Sickness certification in the general practice consultation: the patients' perspective, a qualitative study

Background: Up to a third of general practice consultations involve issuing sickness certificates. Recent research has looked at the GPs' perspective of sickness certification but there has been no in-depth research exploring patients' views of these consultations. Aim: To explore patients' views of sickness certification within general practice consultations, and how these could be improved. Methods: A qualitative study was carried out with 12 general practices in South Wales; interview study of 19 patients who had recently received a sick note from a GP. Results: Patients rarely attended just for a sick note, more often wanting advice or an opportunity to ask questions. Patients valued continuity of care, a good doctor–patient relationship, adequate consultation time and discussion about their illness, social situation and work-related issues when consulting with their GP for a sick note. Many patients felt doctors did not have enough time or knowledge of the patient to the able to address this issue adequately and this increased feelings of anxiety. Patients did not feel that being questioned by their GP or discussing return to work threatened the doctor–patient relationship. Conclusions: GPs who simply give out sick notes without question or discussion are not necessarily giving the patient what they want. More time should be spent discussing work and illness-related issues. Policy makers should recognize that continuity of care a good doctor–patient relationship and adequate consultation time are important to patients and any initiatives aimed at GPs to improve return to work rates should take these into consideration