Journal of Occupational Rehabilitation

, Volume 23, Issue 3, pp 450–461 | Cite as

Primary Healthcare Professionals’ Experiences of the Sick Leave Process: A Focus Group Study in Sweden

  • Emma NilsingEmail author
  • Elsy Söderberg
  • Carina Berterö
  • Birgitta Öberg


Purpose The aim of this study was to explore primary healthcare (PHC) professionals’ experiences of the sick leave process. Methods This is an explorative study using data from four semi-structured focus group discussions with a purposeful sample of PHC professionals in Östergötland County, Sweden. Content analysis with an inductive approach was used in the analysis. Results Four key themes emerged from the analysis; priority to the sick leave process, handling sickness certifications, collaboration within PHC and with other stakeholders, and work ability assessments. Patients’ need for sick leave was handled from each professional group’s perspective. Collaboration was considered important, but difficult to achieve and all the competencies available at the PHC centre were not used for work ability assessments. There was insufficient knowledge of patients’ work demands and contact with an employer was rare, and the strained relationship with the social insurance officers affected the collaboration. Conclusions This study highlights the challenges physicians and other PHC professionals face when handling the need for sick leave, especially when encountering patients with symptom-based diagnoses, and the influence of non-medical factors. Hindrances to good practice were increased demands, collaboration, and role responsibility. The challenges in the sick leave process concerned both content and consequences related to poor collaboration within PHC and with representatives from various organizations, primarily employers and social insurance officers. Further research on how to develop a professional approach for handling the sick leave process is needed.


Sick leave Work ability Rehabilitation Return to work Physicians Healthcare professionals Sickness certificates Primary healthcare Sweden 



The authors would like to thank all the healthcare professionals who agreed to be interviewed.

Conflict of interest

The authors declare that they have no competing interests. The study was funded by the County Council in Östergötland, Sweden.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Emma Nilsing
    • 1
    Email author
  • Elsy Söderberg
    • 2
  • Carina Berterö
    • 3
  • Birgitta Öberg
    • 1
  1. 1.Division of Physiotherapy, Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
  2. 2.Division of Community Medicine, Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
  3. 3.Division of Nursing Science, Department of Medical and Health SciencesLinköping UniversityLinköpingSweden

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