IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v107y2014icp52-60.html
   My bibliography  Save this article

General practitioners' management of the long-term sick role

Author

Listed:
  • Higgins, Angela
  • Porter, Sam
  • O'Halloran, Peter

Abstract

In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees/patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons's model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

Suggested Citation

  • Higgins, Angela & Porter, Sam & O'Halloran, Peter, 2014. "General practitioners' management of the long-term sick role," Social Science & Medicine, Elsevier, vol. 107(C), pages 52-60.
    • Handle: RePEc:eee:socmed:v:107:y:2014:i:c:p:52-60
    DOI: 10.1016/j.socscimed.2014.01.044
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953614000719
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2014.01.044?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Rigmar Osterkamp & Oliver Röhn, 2007. "Being on Sick Leave: Possible Explanations for Differences of Sick-leave Days Across Countries," CESifo Economic Studies, CESifo Group, vol. 53(1), pages 97-114, March.
    2. Glenton, Claire, 2003. "Chronic back pain sufferers--striving for the sick role," Social Science & Medicine, Elsevier, vol. 57(11), pages 2243-2252, December.
    3. Rhodes, Lorna A. & McPhillips-Tangum, Carol A. & Markham, Christine & Klenk, Rebecca, 1999. "The power of the visible: the meaning of diagnostic tests in chronic back pain," Social Science & Medicine, Elsevier, vol. 48(9), pages 1189-1203, May.
    4. Ian Kirkpatrick & Stephen Ackroyd & Richard Walker, 2005. "The New Managerialism and Public Service Professions," Palgrave Macmillan Books, Palgrave Macmillan, number 978-0-230-50359-5, December.
    5. Armstrong, David, 2002. "Clinical autonomy, individual and collective: the problem of changing doctors' behaviour," Social Science & Medicine, Elsevier, vol. 55(10), pages 1771-1777, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sim, Julius & Madden, Sue, 2008. "Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies," Social Science & Medicine, Elsevier, vol. 67(1), pages 57-67, July.
    2. Nettleton, Sarah, 2006. "'I just want permission to be ill': Towards a sociology of medically unexplained symptoms," Social Science & Medicine, Elsevier, vol. 62(5), pages 1167-1178, March.
    3. Wilson, Nicky & Pope, Catherine & Roberts, Lisa & Crouch, Robert, 2014. "Governing healthcare: Finding meaning in a clinical practice guideline for the management of non-specific low back pain," Social Science & Medicine, Elsevier, vol. 102(C), pages 138-145.
    4. Perrotta, Manuela & Geampana, Alina, 2020. "The trouble with IVF and randomised control trials: Professional legitimation narratives on time-lapse imaging and evidence-informed care," Social Science & Medicine, Elsevier, vol. 258(C).
    5. Timmermans, Stefan & Almeling, Rene, 2009. "Objectification, standardization, and commodification in health care: A conceptual readjustment," Social Science & Medicine, Elsevier, vol. 69(1), pages 21-27, July.
    6. Melander, Stina, 2023. "Different logics of pain: the gendered dimension of chronic pain in a relational setting," Social Science & Medicine, Elsevier, vol. 335(C).
    7. Pouliakas, Konstantinos & Theodossiou, Ioannis, 2010. "An Inquiry into the Theory, Causes and Consequences of Monitoring Indicators of Health and Safety at Work," IZA Discussion Papers 4734, Institute of Labor Economics (IZA).
    8. May, Carl & Rapley, Tim & Moreira, Tiago & Finch, Tracy & Heaven, Ben, 2006. "Technogovernance: Evidence, subjectivity, and the clinical encounter in primary care medicine," Social Science & Medicine, Elsevier, vol. 62(4), pages 1022-1030, February.
    9. Walshe, Catherine & Chew-Graham, Carolyn & Todd, Chris & Caress, Ann, 2008. "What influences referrals within community palliative care services? A qualitative case study," Social Science & Medicine, Elsevier, vol. 67(1), pages 137-146, July.
    10. Pilkington, Karen & Ridge, Damien T. & Igwesi-Chidobe, Chinonso N. & Chew-Graham, Carolyn A. & Little, Paul & Babatunde, Opeyemi & Corp, Nadia & McDermott, Clare & Cheshire, Anna, 2020. "A relational analysis of an invisible illness: A meta-ethnography of people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their support needs," Social Science & Medicine, Elsevier, vol. 265(C).
    11. Diane van den Broek, 2008. "`Doing things right', or `doing the right things'? Call centre migrations and dimensions of knowledge," Work, Employment & Society, British Sociological Association, vol. 22(4), pages 601-613, December.
    12. Micol Bronzini, 2016. "Il benessere organizzativo in sanit?. Riflessioni da una ricerca sui medici marchigiani," PRISMA Economia - Societ? - Lavoro, FrancoAngeli Editore, vol. 2016(1), pages 90-114.
    13. Phillips, Tarryn, 2012. "Repressive authenticity in the quest for legitimacy: Surveillance and the contested illness lawsuit," Social Science & Medicine, Elsevier, vol. 75(10), pages 1762-1768.
    14. Gemma Edwards, 2009. "Public sector trade unionism in the UK," Work, Employment & Society, British Sociological Association, vol. 23(3), pages 442-459, September.
    15. Daniel S. J. Lechmann & Claus Schnabel, 2014. "Absence from Work of the Self-Employed: A Comparison with Paid Employees," Kyklos, Wiley Blackwell, vol. 67(3), pages 368-390, August.
    16. Richardson, Jane C. & Ong, Bie Nio & Sim, Julius, 2006. "Is chronic widespread pain biographically disruptive?," Social Science & Medicine, Elsevier, vol. 63(6), pages 1573-1585, September.
    17. M. A. Ben Halima & V. Hyafil-Solelhac & M. Koubi & C. Regaert, 2015. "The Effects of the Complementary Sickness Benefits (CSB) on Sick Leave Duration: an Approach Based on Collective Bargaining Agreements," Documents de Travail de l'Insee - INSEE Working Papers g2015-05, Institut National de la Statistique et des Etudes Economiques.
    18. Svetlana Solovieva & Karina Undem & Daniel Falkstedt & Gun Johansson & Petter Kristensen & Jacob Pedersen & Eira Viikari-Juntura & Taina Leinonen & Ingrid Sivesind Mehlum, 2022. "Utilizing a Nordic Crosswalk for Occupational Coding in an Analysis on Occupation-Specific Prolonged Sickness Absence among 7 Million Employees in Denmark, Finland, Norway and Sweden," IJERPH, MDPI, vol. 19(23), pages 1-24, November.
    19. Nigam, Amit, 2012. "Changing health care quality paradigms: The rise of clinical guidelines and quality measures in American medicine," Social Science & Medicine, Elsevier, vol. 75(11), pages 1933-1937.
    20. Julie Rayner & Alan Lawton & Helen Williams, 2012. "Organizational Citizenship Behavior and the Public Service Ethos: Whither the Organization?," Journal of Business Ethics, Springer, vol. 106(2), pages 117-130, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:107:y:2014:i:c:p:52-60. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.