Presentation M P5

M P5 (Poster Presentation):
Occupational Physicians’ Rationales for Early Return to Work and Work Modifications: a Qualitative Study

Presented by: Ritva Sinikka Horppu


Horppu R1, Martimo KP1, Viikari-Juntura E1, Lallukka T1, MacEachen E2

  1. Finnish Institute of Occupational Health, Helsinki, Finland
  2. Institute for Work & Health, Toronto, Canada



Early activity is recommended especially for musculoskeletal and often also for mental disorders. Temporary work modifications (TWMs) may be needed to enable early return to work (ERTW). Occupational physicians (OPs) play a crucial role in initiating TWMs. The aim of this study was to investigate OPs’ rationales for ERTW and TWMs.


Two individual interviews and one with two OPs were used for preliminary understanding of the practice context. Based on these, five topics for arguments were developed on the issues of ERTW and TWM. Eleven OPs discussed the topics in four focus groups. Interviews and discussions were recorded. Transcribed data were analyzed using qualitative content analysis.


Five different categories of rationales were identified for why OPs engage in RTW and TWM. 1) Medical rationales, e.g. enhancing recovery and avoiding prolonged sick leaves. 2) Prolonging work careers: e.g. securing employee’s job in times of lay-off; and using TWMs as a means to improve safety at work and prevent future work disability. 3) Improving the economy of companies and well-being of work communities: e.g. reducing companies’ expenses for sick leaves and disability pensions, and reducing supervisors’ and colleagues’ workload by keeping employees working at least part time. 4) Societal rationales: e.g. reducing social security costs related to sick leave and retirement, and disseminating the message of “work is good for your health”. 5) OP’s own well-being at work: e.g. meaningful work instead of prescribing sick notes, and negotiations and cooperation seen as pleasurable tasks. Participants differed in their views of the importance and priority of the different rationales. Categories 1 and 2 were expressed in all discussions, whereas category 5 was used most seldom. ERTW and TWM were often described as demanding for OPs.


OPs have a specific role in ERTW as mediators between the employee and the workplace. In this role they use a variety of rationales, most commonly on recovery and individuals’ work careers. Future studies will focus on OPs’ perceptions on the interaction between these rationales and attempts to solve potential tensions.

Schedule Details

Monday September 29
12:45 - 13:45 Poster Viewing
Session: RTW interventions