Irish GP attitudes towards sickness certification and the 'fit note'.
BACKGROUND
Sickness certification poses significant challenges to most general practitioners (GPs). As an alternative form of certification, in 2010, the UK implemented the 'fit note', which focuses on returning to work after illness. It has been well received in the UK but little is known of non-UK GP attitudes towards the fit note.


AIMS
To evaluate the challenges Irish GPs experience with the current sickness certification system and their attitudes towards the fit note.


METHODS
A questionnaire assessing attitudes, practices and preferences regarding the fit note was developed, piloted and posted to a representative sample of Irish GPs selected by systematic sampling. Descriptive statistics, chi-square tests and binary logistic regression were used to analyse the results.


RESULTS
Of 305 GPs surveyed, 64% (196) completed the survey. Ninety per cent (177) of responders reported a lack of available rehabilitation services for patients on sick leave and 66% (124) reported adverse effects of sickness certification on therapeutic relationships with patients. Those who indicated a preference for introducing the fit note (53%; 104) were significantly more likely to endorse both an excessive focus on disability [odds ratio (OR) = 3.16] and lack of GP training (OR = 2.04) in the sickness certification process.


CONCLUSIONS
Difficulties associated with sickness certification are apparent at GP-patient, GP-employer and GP-health service levels. Addressing these will require intervention at each of these levels and may be facilitated by challenging the assumption that illness equates to disability.
['King|R|R|', 'Murphy|R|R|', 'Wyse|A|A|', 'Roche|E|E|']
D000328:Adult D001291:Attitude of Health Personnel D002568:Certification D005260:Female D058005:General Practitioners D019538:Health Care Surveys D058015:Health Communication D006801:Humans D007494:Ireland D008297:Male D008875:Middle Aged D009787:Occupational Medicine D010818:Practice Patterns, Physicians' D036301:Qualitative Research D062707:Return to Work D018582:Sick Leave D014938:Work Capacity Evaluation
Fit note fitness to work general practice occupational health sick certification.