Enhancing medical evaluations of sick-listed employees: an educational intervention to improve professional practice of physicians performing work ability assessments of employees on long-term sick leave

  • Patricia M. Dekkers-SánchezEmail author
  • Annette E. de Wind
Original Article



Long-term sick leave (LTSL) is a complex phenomenon. Medical and non-medical factors can delay return-to-work (RTW); therefore, the assessment of work ability is complicated. A checklist for identifying factors associated with delayed RTW was developed in a prior study to facilitate the exploration of barriers and facilitators for RTW. The purpose of the present study was to determine if use of the checklist enhances professional practice of physicians performing work ability assessments of employees on long-term sick leave and whether the reporting of work ability assessments improved when using the checklist in the routinely practice-based context.


An educational intervention study was performed using qualitative framework analysis. Thirty-five Dutch physicians were asked to identify and report the barriers and facilitators for RTW and the consequences for the work ability and for the prognosis regarding work reintegration using the checklist. A pre-post qualitative analysis of the medical records was performed using a gradual classification of the reporting of the work ability to evaluate the change in reporting following the educational intervention.


A total of 337 work ability assessments were performed using the checklist. The identification of factors influencing RTW and the comprehensiveness of the medical records increased when compared with the reporting before the educational intervention. The reporting of the work ability assessments improved after the educational intervention. Most physicians reported at least one of the factors of the checklist. 72% participants reported and described adequately at least one factor. 48% participants reported how the factors influenced the work ability, 20% participants reported how the factors influenced the prognosis regarding RTW and 12% participants reported which advice was provided by the physician to influence the barriers for RTW.


Use of the checklist enhances professional practice of physicians performing work ability assessments of employees on long-term sick leave and is associated with increased identification of barriers and facilitators for RTW. The use of the checklist should be considered to improve professional practice of physicians performing work ability assessments.


Work ability assessment Long-term sick leave Checklist Return to work Factors Educational intervention 


Author contributions

PMD-S: conception and design, acquisition of data, analysis and interpretation of data, writing the manuscript, revising it critically for important intellectual content, final approval of the version to be published. AW: acquisition of data, qualitative analysis of data, revising it critically for important intellectual content, final approval of the version to be published.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interests.

Ethical standards

The present study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Social Medical AffairsDutch Employee Insurance Agency (UWV)RotterdamThe Netherlands
  2. 2.Environment and Health, Department of Public Health and Primary CareKU Leuven UniversityLeuvenBelgium

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