefGoogle Scholar
- Smits, P. B. A., de Graaf, L., Radon, K., de Boer, A. G., Bos, N. R., van Dijk, F. J. H., et al. (2011). Case-based e-learning to improve the attitude of medical students towards occupational health, a randomised controlled trial. Occupational and Environmental Medicine, 69(4), 280–283.PubMedCrossRefGoogle Scholar
- van Rijssen, J., Schellart, A. J. M., Anema, J. R., de Boer, W. E. L., & van der Beek, A. J. (2011). Systematic development of a communication skills training course for physicians performing work disability assessments: From evidence to practice. BMC Medical Education, 11, 28.PubMedCrossRefGoogle Scholar
- Varekamp, I., Verbeek, J. H., de Boer, A., & van Dijk, F. J. H. (2011). Effect of job maintenance training program for employees with chronic disease—A randomized controlled trial on self-efficacy, job satisfaction, and fatigue. Scandinavian Journal of Work, Environment & Health, 37(4), 288–297.CrossRefGoogle Scholar
- Varekamp, I., Verbeek, J. H. A. M., & van Dijk, F. J. H. (2006). How can we help employees with chronic diseases to stay at work? A review of interventions aimed at job retention and based on an empowerment perspective. International Archives of Occupational and Environmental Health, 80, 87–97.PubMedCrossRefGoogle Scholar
- Verbeek, J. H. (2006). How can doctors help their patients to return to work? PLoS Medicine. doi: 10.1371/journal.pmed.0030088.
- Verbeek, J., & Spelten, E. (2007). Work. In M. Feuerstein (Ed.), Handbook of cancer survivorship. Berkely: Springer.Google Scholar
- Waddell, G., & Burton, A. K. (2006). Is work good for your health and well-being? London: The Stationery Office.Google Scholar
- WHO. (2007). Global plan of action on workers’ health. Geneva: WHO.Google Scholar
- WHO, TNO, Government of the Netherlands. (2011). Programme global conference. Connecting health and labour: What role for occupational health in primary health care? The Hague, WHO global conference, 29 November to 1 December 2011.Google Scholar
- World Health Organization. (2001). International classification of functioning, disability and health. Geneva: World Health Organization. Retrieved December 24, 2011, from http://www.who.int/classifications/icf/en