sh.sePublikationer
Driftstörningar
Det förekommer återkommande driftstörningar på några av sök-portalerna på grund av hög belastning. Vi arbetar på att lösa problemet, ni kan tillfälligt mötas av ett felmeddelande.
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • harvard-anglia-ruskin-university
  • apa-old-doi-prefix.csl
  • sodertorns-hogskola-harvard.csl
  • sodertorns-hogskola-oxford.csl
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Unsanctioned techniques for having sickness certificates accepted: a qualitative exploration and description of the strategies used by Swedish general practitioners
Södertörns högskola, Institutionen för kultur och lärande, Centrum för praktisk kunskap.
2019 (Engelska)Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, nr 1, s. 10-17Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVES: To explore informal and unsanctioned techniques general practitioners (GPs) employ as a means to increase the likelihood of sickness certificate approval, following the Swedish Social Insurance Agency's (SSIA's) consolidation of the gatekeeping role in sickness benefit evaluation.

DESIGN: Qualitative semi-structured interviews with 20 GPs working in Swedish primary care. A thematic analysis of the transcribed material was carried out to map different techniques employed by the practitioners.

RESULTS: Eight techniques were identified, particularly with respect to the way in which the sickness certificate is written to ensure approval by the SSIA. The identified techniques were most commonly adopted when the patient's case was perceived to be at high risk for rejection by the SSIA (such as psychiatric illnesses, chronic pain etc.).

CONCLUSIONS: The findings imply that the informal and unsanctioned techniques are complex and ambiguous. They are used intentionally and covertly. The study also suggests that, while the consolidation of SSIA's gatekeeping role may have resolved some sickness absence issues, a consequence may be that GPs develop unsanctioned techniques to ensure compliance.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2019. Vol. 37, nr 1, s. 10-17
Nyckelord [en]
Family practice, Sweden, non-compliance, praxis, qualitative research, sickness certification
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
URN: urn:nbn:se:sh:diva-37543DOI: 10.1080/02813432.2019.1569426ISI: 000462849900003PubMedID: 30689481Scopus ID: 2-s2.0-85060872064OAI: oai:DiVA.org:sh-37543DiVA, id: diva2:1285959
Forskningsfinansiär
ÖstersjöstiftelsenTillgänglig från: 2019-02-05 Skapad: 2019-02-05 Senast uppdaterad: 2025-10-07Bibliografiskt granskad
Ingår i avhandling
1. Tricks of the Medical Trade: Cunning in the Age of Bureaucratic Austerity
Öppna denna publikation i ny flik eller fönster >>Tricks of the Medical Trade: Cunning in the Age of Bureaucratic Austerity
2021 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Being a “good” doctor nowadays involves more than having virtues and capacities conducive to the content of encounters between physicians and patients. Physicians can and must be able to act on the surrounding conditions of the doctor-patient encounter, in order to keep external interests at bay. Hence, the patient-related virtues, such as compassion, prudence, temperance and the like might not constitute sufficient cause for “good” doctoring. Resistance against the invasion of external interests requires another set of capacities. In this compilation thesis, one such capacity is explored: cunning. While certainly not part of the repertoire of skills in relation to the patient, cunning intelligence is an indispensable “virtue” of good doctoring insofar as doctors must cleverly navigate institutions that block off paths toward the ultimate ends of healthcare. The role of cunning is examined through a particular case, namely, the struggle over social insurance, especially sickness benefits (“sjukpenning”), and the complex relationship between physician, patient and the Swedish Social Insurance Agency (“Försäkringskassan”). In these times of increased austerity, physicians have honed skills, retaining thereby good medical practice, and by extension also maintaining the integrity of the patient-related virtues of medicine. In the empirical material, techniques were identified, particularly with respect to the way in which the sickness certificate is written to ensure approval by the SSIA. Based on these findings, the ambiguities, contradictions and possibilities inherent in the cunning resistance of physicians are analyzed and problematized. Despite its many issues, what doctors do when issuing sickness certificates in this particular way, is certainly motivated and carried out by more than mere ignorance. Cunning intelligence is not merely a defective form of prudence (phronesis), nor is it simply an instance of instrumental reason (techne), but rather an ability that occupies a distinct place among the intellectual abilities generally ascribed to professionals. Finally, I explore if the use of these capacities indicates a change in the doctor-patient relationship. I argue that both doctor and patient are conditioned by an equality in powerlessness—the hallmark of “the age of bureaucratic parsimony”, which can be appropriately described in terms of solidarity between comrades.

Ort, förlag, år, upplaga, sidor
Huddinge: Södertörns högskola, 2021. s. 193
Serie
Södertörn Doctoral Dissertations, ISSN 1652-7399 ; 194
Nationell ämneskategori
Filosofi, etik och religion
Forskningsämne
Kritisk kulturteori; Östersjö- och Östeuropaforskning
Identifikatorer
urn:nbn:se:sh:diva-45429 (URN)978-91-89109-78-0 (ISBN)978-91-89109-79-7 (ISBN)
Disputation
2021-09-24, MA648, Alfred Nobels allé 7, Huddinge, 13:00 (Svenska)
Opponent
Handledare
Forskningsfinansiär
Östersjöstiftelsen
Tillgänglig från: 2021-09-01 Skapad: 2021-05-24 Senast uppdaterad: 2025-10-07Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

Övriga länkar

Förlagets fulltextPubMedScopusPMC Full text

Person

Shutzberg, Mani

Sök vidare i DiVA

Av författaren/redaktören
Shutzberg, Mani
Av organisationen
Centrum för praktisk kunskap
I samma tidskrift
Scandinavian Journal of Primary Health Care
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi

Sök vidare utanför DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 561 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • harvard-anglia-ruskin-university
  • apa-old-doi-prefix.csl
  • sodertorns-hogskola-harvard.csl
  • sodertorns-hogskola-oxford.csl
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf